• Health systems

In a world of interdependencies and multiple, overlapping crises, peace is an essential enabler of resilient, equitable and healthy societies. As social institutions, health systems can be instrumental in building trust in fragmented societies—strengthening them is a key step in rebuilding societies riven by conflict.1 Peace enables good health and vice versa.

Conversely, conflict and sickness are among the greatest drivers of vulnerability and inequalities in society. In Afghanistan, Ethiopia, the Syrian Arab Republic, Ukraine, Yemen and other conflict zones around the world, the absence of peace is exacerbating inequalities that destabilise health and security—prompting a vicious cycle of conflict and poverty. Peace and health are inextricably connected, and the two must go hand in hand if we are to offer people basic protections and build secure and healthy societies

WHO has long been an advocate of promoting peace for health and health as a pathway to peace. In the late 1980s, WHO supported countries in Central America to start building ‘health as a bridge to peace’.2 Such initiatives introduced the concept of ‘days of tranquillity’—temporary ceasefires to allow for the delivery of essential health services, like vaccination campaigns for children. These ceasefires are a powerful example of the role health can play in creating peace. It was something that all sides could agree was important. Building on the legacy of such initiatives3 WHO launched the Global Health for Peace Initiative in 2020,4 leveraging WHO’s core strengths in health to deliver health programmes in conflict-affected areas that also help to build peace.

The Health for Peace approach builds on the understanding that health programmes can not only alleviate suffering in conflict, but can also be used to address some of the conflict’s underlying causes. Peace-relevant health interventions in this approach work to mainstream conflict-sensitivity into all aspects of humanitarian programming, and to improve trust and communication between citizens and the state. They also use common health-related objectives to build collaboration between different sides, and improve social cohesion through inclusive health promotion initiatives.

While it is relatively easy to start a conflict, the search for peace is often elusive, as wars have a habit of spiralling and leading to unforeseen escalations and negative consequences.5 For health workers, WHO staff and for humanitarian partners on the ground, war makes everything exponentially harder and sometimes even impossible. The impact of war is immediate on the front lines, but conflicts also displace hundreds of thousands of people, straining health systems nearby. Of particular, concern is the growing number of attacks on health facilities and health workers in these zones of conflict. In the first half of 2022 alone, WHO has verified 398 attacks on health in 14 countries and territories, claiming the lives of 157 health workers and patients, and leaving 161 injured.6 Attacks on healthcare are a violation of international humanitarian law.

In recognition of the current global situation with multiple conflicts hindering the health and well-being of societies, I decided to make ‘health for peace and peace for health’ the theme of this year’s World Health Assembly (May 2022). During the Health Assembly, WHO’s Member States requested that the secretariat develop a roadmap to implement the health and peace initiative. We welcome this request and look forward to working with the Member States to develop it.

In addition to political commitment and active diplomacy, a stronger evidence base on health interventions that support peacebuilding and health security has the potential to strengthen the hands of those who want to negotiate for peace and health. A better understanding of the linkages, pathways and mutual benefits of health and peace is essential so that we can develop effective policies and work better across sectors for positive change. Health policy and systems research, because of its transdisciplinary nature, is an important vehicle to strengthen and clarify the link. This special issue is an important contribution as we work towards a more just world, with heath and peace for all.