| Issue/Objective |
Health inequities in fragile and conflict-affected settings are often framed in terms of limited access to care and weakened health systems. However, upstream structural force, particularly armed conflict, play a central role in shaping health outcomes. Armed conflict can be understood as an upstream determinant of health equity, influencing governance, access to services, and exposure to risk in complex and interconnected ways.
This study aims to analyze how armed conflict shapes health inequities in eastern Democratic Republic of the Congo (DRC) through a One Health perspective. By examining the interconnections between human, animal, and environmental systems, it seeks to contribute to a better understanding of systemic barriers to health equity and to inform more integrated global health approaches. This work directly aligns with the conference theme by addressing upstream determinants of health equity in fragile and uncertain contexts. |
| Methodology/Approach |
This research (doi: 10.1016/j.onehlt.2024.100849) is based on a systems thinking and conceptual analysis of the nexus between armed conflict and global health in eastern DRC, a region characterized by protracted insecurity and recurrent disease outbreaks. The study adopts a One Health framework to explore how conflict-related processes disrupt interconnected socio-ecological systems.
Drawing on existing literature and personal experience from the region, the analysis examines key pathways through which conflict affects health systems, population dynamics, and environmental conditions. The approach integrates perspectives from global health, veterinary public health, and environmental sciences to provide a systemic understanding of health risks in conflict-affected settings. |
| Results |
Findings show that armed conflict acts as a systemic driver of health inequities through multiple interconnected pathways. First, it weakens healthcare infrastructure and disease surveillance systems, limiting outbreak detection and response capacity. Second, forced displacement and precarious living conditions increase human-animal-environment interactions, facilitating zoonotic disease emergence. Third, environmental degradation and biodiversity loss, driven by insecurity and resource exploitation, further amplify health risks.
These interacting dynamics create conditions that disproportionately affect marginalized populations, reinforcing systemic barriers to health equity and increasing vulnerability to infectious diseases in both local and global contexts.
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| Discussion/Conclusion |
This analysis challenges conventional global health approaches that prioritize technical interventions without adequately addressing underlying socio-political and ecological determinants. By framing armed conflict as an upstream determinant of health equity, it highlights the need for integrated strategies that combine health system strengthening, environmental stewardship, and peacebuilding efforts.
These findings underscore the importance of adopting One Health approaches to address complex health challenges in fragile settings. Addressing these systemic dynamics is essential to restoring equity-oriented global health action and developing more resilient and inclusive health systems. This contribution aligns with Sub-theme 1 by emphasizing the role of structural and governance-related factors in shaping health inequities and calls for action that moves beyond fragmented responses toward systemic change. |
| Presenters and Affiliations |
Olivier Kambere Kavulikirwa 1Department of Social and Preventive Medicine, University of Montral School of Public Health, Canada 2Faculty of Veterinary Medicine, Catholic University of Graben (UCG), Democratic Republic of the Congo 3Groupe de Recherche en Epidémiologie des Zoonoses |
