The world is witnessing its most violent period since the Cold War, with conflict-related deaths hitting a 20-year high in 2022 and more than 123 million people forcibly displaced, according to new findings from a Lancet commission on health, conflict, and forced displacement.
The report, co-chaired by Paul B Spiegel of Johns Hopkins, warns that violations of international law and humanitarian principles have become normalized, with health-care workers and civilian infrastructure routinely targeted. Aid is increasingly instrumentalized for military ends and has become transactional, further undermining humanitarian efforts.
Sudan, Gaza, and Ukraine exemplify the brutality of modern warfare, the commission states. The report emphasizes that the scale of suffering demands a fundamental transformation of the global humanitarian system.
Implications for global health governance are profound. The commission argues that impunity for attacks on health care must end, and that rebuilding reliable public health data systems in fragile states is essential. Neglected scientific capacity in countries like Venezuela also threatens regional research cooperation.
Critics note that the commission's recommendations—while urgent—face steep political and financial obstacles, as many of the conflicts highlighted involve major powers unwilling to submit to international accountability mechanisms.