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Armed conflict tied to higher measles burden worldwide
Laine Bergeson
Today at 12:57 p.m.
Measles Armed conflict is associated with higher measles burden through missed vaccinations, weakened healthcare systems, population displacement, and socioeconomic decline, researchers at King's College London and New York University (NYU) write in PLOS Medicine.
Amid rising military hostilities and forced displacement around the world, the team sought a better understanding of the connection between war and preventable infectious diseases like measles.
The researchers analyzed and modeled data on battle-related deaths, displacement, economic factors, life expectancy, and education from 193 countries from 2000 to 2023. They found that armed conflict is associated with an increased measles burden both directly and indirectly.
“We get reports from conflict-affected settings of polio outbreaks or measles making a comeback. But it’s very hard to marry conflict data and public health data to understand the impact of conflict on health,” Yesim Tozan, PhD, associate professor of global health at NYU’s School of Global Public Health and the study’s senior author, says in a university news release.
“Whenever an external shock strikes—a natural disaster, a pandemic, or armed conflict—it tests the health system's resilience,” she adds. “During these crises, policymakers need an understanding of how the external shocks may lead to increased infectious disease burden.”
Higher case counts even after hostilities end
The researchers estimated about 2,500 additional reported measles cases per year for roughly every 3,700 battle-related deaths.
“For context, the mean number of reported measles cases globally from 2000 to 2023 was ~2,250 per country-year, indicating that the estimated conflict-associated increase is substantial relative to the baseline annual burden,” write the researchers.
Stronger health, education, and economic systems collectively reduce population vulnerability to infectious disease risks.
The effects of conflict often extended beyond periods of active fighting, according to the findings, with higher measles case counts persisting up to a year after hostilities ended. “Such delayed associations underscore the need for sustained surveillance, early recovery investments, and the integration of displaced populations into routine immunization systems,” the researchers note.
Armed conflict and displacement were also associated with lower levels of socioeconomic development, which, in turn, was strongly associated with increased measles burden. Each standard-deviation increase in development was tied to a 0.32 to 0.34 standard-deviation reduction in measles cases, “suggesting that stronger health, education, and economic systems collectively reduce population vulnerability to infectious disease risks,” the researchers write.
Emergency vaccination campaigns not enough
The findings suggest that reducing measles outbreaks and mitigating infectious disease risks in conflict-affected regions will require more than emergency vaccination campaigns.
A more effective approach, according to the researchers, would be a multifaceted strategy that includes sustaining vaccination programs in volatile settings, implementing emergency vaccination campaigns, protecting healthcare systems, maintaining socioeconomic infrastructure, and ensuring that displaced populations have access to vaccines.
Armed conflict tied to higher measles burden worldwide
Laine Bergeson
Today at 12:57 p.m.
Measles Armed conflict is associated with higher measles burden through missed vaccinations, weakened healthcare systems, population displacement, and socioeconomic decline, researchers at King's College London and New York University (NYU) write in PLOS Medicine.
Amid rising military hostilities and forced displacement around the world, the team sought a better understanding of the connection between war and preventable infectious diseases like measles.
The researchers analyzed and modeled data on battle-related deaths, displacement, economic factors, life expectancy, and education from 193 countries from 2000 to 2023. They found that armed conflict is associated with an increased measles burden both directly and indirectly.
“We get reports from conflict-affected settings of polio outbreaks or measles making a comeback. But it’s very hard to marry conflict data and public health data to understand the impact of conflict on health,” Yesim Tozan, PhD, associate professor of global health at NYU’s School of Global Public Health and the study’s senior author, says in a university news release.
“Whenever an external shock strikes—a natural disaster, a pandemic, or armed conflict—it tests the health system's resilience,” she adds. “During these crises, policymakers need an understanding of how the external shocks may lead to increased infectious disease burden.”
Higher case counts even after hostilities end
The researchers estimated about 2,500 additional reported measles cases per year for roughly every 3,700 battle-related deaths.
“For context, the mean number of reported measles cases globally from 2000 to 2023 was ~2,250 per country-year, indicating that the estimated conflict-associated increase is substantial relative to the baseline annual burden,” write the researchers.
Stronger health, education, and economic systems collectively reduce population vulnerability to infectious disease risks.
The effects of conflict often extended beyond periods of active fighting, according to the findings, with higher measles case counts persisting up to a year after hostilities ended. “Such delayed associations underscore the need for sustained surveillance, early recovery investments, and the integration of displaced populations into routine immunization systems,” the researchers note.
Armed conflict and displacement were also associated with lower levels of socioeconomic development, which, in turn, was strongly associated with increased measles burden. Each standard-deviation increase in development was tied to a 0.32 to 0.34 standard-deviation reduction in measles cases, “suggesting that stronger health, education, and economic systems collectively reduce population vulnerability to infectious disease risks,” the researchers write.
Emergency vaccination campaigns not enough
The findings suggest that reducing measles outbreaks and mitigating infectious disease risks in conflict-affected regions will require more than emergency vaccination campaigns.
A more effective approach, according to the researchers, would be a multifaceted strategy that includes sustaining vaccination programs in volatile settings, implementing emergency vaccination campaigns, protecting healthcare systems, maintaining socioeconomic infrastructure, and ensuring that displaced populations have access to vaccines.