Gaza, Sudan, Ukraine: Tracking Outbreaks Amid Conflict
The article examines how ongoing conflicts in Gaza, Sudan, and Ukraine exacerbate infectious disease risks by damaging sanitation infrastructure and disrupting vaccination efforts. It highlights the importance of environmental surveillance, such as wastewater testing, in tracking outbreaks during wartime.
Why it matters
It underscores the long-term public health consequences of war beyond immediate casualties, emphasizing the need for resilient health monitoring systems.
Three years after the October 7, 2023, attacks on Israel and the war in Gaza that followed, infectious-disease risk has become one of the conflict's enduring health consequences.
In 2024, poliovirus was detected in Gaza's wastewater before a paralytic case was confirmed, and the World Health Organization (WHO) found continued environmental circulation into the following year. By the end of 2025, however, no further detections had been reported, suggesting that a targeted vaccination campaign during a brief ceasefire may have interrupted transmission. The episode shows why epidemic intelligence in damaged urban environments cannot depend on clinics alone: wastewater and other environmental signals can reveal transmission when routine care and reporting have been disrupted. Damage to health facilities and water and sanitation systems further weakens the capacity to prevent, detect, and contain outbreaks.
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