Ongoing conflicts in the Eastern Mediterranean Region (EMR): health burden and attributable economic damage estimate

Background: Due to the ongoing conflicts in the Eastern Mediterranean Region (EMR), countries in the region have confronted a severe health crisis in recent years. This study was conducted to describe the direct health burden of conflicts in the region and quantify the fraction of economic damage attributed to the health impact of conflict. Methods: We used Disability Adjusted Life Years (DALYs) from the Global Burden of Disease attributed to conflict and considered the value of a life-year as at least one Gross Domestic Product (GDP) per capita purchasing power parity (PPP) to indirectly estimate the economic burden. Results: From 1990 to 2017, out of the 22 countries in the EMR, Afghanistan, Iraq, Kuwait, Lebanon, Palestine, Libya, Somalia, Sudan, Syria, and Yemen suffered the most from conflict and terrorism. Conflict accounted for 64%, 50%, and 35% of all causes of DALYs in Libya and Syria, and Palestine, in 2011, 2016, and 2008, respectively. In 2017, Iraq, Libya, and Afghanistan had the most significant health-related economic burden of conflict per capita, more than 100 current international dollars. Iraq was affected by a loss of about 80% of its health expenditure due to conflict and terrorism, an estimated total of 23 billion current international dollars. Conclusions: Our study reflects the significance of the health burden due to conflict in the EMR and its subsequent economic consequences. Stability and peace is among the most influential determinants of health and economic development in the region.