Peace is a Public Health Imperative
In 2024, there were 123.2 million people forcibly displaced globally, the highest number ever recorded. These are not just humanitarian statistics, they reflect accelerating political, social, and moral failure with profound consequences for health.
Armed violence, political repression, inequity, and mass displacement now rank among the most powerful determinants of health in the 21st century, shaping who lives, who dies, and who has a future. If public health is truly committed to prevention, equity, and human security, then conflict prevention and peacebuilding must be core public health work, not peripheral crises to be managed after the damage is done.
Conflict as a Determinant of Our Collective Future
The World Health Organization estimates that 60% of conflict-related deaths are civilians, driven not by weapons alone but by the collapse of health, food, and social systems. This pattern is starkly illustrated in the Democratic Republic of Congo (DRC), where during the early 2000 conflicts, fewer than 10% of deaths were due to violence, with most caused by preventable conditions such as malaria, diarrhoea, pneumonia, and malnutrition following systemic collapse from a public health perspective, conflict becomes a population-level health determinant, reshaping health trajectories more profoundly than many traditional risk factors combined.
Today, nearly half a billion children are growing up in conflict-affected settings, a reality UNICEF has described as making 2024 one of the worst years on record for children in conflict. Children exposed to war face disrupted immunisation, chronic undernutrition, interrupted education, untreated trauma, and prolonged toxic stress during critical periods of development. These harms do not end when fighting stops. Early exposure to violence is associated with persistently poorer physical and mental health across the life
course.
From a health equity perspective, this is profoundly unjust. Children born into war and women subjected to gender-based violence are denied the right to health that others rightly take for granted. In crisis settings, 70% of women experience gender-based violence compared with about 35% in non-crisis settings, and women and girls account for over 95% of verified cases of conflict-related sexual. In Sudan, UNICEF has reported conflict-related rape of children, including infants as young as one year old.
Conflict punishes the innocent by concentrating violence and deprivation on those with the least power, entrenching inequality and destroying the health potential of entire generations.
When the Bridge to Survival Is Destroyed
Health systems are among the last bridges in divided societies, protected not by neutrality, but by necessity where human need can momentarily transcend political identity. In 2016, UN Security Council Resolution 2286 condemned attacks on health facilities and personnel and demanded accountability. Yet by 2025, attacks on medical care had reached record levels. The WHO Surveillance System documented over 1,300 attacks and nearly 2,000 deaths of patients and health workers, more than double the fatality count from 2024. The highest numbers occurred in Sudan, Myanmar, the occupied Palestinian territory, and Ukraine.
Scarce resources are diverted to the military and fighting wars. When health systems collapse, people delay or forgo care, women give birth without skilled attendance, children miss immunisations, trauma and chronic disease go untreated, and disease surveillance collapses. Public trust erodes, recovery becomes harder, and reconciliation more distant. Health, once a bridge, becomes a battlefield.
This moment should alarm the global public health community because of the precedent it sets. When attacks on health systems are normalised, labelled as “collateral damage,” or met with silence, the protective architecture that underpins humanitarian response everywhere begins to collapse. What is really frighting is that what becomes permissible in one conflict becomes replicable in others.
Women Leading the Work of Peace
Across Gaza, Sudan, the DRC, Myanmar, and Ukraine, women and children bear the greatest burden of health system collapse. Yet women also sustain societies when formal systems fail. They comprise most frontline health workers globally and serve as caregivers, organisers, and informal negotiators.
Despite this, women remain excluded from peace processes, even though peace agreements are more durable when women are involved. From a public health perspective, this exclusion is not only unjust; it is irrational. Women hold critical knowledge about community dynamics and pathways to resilience. Investing in women’s leadership in health is therefore not symbolic. It can be an important strategic conflict prevention intervention when women are not only seen as beneficiaries of protection, but architects of peace, recovery, and human security.