A study of 193 countries reveals that conflict and displacement drive measles outbreaks by damaging healthcare infrastructure and socioeconomic stability.1


RT’s Three Key Takeaways:

  1. Direct and Indirect Burden: Armed conflict is associated with increased measles cases through both immediate service disruptions and indirect pathways like population displacement and socioeconomic decline.
  2. Socioeconomic Protection: Higher levels of socioeconomic development, including Gross Domestic Product (GDP) and life expectancy, serve as significant protective factors against measles outbreaks.
  3. Extended Risk Period: The association between conflict and increased measles burden persists for at least one year following active fighting, indicating long-term damage to immunization systems.


Armed conflict is associated with an increased measles burden through direct service disruptions and indirect effects on socioeconomic development and population displacement, according to a study published in PLOS Medicine.1

Researchers analyzed longitudinal data from 193 countries between 2000 and 2023 to evaluate how battle-related deaths (BRDs), forcibly displaced population sizes, and socioeconomic factors influence measles cases and incidence.1 The study found that for every 3,700 battle-related deaths, there were approximately 2,500 additional reported measles cases.1

The analysis utilized structural equation modeling (SEM) to identify the interconnected pathways that lead to disease outbreaks. According to the data, armed conflict and displacement were associated with lower levels of socioeconomic development.1 This decline in structural stability was a primary driver of higher measles burden, as each standard deviation increase in socioeconomic development corresponded to a reduction in cases by 0.32 to 0.34 standard deviations.1

“Mitigating infectious disease risks in volatile settings requires a dual strategy: preserving the structural foundations of health and education while systematically integrating displaced populations into routine immunization programs,” said the study authors in the report.1

The researchers identified population displacement as a critical mechanism linking conflict to increased outbreak risk.1 While displacement did not always show a direct association with total case counts, it was consistently associated with higher measles incidence rates.1 This suggests that the concentration of susceptible individuals in underserved settings facilitates the transmission of the virus.1

The study also highlighted a lag effect in conflict-related health outcomes. While contemporaneous battle-related deaths were associated with measles surges, the association was even stronger when accounting for conflict from the previous year. This indicates that the disruption to healthcare systems and immunization programs endures beyond the period of active violence.

Data for the study were sourced from the World Health Organization (WHO), the World Bank, and the United Nations High Commissioner for Refugees (UNHCR).1 The researchers noted that national-level aggregates might mask localized disruptions in conflict zones, suggesting that the findings likely represent a conservative estimate of the true public health impact.1

Tyler Y Headley, a researcher at King’s College London, and Yesim Tozan, an associate professor at New York University, led the study.1 The authors concluded that reducing measles outbreaks in conflict-affected settings requires protecting the healthcare systems and economies that underpin long-term population health.1


Reference

  1. Headley T, et al. Association of armed conflict and global measles cases: A structural equation modeling analysis of 193 countries from 2000 to 2023. Plos Medicine. June 25, 2026. https://doi.org/10.1371/journal.pmed.1004819