Conflict Zones Face Rising Infectious Disease Risks

Key Developments:

• Conflict damage to water systems and clinics raises outbreak risks
• Environmental monitoring can detect threats missed by clinics
• Recovery plans should link disease surveillance with infrastructure repair

(Think Global Health) — October 10, 2026: The consequences of armed conflict extend beyond immediate casualties and physical destruction. When healthcare services collapse, water supplies become unsafe and communities are displaced, infectious diseases can spread more easily. Public-health preparedness must therefore be treated as a core component of reconstruction, rather than a responsibility limited to hospitals and medical facilities.

Gaza provides a clear example of why conventional disease monitoring may be insufficient during a humanitarian emergency. Authorities detected poliovirus in wastewater before identifying a paralytic case, showing that environmental testing can provide an early indication of transmission. Such monitoring is particularly valuable when damaged clinics, interrupted reporting and restricted access prevent health workers from obtaining a complete picture of conditions on the ground.

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Vaccination campaigns and continued monitoring can help limit transmission, but their effectiveness depends on reliable access to communities and functioning public-health services. Damage to sewage networks, shortages of clean water and disruptions to routine medical care can undermine these efforts long after the immediate fighting has subsided.

The wider problem is not limited to one disease or territory. Conflict creates circumstances in which existing pathogens can spread more readily: immunisation programmes are interrupted, diagnostic services become fragmented, patients struggle to obtain treatment and displaced families may have to live in overcrowded shelters. Weak infection-control procedures can also increase the danger of antimicrobial resistance.

A displaced Palestinian mother, Wafaa Abdelhadi, walks past the rubble of a house destroyed in an Israeli strike as she returns to her shelter with her daughters Lynn and Roueida, after they got vaccinated against polio, in Deir Al-Balah, in the Gaza Strip, on September 1, 2024. CREDIT: REUTERS/Ramadan Abed.

Recent conflict research points to a growing global challenge. The number of state-based conflicts recorded in 2025 reached its highest level in the historical dataset examined by researchers. In the Eastern Mediterranean, overlapping humanitarian emergencies have placed additional pressure on public-health systems, while outbreaks of polio and cholera have highlighted the consequences of inadequate prevention and response capacity.

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Sudan shows how failures in essential services can turn a disease outbreak into a nationwide emergency. Cholera spread throughout the country’s 18 states, with reported cases exceeding 124,000 and deaths reaching more than 3,500 during the major outbreak. Although that outbreak was declared over, subsequent cholera activity has underlined the continuing vulnerability of communities where safe water, sanitation and healthcare remain difficult to access.

Ukraine presents a related but distinct concern. Hospitals treating people injured during the war must manage complex wounds, frequent patient transfers and demanding treatment requirements. These conditions can make it harder to prevent healthcare-associated infections and control drug-resistant organisms. A multicentre investigation in five Ukrainian hospitals found infections among patients treated for war-related injuries, with particularly concerning findings in intensive-care units. The researchers noted that available hospital data do not establish the full national scale of the problem.

CaptDamage in Gaza CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0/deed.en Palestinian News &Information Agency (Wafa) in contract with APAimages via the Wikimedia Commons. No changes made.ion. CREDIT: Springer Nature.

The effects on health can persist even when patients are not receiving emergency treatment for injuries. Displacement, damaged facilities and interruptions to medical services can disrupt care for tuberculosis, HIV and other illnesses. Delayed diagnosis and gaps in treatment can worsen outcomes and may contribute to drug resistance, making continuity of care an important part of long-term recovery.

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Reconstruction programmes commonly assess damage to housing, transport, energy, agriculture, healthcare and water infrastructure. However, these sectors are closely connected to infectious-disease prevention. Restoring a water network, reopening a clinic or repairing a road can influence how quickly a community detects an outbreak and how effectively health workers respond.

Existing monitoring systems provide a foundation for stronger coordination. The World Health Organization’s Early Warning, Alert and Response System supports the detection of potential outbreaks in emergency settings. Its Health Resources and Services Availability Monitoring System provides information about the status of health facilities and essential services. Combining these health indicators with infrastructure assessments, environmental samples, weather information and transport access could help authorities identify emerging risks earlier.

A nurse at the Mechnykov Hospital treats patients in an intensive care unit, amid Russia's attack on Ukraine, in Dnipro, Ukraine, on May 14, 2025. CREDIT: REUTERS/Alina Smutko.

For example, a damaged sanitation network does not automatically mean an outbreak will occur. But when infrastructure assessments are combined with wastewater findings and local disease reports, officials may be better placed to identify where the danger is increasing. This information could guide decisions about restoring water services, directing vaccination teams, expanding laboratory capacity and improving infection prevention.

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Satellite imagery and other earth-observation techniques can support this process by revealing damage across large areas. A peer-reviewed assessment of water, sanitation and hygiene facilities in Gaza used open-source observation methods to document substantial infrastructure damage. Integrating these findings with environmental and clinical surveillance could help planners determine which communities need urgent intervention, rather than relying on infrastructure damage alone as a measure of disease risk.

Local leadership is essential to making such systems effective. Public-health authorities, municipalities, researchers and affected communities should determine what information is collected and how it is used. International agencies can contribute technical expertise and resources, but monitoring arrangements should respond to local priorities and avoid becoming externally imposed systems.

Protecting personal information is equally important. Data collection should be limited to what is necessary for clearly defined public-health decisions. Aggregated information should be preferred wherever possible, access should be controlled, and safeguards should prevent health data from being used for unrelated security or population-control purposes.

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Financing could determine whether these proposals move beyond planning. Humanitarian health services face funding shortages at a time when damaged infrastructure and disrupted supply chains make disease control more difficult. Investment in laboratory networks, trained personnel, environmental testing and coordinated information systems could help direct limited resources towards the communities facing the greatest risks. International health funds, development institutions and philanthropic organisations could support these efforts alongside wider reconstruction programmes.

Halima Mohammed Adam, a Sudanese cholera patient, looks on as she sits on a bed at a United Nations-Run makeshift clinic, in Tawila, north Darfur, Sudan, on August 5, 2025. CREDIT: REUTERS/Mohammed Jamal.

Post-conflict recovery should ultimately be measured not only by the buildings and services restored, but also by whether communities are better protected against preventable disease. Re-establishing reliable surveillance, safe water, accessible healthcare and rapid-response capacity can help reduce the likelihood that the damage caused by war develops into another public-health emergency.

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