Modern Conflicts as Global Health System Shocks: A Multi-level Framework.

Armed conflict remains a major determinant of population health, with consequences extending well beyond immediate mortality and injury. These effects include disruption of health systems, environmental hazards, and broader socioeconomic instability. The ongoing conflict involving Iran, Israel, and the United States represents a rapidly evolving crisis with implications not only for affected populations but also for regional and global health systems. In this perspective, we argue that conflicts occurring within strategically critical energy and trade corridors should be understood as global health system shocks. Such events generate multi-level impacts that extend beyond national borders and propagate through tightly linked global systems. We introduce a Global Health System Shock Framework that conceptualizes these effects across three levels: direct local impacts, indirect regional consequences, and systemic global disruptions mediated through energy markets, food systems, and medical supply chains. Key risks include trauma-related morbidity and mortality, damage to healthcare infrastructure, environmental exposures linked to energy facilities, and a growing mental health burden. At the global level, disruptions to energy flows and fertilizer supply chains are already influencing fuel prices, agricultural production, and food security. Viewing modern conflicts through this lens underscores the need for coordinated, health-centered responses that prioritize resilience, protect health infrastructure, and anticipate downstream global effects. This perspective highlights the need to reframe conflict preparedness as a cross-sector global health priority.