WARS often create conditions ripe for the spread of epidemics and pandemics. These conflicts benefit the arms industry and uphold power structures in capitalist economies. But they also cause immense collateral damage to civilian populations, extending suffering beyond the battlefield. The relationship between warfare and the spread of infectious diseases is complex and historically significant, with many conflicts facilitating disease transmission and leading to widespread health crises. Recent conflicts have significantly contributed to the spread of infectious diseases.

SPREAD OF POLIOVIRUS

The ongoing genocidal war by Israel in Gaza has led to a resurgence of polio, raising alarms about a potential health crisis in an already beleaguered region. The World Health Organisation has reported instances of vaccine-derived poliovirus in the region, highlighting how conflict disrupts immunisation programmes and leads to outbreaks of diseases previously under control.

The Gaza ministry of health recently declared a polio epidemic, attributing the outbreak to dire humanitarian conditions exacerbated by military actions and a longstanding blockade that severely limits access to healthcare and sanitation. The detection of poliovirus in sewage samples underscores the precarious health situation in Gaza, particularly among displaced populations living in overcrowded tent camps. The collapse of sewage systems has led to widespread contamination of water sources, posing a significant risk of polio transmission.

The indiscriminate bombings by Israel have restricted the movement of people and impeded the delivery of essential medical supplies, including vaccines. Many children in Gaza have gone without polio vaccinations for over nine months, leaving them vulnerable to the disease. Urgent international intervention is needed to address the humanitarian crisis and facilitate vaccination efforts. The lack of access to clean water and proper sanitation has further compounded health risks, with rising cases of other diseases reported alongside polio. The UN recently reported a dramatic rise in cases of Hepatitis A, a viral liver infection spread through contaminated food and water. Since October, there have been 40,000 cases due to a waste management collapse causing unsanitary conditions and disease spread.

In response to the outbreak, the World Health Organisation (WHO) has pledged to send over one million polio vaccines to Gaza. This initiative aims to protect children from the virus and curb the outbreak's spread. However, the success of these efforts relies on ensuring the safe delivery and administration of the vaccines amidst ongoing war and instability. Israeli health authorities have selfishly begun vaccinating only their troops in response to the detected poliovirus, ignoring the broader implications of the outbreak for both Gaza and neighbouring regions. They fail to recognise that viruses do not respect human-made borders.

Without immediate action to restore healthcare access and vaccination programmes, the situation could worsen, posing grave risks not only to Gaza's residents but also to public health in the region. The international community must prioritise humanitarian assistance to ensure the safety and health of vulnerable populations in Gaza. There have been 1.8 million reported cases of infectious diseases in Gaza since Israel started the war and genocide on the Palestinian people in Gaza.

RISE OF ANTIBIOTIC RESISTANCE

Ongoing wars also heighten the spread of antibiotic-resistant bacteria, known as superbugs. During the US invasion of Iraq in 2003, soldiers returned home with drug-resistant infections. This issue extends beyond military personnel to civilians in conflict zones like Ukraine and Gaza, where superbugs thrive in chaotic environments. These pathogens transfer easily from soldiers to civilians in ill-equipped hospitals. Mines and missile fragments contaminated with bacteria worsen the situation.

The conflicts in Ukraine, sustained by the US and NATO, have raised significant public health concerns, particularly regarding antibiotic-resistant bacterial infections. The war has disrupted healthcare services, increasing untreated infections and spreading resistant bacterial strains.

Heavy-metal contamination from war remnants creates environments that favour bacterial growth. Despite the severity of AMR, global initiatives to combat superbugs have largely faltered over the past two decades. Experts liken AMR to climate change, viewing it as a slow-moving catastrophe that has received minimal political attention or funding.

Addressing AMR requires urgent international cooperation and the development of new antibiotics or alternative treatments. Researchers at Harvard Medical School and elsewhere are working to create new classes of antibiotics to combat superbugs. One promising compound, zosurabalpin, uses a different mode of action from currently available ones and is undergoing phase 1 clinical trials. However, human ingenuity and technology cannot provide a long-term solution for what essentially needs a humanitarian and political solution.

PREVIOUS INSTANCES

Conflicts can worsen the spread of the virus by displacing populations and disrupting healthcare systems, while the pandemic can increase conflicts through heightened nationalism and xenophobia. For example, the Covid19 pandemic intensified the Nagorno-Karabakh conflict in the South Caucasus, resulting in the highest human toll for that region in thirty years.

During World War II, troop movements and military camps again created environments conducive to spreading infectious diseases. Measles and tuberculosis outbreaks were common among soldiers, and the war severely disrupted public health systems, complicating efforts to control diseases. The Vietnam War (1955-1975) similarly witnessed outbreaks of malaria and other tropical diseases, exacerbated by troop movements and population displacements.

The 1918-1919 Influenza pandemic, emerging during the final stages of World War I, exemplifies how war fuels pandemics. Initial cases were reported in US military camps, and soldiers transported in crowded conditions facilitated the virus's spread. The dire living conditions in the trenches characterised by close quarters, malnutrition, and poor hygiene, increased susceptibility and led to spread of influenza. It also resulted in secondary bacterial infections. Overall there were estimated 50 million deaths globally.

Throughout history, armies have often been accompanied by diseases, which frequently claim more lives than combat. The connection between warfare and epidemics is well-documented. Mass movements of military and civilian populations have frequently contributed to the spread of diseases. For instance, during the US Civil War (1861-1865), diseases like measles, dysentery, and smallpox claimed more lives than combat due to unsanitary conditions. Similarly, the Crimean War (1853-1856) saw more soldiers dying of cholera and typhus than from battle injuries. Interestingly, when Florence Nightingale returned after the Crimean War,  she was affected by the poor conditions she had witnessed. She had seen numerous soldiers die from preventable diseases because of poor sanitation, crowding in hospitals, and bad medical practices.  Nightingale collaborated with her team to create innovative data visualisations that illustrated the impact of poor sanitation on soldier mortality. Her compelling graphics, which compared army and civilian mortality rates, made the data clear and persuasive. Nightingale's efforts saved lives and pioneered the use of graphical storytelling in public health advocacy.

 RISK TO GLOBAL HEALTH

There is a pressing need to integrate traditional public health measures with actions aimed at promoting peaceful conflict resolution. Addressing both pandemics and ongoing conflicts is essential for improving global health and social equity. It is crucial to emphasize the importance of incorporating a peace-building component into global vaccination efforts, especially in conflict-affected areas where the risk of virus transmission is heightened.

Historical and contemporary evidence clearly demonstrates that wars create conditions conducive to the spread of infectious diseases. From the Spanish Flu during World War I to the resurgence of polio in Gaza and the threat of antibiotic resistance in Ukraine, the impact of conflict on public health is profound. The international community must prioritise humanitarian assistance to ensure the safety and health of vulnerable populations in conflict-affected areas.

 Wars, especially the ongoing genocide in Palestine, need to be stopped. Without immediate action, the proliferation of superbugs and pathogenic viruses fuelled by wars may trigger a global health crisis of infectious diseases and potentially a pandemic.