War Sucks. So What?

By Joy Portella, President, Minerva Strategies —

Everyone knows that war hurts people. Media provide almost daily examples of this. Look at what we’ve heard and seen from Syria in just the past month: The tragic plight of conjoined twins in Eastern Ghouta, the despair of doctors in Aleppo, and most famously, the battered and bloodied body of five-year old Omran Daqneesh.

But on a macro-level, what does this suffering look like? Beyond the obvious casualties of military battles and civilian attacks, how does war really impact health? Are there data that string together the numerous anecdotes of war’s tremendous human toll?

This week, a study in The Lancet Global Health tried to answer these questions. The study was officially an analysis of health challenges of 22 countries that comprises something called the Eastern Mediterranean Region (EMR), a swath of the globe encompassing the Middle East, North Africa, but also places like Somalia and Afghanistan. The study examines how a range of diseases, injuries, and risk factors impacted health in the region between 1990 and 2013.

But against this comprehensive backdrop, the study focuses on the region’s greatest threat to health: conflicts and instability that have recently raged through several countries in the region. Civilians have been killed with bombs and bullets. Vital infrastructure – including critical water and sanitation systems – has been destroyed. Health workers have fled, leaving people unable to get medical care for everything from shrapnel to diabetes. Refugees have poured into neighboring countries, straining their often meager health resource and increasing the threat of disease outbreaks. As a result, health progress has been stunted and even rolled back.

Syria is the most dramatic case. This week’s study found that projected life expectancy has declined in several Middle East countries since 2010. For example, if the 1990-2008 rate of increase for life expectancy in Syria had continued, women would be living five years longer than they are now, and men would have added six years to their lives. In addition, infant mortality in Syria had been declining at an average annual rate of 5.6% between 1990 and 2010. In a stunning development, that rate has been rising by 9.3% in recent years.

The study finds less marked but similar trends in other countries. Libyans experienced a significant decrease in life expectancy in 2011, which has since leveled out. In Egypt, Tunisia, and Yemen, people lost about .25 years of life expectancy due to the uprising that began in 2011. That may sound minor compared to the situation in Syria, but these are countries where, between 1990 and 2010, people were gaining life expectancy at a pace of .25 years annually. This trend has now been dramatically reversed.

This week’s study was conducted by a global collaborative of researchers led by the Seattle-based Institute for Health Metrics and Evaluation (IHME), a long-time partner of Minerva Strategies. IHME traditionally avoids policy recommendations. They stick to collecting the best, most up-to-date data available, and explaining what those data tell us about health. They usually keep their studies to “just the facts ma’am.”

This paper is different. The overwhelming negative impact of war on health leads the researchers to make a collective call to action: To end conflicts and stabilize the region. This isn’t inspired by a political agenda. The evidence is clear that war is so devastatingly bad for people that it constitutes a public health emergency, and progress cannot resume until peace makes it possible.

Researchers aren’t normally overt peaceniks, except when the data dictate they need to be.