New research highlights a significant link between armed conflict and increased measles incidence. A study by academics at King’s College London and New York University, published in PLOS Medicine, found that conflict contributes to a greater measles burden through various mechanisms.
As global hostilities and forced displacement rise, the study aimed to clarify the relationship between war and vaccine-preventable diseases like measles. Researchers examined data from 193 countries between 2000 and 2023, considering factors such as battle-related deaths, displacement, economic indicators, life expectancy, and education. Their analysis revealed both direct and indirect associations between armed conflict and a heightened measles burden.
"We often hear reports from areas affected by conflict about polio outbreaks or the resurgence of measles. However, it’s challenging to connect conflict data with public health data to truly understand the impact of conflict on health," stated Yesim Tozan, PhD, associate professor of global health at NYU’s School of Global Public Health and the study’s senior author. "Whenever an external shock occurs – whether a natural disaster, a pandemic, or armed conflict – it tests the resilience of the health system. During these crises, policymakers need to understand how these external shocks can lead to an increased burden of infectious diseases."
Sustained Rise in Cases Post-Conflict
The study estimated that for approximately every 3,700 battle-related deaths, there were around 2,500 additional reported measles cases annually. This is a substantial increase when compared to the global average of approximately 2,250 reported measles cases per country-year between 2000 and 2023.
The impact of conflict, the findings suggest, often lingers beyond active fighting. Measles cases remained elevated for up to a year after hostilities ceased. This delayed effect emphasizes the need for ongoing surveillance, investment in early recovery efforts, and the integration of displaced individuals into routine immunization programs.
Furthermore, armed conflict and displacement were linked to lower levels of socioeconomic development, which in turn was strongly associated with increased measles cases. For every standard deviation increase in development, there was a corresponding reduction of 0.32 to 0.34 standard deviations in measles cases. This indicates that robust health, education, and economic systems play a crucial role in lessening a population’s vulnerability to infectious disease risks.
Beyond Emergency Vaccinations
The research suggests that addressing measles outbreaks and reducing infectious disease risks in conflict zones requires a strategy that goes beyond emergency vaccination campaigns alone.
The authors propose a more comprehensive approach that includes maintaining vaccination programs in unstable environments, conducting emergency vaccination drives, safeguarding healthcare systems, preserving socioeconomic infrastructure, and ensuring that displaced populations have access to vaccines.