War is a global threat to public healthBMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4031 (Published 06 June 2019) Cite this as: BMJ 2019;365:l4031
- Michele Heisler, board member,
- Vincent Iacopino, senior medical adviser
- Physicians for Human Rights, New York, USA
A 2000 World Health Organization working paper begins with two simple declarations: “The first principle of health is life. War is a direct threat to life.”1 These assertions may seem statements of the obvious but for millions of people worldwide, surviving war is the main health challenge they face.
More people die and are disabled by war than by diabetes or heart disease. An estimated 191 million people died as a result of conflict during the 20th century, more than half of whom were civilians.2 Public health challenges faced in war extend beyond efforts to protect civilians’ security. They include preventing illness and death from inadequate or contaminated food or water, poor sanitation, lack of shelter, and disrupted or destroyed healthcare systems and other infrastructure necessary to sustain health.
An equally uncontroversial statement is that the most fundamental duty of doctors and other health professionals is to protect life. As WHO resolution 34.38 proclaims: “The role of physicians and other health workers in the preservation and promotion of peace is the most significant factor for the attainment of health for all.” …