KARACHI: Armed conflicts are becoming increasingly complex and protracted and are threatening to block access to essential health services, affecting at least 630 million women and children, or about eight per cent of the world’s population, according to a new four-paper series published by The Lancet on Sunday.

The series, led by academic investigators and partners affiliated with BRANCH (Bridging Research & Action in Conflict Settings for the Health of Women & Children) Consortium, analyses existing evidence with new modelling and insights from a range of local research partners, humanitarian agencies and civil society organisations.

The authors of the series have highlighted the failure of the global community to prioritise women’s and children’s health in areas of conflict, and called for an international commitment from humanitarian actors and donors to confront political and security challenges, together with consensus on a framework for identifying high-priority interventions to reach the most vulnerable women and children with the best care possible.

“The new estimates provide compelling evidence of the enormous indirect toll of modern warfare caused by easily preventable infectious diseases, malnutrition, sexual violence, and poor mental health, as well as the destruction of basic services such as water and medical facilities,” said Prof Zulfiqar Bhutta from the Centre for Global Child Health, The Hospital for Sick Children in Toronto in Canada and the Institute for Global Health & Development, The Aga Khan University, who led the series.

According to a series of papers published by The Lancet, about a third of those affected live in Pakistan, Nigeria and India

“Today, more than half of the world’s women and children are living in countries experiencing active conflict. The international community cannot continue to ignore their plight. It’s time for a radical rethink of the global response that confronts challenges to insecurity, access, politics, coordination, and the logistics of delivering high-priority interventions to women and children in politically unstable and insecure settings,” he added.

The papers in the series explore the changing nature of war and conflict, its short- and long-term health effects on women and children, strategies for identifying best responses, and interventions supported by in-country assessments and studies.

Indirect effects of war

New estimates suggest that the number of women and children affected by armed conflict around the world has risen steadily since 2000, as a result of population growth, more conflicts, increasing use of conventional and chemical weapons in urban areas, and growing numbers of refugees and internally displaced people.

In 2017, one in 10 (10 per cent) women and almost one in six (16pc) children worldwide were either forcibly displaced by conflict or living dangerously close (within 50km) to conflict zones. Around a third of those affected lived in Pakistan, Nigeria and India.

Evidence suggests that the risk of dying from non-violent causes increases substantially with proximity to more intense and chronic conflicts, with women of childbearing age in Africa living near the high-intensity fighting three times more likely to die than women in peaceful areas, and the risk of death among infants higher by more than 25pc.

Between 6.7m and 7.5m infants and more than 10m children under five years of age, born within 50km of armed conflicts, are estimated to have died from the indirect consequences of fighting across Africa, Asia and the Americas between 1995 and 2015.

“It is clear that the indirect effects of armed conflict on women and children are far greater than the effects of actual fighting,” said co-author Dr Halla Gattas from the American University of Beirut, Lebanon.

Published in Dawn, January 25th, 2021