Safeguarding Physical and Mental Health Rights in African Conflict Regions: Ethical Responsibilities, Barriers, and Collaborative Efforts.

Armed conflicts in Africa disrupt physical and mental healthcare, yet ethical frameworks guiding interventions remain underdeveloped and rarely grounded in local political, cultural, and global realities. Mental health, chronically underfunded, is further devastated by conflict. This paper advances a human rights ethics approach to safeguarding health rights. Integrating Martha Nussbaum's capabilities approach, John Rawls's difference principle, and the African value of ubuntu, it focuses on mental health while assigning responsibilities to global actors whose economic policies fuel conflict. It reframes destruction of health infrastructure, cultural stigma, and weak accountability as violations of dignity and justice, not logistical challenges. Subsidiarity assigns primary responsibility to local actors; international actors bear a duty of solidarity, including addressing upstream conflict drivers. Restoring mental health services empowers individuals and communities-agency is central to healing. Short-term actions include integrating mental health into emergency responses, scaling community-based care, and launching culturally grounded anti-stigma campaigns. Long-term, resilient health systems and accountability, through the African Court on Human and Peoples' Rights and targeted international measures that avoid civilian harm-can hold violators responsible, even governments. Grounded in a coherent, locally situated human rights ethics, even fragile settings can advance the right to health, affirming dignity and solidarity as non-negotiable in war.