- Press Release Distribution

The Lancet: World failing to address health needs of 630 million women and children affected by armed conflict

New estimates reveal extent of the health burden of armed conflict--affecting at least 630 million women and children worldwide in 2017, and contributing to more than 10 million deaths among children under 5 years of age over 20 years

( New estimates reveal extent of the health burden of armed conflict--affecting at least 630 million women and children worldwide in 2017, and contributing to more than 10 million deaths among children under 5 years of age over 20 years. Changing nature of war is a growing threat to humanitarian access and the provision of essential health services for women and children, but responses in countries like Syria, Pakistan, and Colombia may provide context-specific innovative ways forward. Armed conflicts are becoming increasingly complex and protracted and a growing threat to humanitarian access and the delivery of essential health services, affecting at least 630 million women and children--over 8% of the world's population--in 2017, according to a new four-paper Series exposing the far-reaching effects of modern warfare on women's and children's health, published today in The Lancet.

The authors highlight the failure of the global community to prioritise women's and children's health in areas of conflict, and call for an international commitment from humanitarian actors and donors to confront political and security challenges, together with consensus on a framework for identifying high-priority interventions to reach the most vulnerable women and children with the best care possible.

The Series led by academic co-investigators and partners affiliated with the BRANCH (Bridging Research & Action in Conflict Settings for the Health of Women & Children) Consortium synthesises existing evidence with new modelling and insights from a range of local research partners, humanitarian agencies, and civil society organisations.

"The new estimates provide compelling evidence of the enormous indirect toll of modern warfare caused by easily preventable infectious diseases, malnutrition, sexual violence, and poor mental health, as well as the destruction of basic services such as water and medical facilities", says Professor Zulfiqar Bhutta from the Centre for Global Child Health, The Hospital for Sick Children in Toronto in Canada and the Institute for Global Heath & Development, The Aga Khan University, who led the Series. [1]

He continues, "Today, more than half of the world's women and children are living in countries experiencing active conflict. The international community cannot continue to ignore their plight. It's time for a radical rethink of the global response that confronts challenges to insecurity, access, politics, coordination, and the logistics of delivering high-priority interventions to women and children in politically unstable and insecure settings." [1]

The Series papers explore the changing nature of war and conflict, its short- and long-term health effects on women and children, strategies for identifying best responses, and interventions supported by in-country assessments and studies.

Growing threats of armed conflict to women's and children's health

New estimates suggest that the number of women and children affected by armed conflict around the world has risen steadily since 2000, as a result of population growth, more conflicts, increasing use of explosive and chemical weapons in urban areas, and growing numbers of refugees and internally displaced people [2].

In 2017, one in 10 (10%) women and almost one in six (16%) children worldwide were either forcibly displaced by conflict or living dangerously close (ie, within 50 km) to conflict zones. Around a third of those affected live in Pakistan, Nigeria, and India.

Evidence suggests that the risk of dying from non-violent causes increases substantially with proximity to more intense and chronic conflicts, with women of childbearing age in Africa living near the highest-intensity fighting three times more likely to die than women in peaceful areas, and the risk of death among infants higher by more than 25%.

Between 6·7 and 7·5 million infants, and more than 10 million children under 5 years of age, born within 50 km of armed conflict are estimated to have died from the indirect consequences of fighting across Africa, Asia, and the Americas between 1995 and 2015.

"It is clear that the indirect effects of armed conflict on women and children are far greater than the effects of actual fighting", says Series co-author Dr Hala Ghattas, Director of the Center for Research on Population and Health, American University of Beirut, Lebanon. "But the reality could be much worse. Insecurity and insufficient resources mean data are often scarce and of poor quality. Far greater investment in strengthening data collection and collaboration between humanitarian agencies and local authorities is needed to generate better, more readily available, and actionable information to improve the response in humanitarian crises." [1]

Changing nature of armed conflict demands new humanitarian strategies In 2019, there were 54 ongoing state-based armed conflicts in 35 countries, averaging 20 years or more [3]. Once mostly confined to warring nations, armed conflict increasingly involves clashes between nations and insurgent groups in control of large geographical areas, and is characterised by a lack of respect for International Humanitarian Law, the systematic use of explosive and chemical weapons in cities, pervasive sexual violence against women and girls, and hybrid warfare (eg, cyberattacks and the manipulation of social media).

How war is being fought and who is fighting bring new challenges to humanitarian access, the delivery of health services, and the protection of humanitarian workers and health facilities from attack. Climate change and new health threats such as the COVID-19 pandemic have further complicated the response. At the same time, new medical capabilities such as modern trauma care offer opportunities for improved health provision.

According to Series co-author, Dr Michele Barry, Senior Associate Dean for Global Health and Director of the Center for Innovation in Global Health, Stanford University School of Medicine: "Given the changing nature of armed conflict, this Series underscores the importance of a humanitarian response that includes the empowerment of local communities and leaders as they are best able to deliver life-saving services, services that rely on a community's capabilities, perceptions, and trust." [1]

Lessons learnt from ten conflict-affected countries

The Series also assessed the provision of proven health interventions for women and children in 10 conflict-affected countries in different stages (eg, acute, protracted, post-conflict) of conflict and geographical, political, and economic conditions--Afghanistan, Colombia, Democratic Republic of the Congo, Mali, Nigeria, Pakistan, Somalia, South Sudan, Syria, and Yemen.

While priority is commonly given to a range of interventions including antenatal care, emergency obstetric care, childhood vaccination, and infant and young child feeding, evidence suggests that the delivery of many life-saving services, including most sexual, reproductive, newborn, and adolescent health services, is limited.

The authors recognise that humanitarian agencies and national authorities face a wide variety of barriers to delivery, from limited funding and shortages of skilled health-care workers (eg, midwives and nurses in Pakistan and Syria) to insecurity (eg, attacks and kidnapping of health workers in Colombia and Somalia), and mistrust due to the politicisation of aid.

But these challenges have also spurred extraordinary creativity in the humanitarian response. Innovative approaches include: task sharing and hiring other types of community health workers (eg, traditional healers and birth attendants); using new modes of delivery such as remote management (ie, subcontracting to local organisations) and technology like WhatsApp; and establishing contingency funds for emergencies.

In Afghanistan, for example, mobile clinics are used to deliver health services to remote areas, and in South Sudan, donors made emergency funds available to stock up on medical supplies to ensure rapid respond to future disease outbreaks (eg, cholera). In Pakistan, senior health workers living in the middle of the Keich district rotate week-long visits to remote areas every month to address the workforce shortage.

Professor Isabel Garcés-Palacio from the Universidad de Antioquia in Colombia says, "Although these solutions need more rigorous evaluation, they have the potential to provide a timely response to current implementation challenges and remind health authorities of their responsibility to deliver basic health services to the whole population." [1]

However, there are also wider issues in the humanitarian system that need to be addressed. "Predefined packages of priority health services for women and children are not commonly agreed upon. Instead, international donors remain the key drivers of influencing what, where, and how interventions are delivered", explains Dr Jai Das from The Aga Khan University in Pakistan. "Although technical and operational guidance on promoting women's and children's health in humanitarian crises exist, they are not specific to conflict settings and have been developed as a broad response to a range of emergencies including natural disasters and epidemics."[1]

A way forward As a first step towards filling the guidance gap, the authors call for humanitarian health actors including global and local agencies and NGOs, and academia working in conflict settings to establish a decision-making framework to guide the selection of priority interventions and improve accountability.

"While the needs of conflict-affected communities are great, their voices are also often unheard or overlooked, so it is imperative they have a seat at the table--and that humanitarian actors listen to them--when decisions concerning them are made", says Series co-author Assistant Professor Neha Singh, Co-Director of the Health in Humanitarian Crises Centre at The London School of Hygiene & Tropical Medicine, UK. "It is imperative that the world make more concerted efforts to reduce the risk of conflict, but until that happens, improving the delivery of health and nutrition services for women, children, and adolescents affected by conflict remains an ethical and moral responsibility." [1]

Writing in a linked Comment, Helen Clark, Chair of The Partnership for Maternal, Newborn & Child Health (PMNCH) and former Prime Minister of New Zealand (who was not involved in the Series papers) writes: "The rights and needs of women, children, and adolescents must to be placed at the centre of all humanitarian, development, and peace-building efforts, in line with the concept of centrality of protection. Doing this isn't the responsibility of any one sector or stakeholder group, and all actors need collectively to agree on and demand greater alignment, investment, and political attention for women, children, and adolescents who are trapped in conflict zones. Only then can the unequal burden of preventable morbidity and mortality in the world's most challenging regions be addressed in a way that ensures that no one is left behind."


Peer-reviewed / Review and modelling / People

NOTES TO EDITORS As coordinator of the BRANCH Consortium, the SickKids Centre for Global Child Health has received funding for BRANCH research activities from the International Development Research Centre (IDRC), the Norwegian Agency for Development Cooperation (Norad), the Bill & Melinda Gates Foundation, and UNICEF. Aga Khan University has received funding for BRANCH research activities from the Family Larsson-Rosenquist Foundation. Additional costs to convene consortium members and collaborators, and support to advocacy and communications for the Series have been provided directly by The Partnership for Maternal, Newborn & Child Health (PMNCH).

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: if you have any questions or feedback, please contact The Lancet press office

[1] Quotes direct from authors and cannot be found in Series papers. [2] Worldwide, the number of a children forcibly displaced by violence or conflict almost doubled from nearly 19 million in 2009 to almost 36 million in 2017, and the number of women increased from almost 11 million to over 16 million. Similarly, the number of non-displaced women and children living dangerously close to armed conflict zones (within 50km) rose from 185 million women and 250 million children in 2000, to 265 million women and 368 million children in 2017. [3] FAQ - Department of Peace and Conflict Research - Uppsala University, Sweden (


Dramatic changes to radiotherapy treatments due to COVID-19

Dramatic changes were seen in the delivery of radiotherapy treatments for cancer during the first wave of the coronavirus pandemic in England. Much shorter radiotherapy courses were delivered, treatments were delayed where it was safe to do so and some increases were seen in order to compensate for reduced surgical capacity. Experts believe the changes reflect an impressive adaption of services by the NHS, and that the overall impact on cancer outcomes is likely to be modest. The new research, led by the University of Leeds, with Public Health England and the Royal College of Radiologists, reveals that there was a decrease in radiotherapy treatment courses of 19.9% in April, 6.2% in May, and 11.6% in June 2020, compared with the same months the previous year. These decreases equated ...

UTMB team proves potential for reducing pre-term birth by treating fetus as patient

GALVESTON, Texas - The results of a study by researchers at the University of Texas Medical Branch may pave the way for a new medicine delivery system that could reduce the incidence of pre-term labor and premature birth by allowing physicians to treat the 'fetus as the patient'. The study has been published in Science Advances. It has long been suspected that pre-term labor is triggered by inflammation caused by a sick fetus. A new study by scientists at UTMB has proved the hypothesis by studying several important assumptions about the relationship between the health of a mother and her unborn child. According to Dr. Ramkumar Menon, ...

New technique builds super-hard metals from nanoparticles

New technique builds super-hard metals from nanoparticles
PROVIDENCE, R.I. [Brown University] -- Metallurgists have all kinds of ways to make a chunk of metal harder. They can bend it, twist it, run it between two rollers or pound it with a hammer. These methods work by breaking up the metal's grain structure -- the microscopic crystalline domains that form a bulk piece of metal. Smaller grains make for harder metals. Now, a group of Brown University researchers has found a way to customize metallic grain structures from the bottom up. In a paper published in the journal Chem, the researchers show a method for smashing individual metal nanoclusters together to form solid macro-scale hunks of solid metal. Mechanical testing of the metals manufactured ...

Regulating the ribosomal RNA production line

Regulating the ribosomal RNA production line
The enzyme that makes RNA from a DNA template is altered to slow the production of ribosomal RNA (rRNA), the most abundant type of RNA within cells, when resources are scarce and the bacteria Escherichia coli needs to slow its growth. Researchers used cryo-electron microscopy (cryo-EM) to capture the structures of the RNA polymerase while in complex with DNA and showed how its activity is changed in response to poor-growth conditions. A paper describing the research led by Penn State scientists appears January 22, 2020 in the journal Nature Communications. "RNA polymerase is an enzyme that produces a variety of RNAs using information encoded in DNA," said Katsuhiko Murakami, professor of biochemistry and molecular biology at Penn State and the leader of the research ...

ECMO/CRRT in the treatment of critically ill SARS-CoV-2 pneumonia patients

In a new publication from Cardiovascular Innovations and Applications; DOI, Hai Zou and Shengqing Li from the Institute of Pulmonary and Critical Care Medicine, Huashan Hospital, Fudan University, Shanghai, China consider ECMO/CRRT combined support in the treatment of critically ill SARS-CoV-2 pneumonia patients. The authors of this article explored the experience with, and complications of, extracorporeal membrane oxygenation (ECMO) combined with continuous renal replacement therapy (CRRT) for treatment of critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia. The survival rate of patients with cardiopulmonary failure treated with ECMO/CRRT in whom conventional ...

Risk factors for intraoperative pressure injury in aortic surgery

In a new publication from Cardiovascular Innovations and Applications; DOI, Yao Dong, Jun-E Liu and Ling Song from the Capital Medical University, Beijing, China consider risk factors for intraoperative pressure injury in aortic surgery. Intraoperative pressure injuries are some of the most significant health problems in clinical practice. Patients undergoing aortic surgery are at high risk of developing an intraoperative pressure injury, with an incidence much higher than that associated with other types of cardiac surgery. In this article the authors identify risk factors associated with an increased risk of intraoperative pressure injury in patients undergoing aortic ...

Predictive value of blood pressure, heart rate, and blood pressure/heart rate ratio in a Chinese subpopulation with vasovagal syncope

In a new publication from Cardiovascular Innovations and Applications; DOI, Zhuzhi Wen, Jingying Hou, Zun Mai, Huifen Huang, Yangxin Chen, Dengfeng Geng and Jingfeng Wang from Sun Yat-sen University, Guangzhou, China and Guandong Province Key Laboratory of Arrhythmia and Electrophysiology, Guangzhou, China consider predictive value of blood pressure, heart rate, and blood pressure/heart rate ratio in a Chinese subpopulation with vasovagal syncope. Blood pressure, heart rate and ratios of blood pressure to heart rate in the titled position during the simplistic tilt test had predictive value with regard ...

A method for calculating optimal parameters of liquid chrystal displays developed at RUDN University

A method for calculating optimal parameters of liquid chrystal displays developed at RUDN University
A professor from RUDN University together with his colleagues from Saratov Chernyshevsky State University and D. Mendeleev University of Chemical Technology of Russia developed a method for calculating the parameters of diffraction optical elements used in LCDs. In particular, the new technology can be used to expand the angle of view while preserving high resolution and color rendition. The results of the study were published in the Journal of The Society for Information Display. Each pixel on a display corresponds to a group of three light sources: red, green, and blue. When the brightness of all three diodes is the same, white light is produced; and by changing the share of each respective ...

No more needles for diagnostic tests?

No more needles for diagnostic tests?
Blood draws are no fun. They hurt. Veins can burst, or even roll -- like they're trying to avoid the needle, too. Oftentimes, doctors use blood samples to check for biomarkers of disease: antibodies that signal a viral or bacterial infection, such as SARS-CoV-2, the virus responsible for COVID-19; or cytokines indicative of inflammation seen in conditions such as rheumatoid arthritis and sepsis. These biomarkers aren't just in blood, though. They can also be found in the dense liquid medium that surrounds our cells, but in a low abundance that makes it difficult to be detected. Until now. Engineers at the McKelvey School of Engineering at Washington University in St. Louis have developed a microneedle patch that can be applied to the skin, capture a biomarker of interest ...

A professor from RUDN University developed new liquid crystals

A professor from RUDN University developed new liquid crystals
A professor from RUDN University together with his Indian colleagues synthesized and studied new dibenzophenazine-based liquid crystals that could potentially be used in optoelectronics and solar panels. The results of the study were published in the Journal of Molecular Liquids. Liquid crystals are an intermediate phase between a liquid and a solid body. They are ordered like regular chrystals but at the same time have a flow like liquids. It is this duality that allows them to be used in organic LEDs and LCDs. Unlike other liquid crystals, discotic ones (DLC) are capable of self-assembly into ordered structures. This makes them a promising material for industrial electronics, namely, for the production of displays. ...


Ecology: The scientific literature dominated by men and a handful of countries

New report offers detailed analysis of Capitol Hill siege

2nd window ICG predicts gross-total resection/progression-free survival in brain metastasis

Coffee for the birds: connecting bird-watchers with shade-grown coffee

New study proposes a low cost, high efficiency mask design

A materials science approach to combating coronavirus

High fat diets may over-activate destructive heart disease protein

Tissue, scaffold technologies provide new options for breast cancer, other diseases

Neanderthal and early modern human stone tool culture co-existed for over 100,000 years

The time is ripe! An innovative contactless method for the timely harvest of soft fruits

Rarest seal breeding site discovered

WHO expert panel strongly advises against use of hydroxychloroquine to prevent covid-19

Alcohol and tobacco sales climb during early months of COVID-19 pandemic

Researchers find frustration is an additional factor of addiction

Why some rural enrollees in Medicare Advantage are switching to traditional Medicare

Stressed-out young oysters may grow less meat on their shells

Antibodies deplete cancer cells in mice and human cell lines; reach previously inaccessible targets

What's happening to the most remote coral reefs on Earth?

Increase in medicaid managed care for youth linked to slightly more preventive care

School-based dental program reduces cavities by more than 50%

The enemy within: Understanding the mechanisms of r-chop resistance in b-cell lymphoma

Future of immunotherapy could be 'off-the-shelf' treatments

Repurposed arthritis drug did not significantly improve severe COVID-19 pneumonia

COVID-19 lockdown highlights ozone chemistry in China

Oregon State research shows how tissue's microscopic geometry affects spread of cancer

Plant clock could be the key to producing more food for the world

Goodbye UTIs: Duke scientists develop vaccine strategy for urinary tract infections

Rapid antigen testing for COVID-19: piecing the puzzle together

Predicting microbial interactions in the human gut

Through the looking glass: Artificial 'molecules' open door to ultrafast polaritonic devices

[] The Lancet: World failing to address health needs of 630 million women and children affected by armed conflict
New estimates reveal extent of the health burden of armed conflict--affecting at least 630 million women and children worldwide in 2017, and contributing to more than 10 million deaths among children under 5 years of age over 20 years