1.
of them are deprived of essential health services, according to WHO (Yoshizu, 2017) (Figure 2). The planet earth is probably seeing its worst days after civilization has started as climate (Carrington, 2022) and economic crisis (Georgieva, 2022), along with global conflicts (Xia et al., 2022) are reaching their top. When viewed from the perspective of humanity, wars and invasions are always disastrous for both combatants and war victims-especially women, the injured, children of all ages, the elderly, the functionally disabled, and the refugees. The present study aims to bring and correlate the effects of pandemic, conflict and climate issues over the world economy and interconnect them with victims and future public health (Figure 1).
2. IV. A BRIEF REVIEW OF PRESENT GLOBAL SITUATION
A. Climate Issues over Public Health About 7.6 billion people-or 96% of humanity have experienced a g lobal warming effect on temperature in the past 12 months. The World Bank says, more than 1 billion people could be displaced globally by 2050 due to climate change and natural disasters (Henley, 2020) (Figure 3).
And more than five million extra deaths a year can be attributed to the disease burden associated with climate change, which is at least 30 times higher compared to 20 years ago (Zhao et al., 2021) (Figure 3). In those years, the lion's share (more than 96%) of disaster-related deaths had taken place mainly in developing countries (Kirigia et al., 2004), which has greatly shifted across 19 countries in North America, Europe, and the Asia-Pacific region that label global climate change as a major threat (Smart, 2022). Global warming is influencing weather patterns, causing heat waves, heavy rainfall, droughts, cyclones, and wildfires (Zamir, 2021). According to the Centre for Research on the Epidemiology of Disasters, Brussels (CRED), floods, storms, and draughts caused losses to the global economy of more than $224 billion in 2021 and could cost $5.6 trillion by 2050 (Dickie, August 2022) (Figure 3). Less than 3% of the earth's water is fresh water that can be used for daily necessities or agricultural use, and less than half of it can be used for drinking (Albert et constitutes 81% of the world's workforce, were affected by the lockdown, and the world incurred a loss of 9% of global working hours, followed by 4.4% of the global GDP in lost labor incomes (Moyer et al., 2022). Economically and socially disadvantaged populations were twice as likely to present with COVID-19 symptoms to the emergency department and were more likely to require re-hospitalization within 30 days of discharge (Tuczy?ska et al., 2022). During the pandemic, child marriage, gender-based or domestic violence increased; routine health services were jeopardized; and routine vaccinations were halted for 80 million children in 70 countries (Dhaliwal et al., 2022) (Figure 4).
3. C. Man-Made Catastrophes
Major oil companies don't disclose the huge amount of greenhouse gases their oil fields emit--BP, Eni, ExxonMobil, Chevron, and Shell emit millions of tons of gas from their oil fields (Stallard et al., 2022). According to the World Wildlife Fund (WWF), as a result of deforestation and ocean pollution, the world's wildlife populations have decreased by more than two-thirds since 1970 (Dickie, October 2022). Man-made catastrophes like mountain destruction, deforestation, and pollution not only hamper food, fuel, and habitat but also cause the spread of acute infections (Reddington et al., 2021; Zimmer, 2019), chronic conditions (Beyer, 2022) and communicable diseases (Rainforest Foundation Norway, n.d.). For example, cardiovascular disease accounts for more than 60% of pollution-related disease and death (Münzel et al., 2022); each kilometer square of Brazilian Amazon deforestation results in 27 new malaria cases (Chaves et al., 2018). This is particularly important as, from California to Germany and China, droughts have shrunk the rivers that drive huge hydroelectric plants (Bloomberg News, October 2022). As global energy supplies tightened last year, India (Varadhan, 2022), China (Chen, 2022), Australia (Mandavia, 2022), and many European Union London Journal of Research in Management and Business countries (Dvorak & Hirtenstein, 2022) increased their reliance on coal-fired power-along with the Russia-Ukraine conflict (Figure 4). 5), making this the fastest-growing refugee crisis since World War II. Over 90% of the fleeing population were women and children, including unaccompanied minors. Children account for 40% of the refugee population (Figure 5). Hundreds of thousands of people are still trapped and faced with a shortage of food, water, and medicines (Kumar et al., 2022). Depression, social withdrawal, and anxiety are just a few of the long-term psychological and physical health repercussions that will afflict subsequent civilizations (Dhawan et al., 2022). In Ukraine, close to 3 million people with disabilities are registered, facing a greater risk of abandonment, violence, and death, while their access to safety and recovery support is limited (United Nations, 2022; Casey, 2022) (Figure 5). The correlation between low vaccination and Russian aggression is still a question, as Ukraine was the second lowest (15%) vaccinated country after Armenia in Europe until the end of October, 2021 (AP, 2021) Thousands of tons of sulfur dioxide and smoke poisoned the air, driving up respiratory illnesses, damaging crops, and causing four times more deaths per capita than the five cleanest countries altogether (Popov et al., 2020). Moreover, most of the energy used for agricultural production, including fuels, electricity, fertilizers, pesticides, and lubricants, is reallocated for military use (Nchasi et al., 2022). The occupiers have so far attacked more than 800 health care facilities; at least hundreds of them were completely damaged (??????, 2022) (Figure 7). At least three major oxygen plants in Ukraine have been damaged, making treatment uncertain for approximately 2,000 people requiring high oxygen flow (Howard, 2022) (Figure 7). Until the 1st week of December 2022, a quarter of its population was facing power shortages and blackouts amid strong winds, rain, and sub-zero temperatures, along with half of its capital Kyiv, for days (Guy et (Kay & Makol, 2022). Close to 40% of antibiotic APIs used in the US are sourced from China, where they are typically 35%-40% less expensive than competitors (Sadek, 2022).
In present years, China has increased economic, military, and political competition with the US, as depicted in numerous official documents and statements (Papageorgiou & de Melo, 2022). The trade war and escalating tariffs could raise manufacturing costs for generics and biosimilars in the US (Zha, 2021). However, the trade war has opened up India's opportunity to export APIs. Currently, more than half of the 342 manufacturing facilities worldwide with more than ten active US-approved API products are located in India (Jimenez, 2022). And very recently, a bill "H.R.7121(IH)-Protecting our Pharmaceutical Supply Chain from China Act of 2022" is introduced in the U.S (Authenticated US Government Information, 2022).
The 2,100-mile long India-China border has long been a source of contention between New Delhi and Beijing (Sud & McCarthy, 2022). Border tensions and the pandemic have jeopardized the supply of drugs and food between these two countries (Chatterjee, 2020; Sharma, 2020; Guerin & Strub-Wourgaft, 2020). However, to reduce Chinese API dependency, India launched a government-backed Production Linked Incentive (PLI), as India's $42 billion pharmaceutical sector is heavily dependent on China for API (Buddhavarapu, 2022).
A military confrontation between China and Japan has come into being for the first time since the end of World War II. After the Diaoyu Islands crises of 2010 and 2012, Japan began to regard China as a main security threat (Zhang, 2021). They have economic relations and cultural exchange but Japan was a pioneer in creating the concept of both the QUAD and the Indo-Pacific area (Cannon & Rossiter, 2022). The volume of trade between Japan and China shrank in 2019 due to China-US trade frictions (Wang, 2022). Japan, the largest pharmaceutical importer in the world, obtains the majority of its supplies from India, the United Kingdom, and Italy. In light of growing concerns about dependence on China around the world, the Japanese government plans to increase domestic pharmaceutical production (Kokumo, 2020).
Taiwan, missiles, and spying remain China's top priorities in the new Xi administration, as spread in many US news media (Shepherd & Wu, 2022). Despite this, President Xi has stated that China is looking for ways to "get along" with America, even as tensions rise (Tang, 2022). However, Taiwan tensions have raised concerns about the safety of undersea cables around the world (Heijmans et al., 2022), as well as the semiconductor industry. In the midst of the US tech war, TSMC (the largest chip foundry with some big clients like Apple, Intel, Qualcomm, AMD, and Nvidea, based in Hsinchu Science Park, Taiwan) is under increasing threat from China (Wintermeyer, 2022). Furthermore, Taiwan is home to more than 90% of the world's advanced semiconductor manufacturing capacity (Cheng, 2022). Semiconductors are widely used in highperformance computer chips, medical equipment, drug delivery systems (implants) and in-vitro diagnostic devices, among other things (Sutradhar & Sumi, 2014). Therefore, China has blocked imports of citrus, fish and other foods from Taiwan but avoided disrupting important technology and manufacturing relationships (AP, 2022). Heat waves, drought, and war left Nagorno-Karabakh losing over 80% of its access to water during the war last year (Mnatsakanyan, 2021). The conflict became even more relevant for Azerbaijan in terms of its drinking water, irrigation, and hydropower. Between 20,000 and 30,000 people were killed in military operations during the Armenia-Azerbaijan clashes (Khurshudyan et al., 2022). Ballistic missiles, drones, and other heavy artillery have been used, including the use of internationally banned cluster London Journal of Research in Management and Business bombs (Kazaryan et al., 2021). Among the series of clashes, 50,000 people were injured or disabled, 700 medical institutions were destroyed, and the damage to the healthcare system was estimated to be $1.2 billion (Shoib et al., 2022a) (Figure 7). Only 15% of the Armenian population was found to be doubly vaccinated until October, 2021. They were found to have the lowest vaccination rates in the Caucasus region as the pandemic has been politicized (Cookman, 2021)
4. (c) Sanctions and Anti-regime protests in Iran
The current anti-regime protest in Iran is a perpetuation of the previous one, sparked by the government's subsidy cut decision that caused price hikes by as much as 300% for a variety of staples (Associated Press, 2022
5. (d) The War-weary Afghanistan
The US Armed Forces completed their withdrawal from Afghanistan on December 31, 2021, ending 20 years of war and leaving 13 million children facing malnutrition (Essar et al., 2022) and one-third of the people food unsecured (Islam et al., 2021). The IMF says, the long-run war in Afghanistan lowered yearly national income by roughly 50% in 2016 (Hameed et al., 2022). Inflation began to rise in early 2021 as strengthening oil prices increased food transportation costs by as much as 50% in some areas (Islam et al., 2021). Since the USA's withdrawal, the World Bank, one of the project's main funders, has stopped funding the country's largest health project, which constituted nearly 80% of the country's total health expenditure London Journal of Research in Management and Business (Hussaini et al., 2022). This has created ripple effects for the healthcare system, as hospitals operate with minimum resources (Walraven et al., 2021). The country has gone through four waves of the COVID-19, and trading economics data shows that the vaccination rate has just touched 30% as of December 3, 2022 (Asady et al., 2022). According to the WHO, deaths due to environmental risks and pollution constitute 26% of overall mortality in Afghanistan. More than 30% children under 5 are underweight and malnutrition reported among 60% children (Masood et al., 2022). Drug abuse prevalence is close to 13% among those who are 15 years and older, and the country is known as the world's largest producer of opium, with an estimated 85% share of the total global supply in 2020 ( 6). As the outbreak in Syria has grown, cholera has spread to neighboring Lebanon (Gebeily, 2022).
d. Afro-Arab Sudan faces 'generational catastrophe'--floods, militia raids and hunger mean a third of children are not in school at all (Salih, 2022). Among the most internally displaced people on the African continent, Sudan is home to over 1.1 million refugees, the majority of whom are fleeing South Sudan (UNHCR, 2022c) (Figure 6). The country has been in the midst of a political crisis ever since long-time leader Omar al-Bashir was overthrown there in April (Sirgany et (Raghavan, 2019). Libya's health system is on the verge of collapse, with three-quarters of primary health care facilities closed due to a lack of medical personnel, supplies, medication, and equipment (Iwendi et al., 2021). Only 40% of hospitals' inpatient beds are adequately functioning with an overall bed capacity of 15 per 10,000 (Elhadi & Msherghi, 2020). According to data from Trading Economics, food inflation in Libya averaged 9.87% from 2005 to 2022 and peaked at 52.64% in December of 2017. Over 80% of all deaths and 78% of years with a disability-adjusted life expectancy in Libya are due to non-communicable diseases, which are particularly susceptible to long-term breakdowns in health services and policymaking processes (Allen et al., 2022). (Tegegne et al., 2022). Armed conflict between the Ethiopian military and the Tigrayan Defense Force (TDF) in northern Ethiopia began on November 4, 2020 (Berhe et al., , 2022) and has displaced over 3 million people and killed about 500,000 in the last 2 years (Sharif, 2022). Armed militants destroyed crops, killed people, looted and vandalized hospitals, clinics, health posts, and ambulances, as well as ransacked and destroyed schools (Wall, 2022). Rape, gang rape, sexual enslavement, torture, beatings and killings of friends and family, and derogatory ethnic slurs have all been reported (Berhe et al.,, 2022). According to the United Nations World Food Programme (WFP), nearly half of Tigray's six million residents are classified as "heavily food insecure," with nearly 90% lacking regular access to food. According to the UN, nearly one in every three children under the age of five is malnourished (Davies, August 2022). Among patients with severe illness, the Covid-19-related mortality rate went up to 40.3% (Temesgen Abebe et al., 2022). Fistula is raging in Tigray as a result of obstructed labor, limited or absent maternal care services, under-nutrition growth, birth difficulties, trauma, and sexually transmitted diseases (STDs) caused by conflict-related sexual London Journal of Research in Management and Business violence (Gesesew et al., 2022). According to Médecins Sans Frontières (MSF) assessment of 106 health facilities in the Tigray region between mid-December 2020 and early March 2021, "nearly 70% had been robbed, and more than 30% had been disrupted; only 13% were operating normally" (Gebregziabher et al., 2022). The ongoing conflict resulted in the destruction or damage of more than 1500 health facilities in Ethiopia in 2021, according to the country's health ministry (Anderson, 2022) (Figure 7). However, a surprise deal has been reached in the Ethiopian civil war with both sides agreeing to halt their two-year conflict (Macaulay & Soy, 2022).
6. (b) Democratic Republic of the Congo-Rwanda Conflict
On
7. (b) Malnutrition is still a world health crisis
Global acute malnutrition increased dramatically and staggeringly from 10% in 2019 to 28% in 2019, and household food security significantly decreased from 59% in 2019 to 15% (Mulugeta & Gebregziabher, 2022). According to the World Innovation Summit for Health, 2018 60% of chronically food-insecure and malnourished people globally, including 75% of all children with stunted growth, live in conflict-affected countries (Gebregziabher et al., 2022) (Figure 7).
8. (c) Poor health literacy still prevails in wealthy and dominant countries
Unfortunately, many European citizens lack health literacy, limiting their ability to make decisions about their own, their families', and their communities' health and well-being (WHO, Regional Committee for Europe, 2019). Even low health literacy (Figure 2) is reported in nearly 40% of US (Emerson et al., 2022)
9. (d) "Net-Zero Carbon" delayed by decades due to 'collaboration gap'
Approximately 80% of global carbon emissions are attributed to energy, according to the International Energy Agency (IEA) (Bhardwaj, 2021). Current trends in global food systems would prevent the 1.5 °C target from being met and put the 2 °C target by the end of the century in jeopardy, even if fossil fuel emissions stopped now (Costa et al., 2022). According to an Oxford study, decarbonizing the energy system by 2050 could result in enormous cost savings, but it will require a massive increase in private investment in renewable energy and sustainable infrastructure around the world. Estimated annual private investment in these sectors until 2050 ranges from US$4.4 trillion to $9.2 trillion (Way et al., 2022;Copley, 2022). Not surprisingly, America and China, two major polluters (40% of total CO2 emissions), were hesitant and noncommittal on the issue at COP27 (Hye, 2022). The IEA estimates that global nuclear capacity will need to double by 2050 to meet net-zero targets (Chestney, 2022), but obstacles remain. In the aftermath of the Fukushima disaster in Japan, Germany, for example, was required to close nuclear power plants by 2022 (Ekblad, 2020). Health care may be low on the list of priorities for children and adolescents who face severe pressures ranging from overcrowded camps or asylums to deep anxiety about their future (Hawke, 2020). Humanitarian crises are associated with increased short-and long-term cardiac morbidity and mortality, as well as elevated blood pressure (Keasley et al., 2020). Hypertensive patients with diabetes mellitus were twice as likely to exhibit poor BP control, as found in war-torn Palestine (Alawneh et al., 2022). Also, a US-based survey of re-settled Rohingya refugees from Myanmar shows a higher trend of chronic diseases like diabetes, hypertension, and obesity (Rahman et al., 2022). A huge increase in benzodiazepine (sedative) dispensing is reported in Canada, and abuse of similar drugs doubled in Italy among people suffering from anxiety and stress caused by COVID-19, between the years 2020 and 2021 (Sarangi et al., 2021) (Figure 7). An announcement from authorities on "simple possession of cannabis" to thousands of convicted citizens prior to the US midterm elections exploded recreational drug abuse in both the US and the EU (Lopez, November 2022; Oltermann, 2022).
10. (g) War and terrorism hits on healthcare system
A terrorist attack on a hospital is not uncommon. In just 2017, there were at least 188 hospitals and clinics that were destroyed or damaged. More than 60 people were kidnapped and 64 healthcare workers were killed; 203 patients died and 141 were injured. Health facilities have been forced to close in Afghanistan, Burkina Faso, the Central African Republic, Egypt, and Turkey (The Lancet-Editorial, 2018). Research finds 454 terrorist attacks against hospitals were identified in 61 different countries over a 50-year period by the Global Terrorism Database (GTD), where more than 50% of the attacks took place in the Middle East, Northern Africa, and South Asia (Figure 7). And in more than 50% of cases, attacks targeted medical personnel (Ulmer et al., 2022). Two other similar studies show that close to 70% of those attacks involved in bomb explosion (McNeilly et. al., 2022) and close to 60% attacks taken place after 2001 (Cavaliere et al., 2021). Attacks on hospitals may have long-term consequences: hospital units may be unavailable for an extended period of time, and replacing staff may take several months, further complicating hospital operations. In addition, hospitals are houses of resources (drugs, toxins, radioactive elements, and biological cultures) and information that could be used for nefarious purposes, making them a tempting target for terrorist groups. A full-fledged war and siege can have devastating consequences for patients who require constant care and well-functioning health infrastructural facilities, especially in resource-limited settings where providing optimal care is already difficult (Sekkarie et al., 2020).
11. London Journal of Research in Management and Business (h) Global transition or a massive work-force redistribution
The pandemic has accelerated job redistribution across sectors, with an estimated 25% of workers worldwide choosing or being forced to change occupations by 2030 (Peters et
12. (i) Healthcare workforce shortage and transition
The redistribution of the workforce and the shortage of workers could lead to a unique situation in healthcare systems around the world. The Eurozone is dealing with severe healthcare shortages (Figure 7). There are fewer doctors in France today than there were in 2012. In Germany, there were 35,000 unfilled positions in the care industry last year, a 40% increase from ten years prior. More than 700,000 people in Spain were awaiting surgery. (j) Fears of nuclear war or biological weapons are not entirely false Invaders of Ukraine launched projectiles at Chernobyl nuclear facility and the active Zaporizhzhia complex, causing international concern and raising fears of a nuclear disaster in Eastern Europe (Tansu & Culp, 2022). The pandemic, hunger, discrimination or racism, climate change, rising inflation or economic crisis, imperialism, political turmoil and nuclear war share a common thing-conflict. In the last 100 years, human civilization has experienced multiple acts of bioterrorism, chemical warfare, and nuclear explosions that have targeted civilians (Williams et al., 2022); all of them were borne out of conflicts. Although, the Geneva Protocol, which was first signed in 1925 and is still in effect today, forbids the development, manufacture, and use of biological weapons in armed conflict ( 7). And, no nuclear-armed state is currentl y disarmin g, nor engaged in nuclear disarmament negotiations (Ruff, 2022). Also, SARS-CoV-2 has already demonstrated its ability to start a pandemic and, in spite of efforts made around the world, it still poses a serious threat to use as a bioweapon (Farkas et al., 2022) (Figure 7). & Rajaeieh, 2020). In response to an expected Russian attack, the Eurozone increased its arms purchases by nearly 20%, despite the fact that spending on healthcare would be more necessary given the region's severe healthcare shortages, which may cause the region's health system to collapse in the near future (Barber, 2022) (Figure 7). This was the case despite the fact that the global trade in major arms fell by 4.6% (Hasselbach, 2022). 10. It is impossible to shelter the population from biological weapons, but possible antidotes or vaccines may have been developed in secret. However, they will not be given away for free, and there will be an option to purchase them at a bargain price. Opportunistic gain is at the heart of all types of mischiefs. If that is the case, the potential for a nuclear attack becomes almost non-existent, because there will be no opportunity for dirty instincts to be satisfied if civilization does not exist. But risk arises when terrorists capture a nuclear weapon through hijacking or, in some cases, misconceptions (Salami, 2022;Williams et al., 2022).
13. VI. LIMITATION OF THE STUDY
Media control and propaganda always put strain over information broadcast, especially when it is related to war and conflict. Therefore, data collection from media source become a limitation for any researcher. However, the present analysis mostly uses statements from
| bankruptcy during the previous two centuries | |
| (TBS Report July 05, 2022; Mohamed, 2022). | |
| The world's | However, according to a UN official at the |
| consumption of coal is taking it back to the record Global expenditure on | November 2022 climate change conference, |
| level it reached nearly a decade ago, says an military weapons exceeded $500 billion in 2020 | COP27, held in Egypt, 54 countries with the |
| International Energy Agency press release (IEA, and military spending surpassed $2 trillion by | poorest development are currently in danger of |
| 2022). In its recent publication, Nature Food now (Rolander, 2022) (Figure 4). After seeing | bankruptcy (Harvey, 2022) (Figure 5). Lebanon, |
| journal is saying "We estimate more than 2 billion 50-100 million deaths in 1918-1919 Flu pandemic | Sri Lanka, Russia, Suriname and Zambia are |
| people could die from nuclear war between India and more than 34 million deaths in World War II, | already in a debt default (Reuters, June 2022). In |
| and Pakistan, and more than 5 billion could die the incorrigible world is thirsty for another great | addition to increased employer's healthcare |
| from a war between the United States and war in the midst of Covid-19 pandemic (Jahan, | insurance cost (Mathews, 2019), currency |
| Russia-underlining the importance of global 2021; Ferguson, 2022; Mollman, 2022; | devaluation (Lubin, 2022), a reduced labor force |
| cooperation in preventing nuclear war" (Xia et Rosenfeld, 2022; Waheeduzzaman, 2022). | or lack of skilled labor (Pizzinelli & Shibata, |
| al., 2022). Whoever wins the war, humanity loses. | 2022), fuel-power crisis (Englund, 2021), and the |
| D. Present Global Economic Crisis: Fact is [1]. Russian Aggression against Ukraine | transportation freight cost (Carrière-Swallow et |
| Stranger Than Fiction The present cold winter distress in Europe and the | al., 2022; Golle, 2021; Miller & Curran, 2022) has hit the supply and demand chain massively and |
| power-fuel crisis, price volatility, inflationary | caused trouble for manufacturers, who have |
| pressure, and recession around the globe are a | undergone layoffs or delayed their economic |
| consequence of this war. The GDP of Ukraine | activities to prevent more loss. |
| could decrease by up to 35 to 40% if the war lasts | |
| longer (Astrov et al., 2022). As of August 4, 2022, | |
| more than 7 million people remain, and around 10 | |
| million refugee movements have been recorded | |
| Global central banks continued raising interest out of Ukraine (Haque et. al., 2022) (Figure | |
| rates following Federal Bank of America to | |
| prevent inflation, at the fastest pace in decades | |
| but failed, so far (Fairless, 2022; Canepa & | |
| Schneider, 2022; Hole, 2022; Smialek, 2022). | |
| Inflation hits 40 years high in the US, UK | |
| (Hagstrom, 2022; Hannon November 16, 2022; | |
| Lopez, April 2022), Japan (Reuters, November | |
| 2022), Germany (Arnold, March 2022); 37 years | |
| high in France (Alkhalifa, 2022) and Italy | |
| (Indo-Asian News Service, September 2022); 20 | , |
| years high in Russia (Bloomberg News, May | 2021; Mahase, 2022). Since 2017, more than one |
| 2022) and Turkey (Pitel, 2022), mostly due to fuel | in every six children lived in a conflict zone |
| crunch, food crisis, currency devaluation and | around the world (were living less than 50 km |
| business confidence nosedive over panic. China's | from where the actual fighting took place) (UN |
| factory inflation hits 25% in 2021 (AFP-Beijing, | News, 2019; Save the Children, 2021, Sever, |
| 2021), economy is slowing down due to adoption | 2022); highest number of women and children |
| of "Zero-Covid strategy" (Tewari, 2022; Woo et | living in conflict zone has been twice since 2000 |
| al., 2022), amid a risk of 1 million deaths in | (Bendavid et al., 2021). Armed conflict, in its |
| "winter wave" (White & Lin, 2022). Eurozone | various forms and manifestations, is prevalent |
| inflation averaged 2.12% from 1991 until 2022, | throughout the world and often results in forced |
| climbed closed to 11% in October, 2022 (Arnold, | |
| 2022; Hannon November 1, 2022). Nearly half of | |
| the countries of the EU, 40% of the countries of | |
| Africa, and 30% of the countries of Asia declared |
Three largest economies in the world-namely, the US, Eurozone, and China-are facing impediments due to higher than expected inflation or lockdown(Gourinchas, 2022). For example, the UK economy is being battered by rising energy costs, rising interest rates, tax increases, and Brexit (TBS Report July 31, 2022). E. Global Conflicts over Health Economics: Adding Insult to Grave Injury Conflict was responsible for more than 10 million deaths of children under the age of five between 1995 and 2015 worldwide (Bendavid et al., 2021). From 2021 to 2022, more than 100 million people will have been driven from their homes by war, violence, persecution, and human rights abuse, according to the UN refugee agency (UNHCR) (UN News, June 2022). Ukraine, Afghanistan, the Democratic Republic of the Congo, Ethiopia, Sudan, the Syrian Arab Republic, and Yemen are the countries with the highest numbers of internally displaced persons (Bendavid et al.migration, an energy crisis, capital flight, and the destruction of societies' infrastructure, which includes a lack of access to food, health care, housing, employment, clean water, and
, 2021). Azerbaijan's Caspian Sea, the world's largest landlocked body of water, is already rising, threatening the country's major urban centers and industrial resources along the coast(Yazdanpanah et al., 2020). With an increase in the frequency of extreme weather events, worsening desertification, and worsening land degradation, climate change is making Armenia more vulnerable. Agriculture, human health, water resources, forestry, transportation and energy infrastructure, and human health are the most at risk (World Bank/ADB, 2021).(b) Kyrgyzstan-Tajikistan border ConflictsKyrgyzstan-Tajikistan border tensions erupted into a brief open conflict in September 2022, and there have been more than 230 border clashes over the last 20 years between the two countries(Reuters, September 20, 2022). The two landlocked countries share an approximately 1,000-km long border, a third of which is disputed (Davies, September 2022). As a result of the COVID-19 pandemic, both of these countries have seen a precipitous drop in migrant laborer remittances from Russia(Tompson et al., 2020). Both of these countries' progress in Western-style public health education and science has been found to be slow (Gotsadze et al., 2022).
| et al., 2020). Iran's economic woes have sparked | ||||
| several waves of protests in recent years. The UN | ||||
| human-rights chief has urged Iranian authorities | ||||
| to stop the "disproportionate use of violence" that | ||||
| has reportedly killed over 50 children and injured | ||||
| many more during Iran's public unrest (Cooper & | ||||
| English, 2022). Many Iranians injured by security | ||||
| forces during the protests are afraid to seek | ||||
| medical attention because some protesters | ||||
| seeking medical assistance have been detained. | ||||
| Iran has long been subject to severe international | ||||
| economic sanctions, which have limited their | ||||
| access to healthcare and are thought to be a | ||||
| contributing | factor | to | their | suffering |
| (Kokabisaghi, 2018). Iran's ability to import drugs | ||||
| and medical equipment has been constrained by | ||||
| the majority of pharmaceutical companies being | ||||
| wary of getting into trouble due to US sanctions | ||||
| (Bastani et al., 2022). Patients with thalassemia, | ||||
| hemophilia, cancer, epilepsy, and multiple | ||||
| sclerosis who need medical care have been | ||||
| severely hampered by sanctions (Asadi-Pooya et | ||||
| al., 2022). According to the 2018 statistics, among | ||||
| those who inject drugs in the Middle East and | ||||
| North Africa (MENA) region, more than 45% of | ||||
| them were from Iran (Mirzaei et al., 2022). | ||||
| Libya has experienced decades of armed | |||
| conflict and political instability. During the | |||
| Gaddafi regime, oil-rich Libya enjoyed free | |||
| education, electricity, and health facilities | |||
| (John, | 2008). | Libyan | health-care |
| infrastructure continues to deteriorate due to | |||
| civil war, inadequate human and financial | |||
| support, and inadequate health facilities. More | |||
| than 37 attacks reported over health facilities | |||
| and medical personnel after violence began in | |||
| April, 2019 | |||
| crises have strong association with conflicts in | |||||||
| Africa (O'Loughlin & Witemer, 2014; Burke et al., | |||||||
| 2009; Cappelli et al., 2022; Ikoku, 2022). | |||||||
| [5]. War and Conflicts in African Countries | Sub-Saharan Africa has the highest number of | ||||||
| conflicts in the world, with at least a thousand | |||||||
| Deserts, grasslands, tropical forests, and semiarid | people killed each year on average over the last | ||||||
| lands are the four major climate zones in Africa | two decades (Chol et al., 2018). Half of the | ||||||
| (Williams et al., 2007). The three most important | Hepatitis E outbreaks in sub-Saharan Africa have | ||||||
| security concerns in Africa to watch in 2022 are | occurred among refugees and displaced persons | ||||||
| intra-state | conflict, | terrorism, | and | living in humanitarian crisis settings (Ahmed et | |||
| unconstitutional changes in government (Gruzd et | al., 2022). | ||||||
| al., 2022). Droughts in Sub-Saharan Africa more | |||||||
| than tripled between 1970 and 2009. According to | (a) Ethiopia's Tigray conflict | ||||||
| the African Development Bank, climate change is | Ethiopia, a landlocked country in the Horn of | ||||||
| costing Africa up to 15% of GDP growth (Reuters, | Africa, is a federal democratic republic. In | ||||||
| September 13, 2022). Another recent study | Ethiopia, the pooled level of poor COVID-19 | ||||||
| commissioned by Christian Aid claims that unless | prevention practice was 51.60%. Inadequate | ||||||
| significant investments in climate adaptation are | COVID-19 knowledge, a negative attitude toward | ||||||
| made, global warming will reduce Africa's | COVID-19 | management, | low | educational | |||
| economic growth by two-thirds by the end of the | attainment, living in a rural area, and being | ||||||
| century (Pearce & Andrijevic, 2022). In 2018, 2.2 | female were all significantly associated with poor | ||||||
| million people were affected by devastating | COVID-19 prevention practices | ||||||
| cyclones in Malawi, Mozambique, and Zimbabwe. | |||||||
| Malaria, dengue fever, Lassa fever, Rift Valley | |||||||
| fever, Lyme disease, Ebola virus, West Nile virus, | |||||||
| and other infections have been linked to natural | |||||||
| disasters (Anugwom, 2021). Furthermore, due to | |||||||
| the central role agriculture plays in African | |||||||
| economies, malnutrition has increased by nearly | |||||||
| 50% since 2012 (Atwoli et al., 2022). African | |||||||
| nations, which have contributed the least to the | |||||||
| global climate crisis, could see a 64% decline in | |||||||
| their GDP growth rate by the end of the century | |||||||
| (Lakhani, 2022). However, the UN and Red Cross | |||||||
| blame the Ukraine crisis for contributing to nearly | |||||||
| 25% of Africans' food insecurity (Phillips, 2022; | |||||||
| Sacko & Mayaki, 2022). Additionally, until | |||||||
| December 2, 2022, only one-third of the | |||||||
| population will have received at least one dose of a | |||||||
| vaccine, making them the continent with the | |||||||
| lowest vaccination rate (Holder, 2022). The | |||||||
| pandemic delayed the first dose of Diphtheria, | |||||||
| Pertussis, Tetanus, Hepatitis B, and Hemophilus | |||||||
| influenza B vaccines for 8 million African children | |||||||
| in 2020 (Njoh et al., 2022). In addition, more | |||||||
| than 95% malaria is reported in African countries | |||||||
| (Elagali et al., 2022). Since 1989, 75% of non-state | |||||||
| armed conflicts have been in Africa (Okiro & | |||||||
| Ayieko, 2018). Many authors have argued climate | |||||||
| (e) Pandemic hits on healthcare system | ||||
| The pandemic's longest and most deadly surge | ||||
| has posed risks to quality of care and left medical | ||||
| professionals exhausted. Various studies on | ||||
| health professionals show work-related stress, | ||||
| sleep disturbances and burnouts in 60% | ||||
| (Koontalay et al, 2021; Al-Otaibi et al., 2022; | ||||
| Biber et al., 2022); and hospitalization within 6 | ||||
| months of the pandemic starting 15% (Gholami et | ||||
| al., 2021). Also, WHO assumes that more than | ||||
| 1,15,000 health professionals may have died in the | ||||
| period between January 2020 and May 2021, and | ||||
| illnesses kept at least 500,000 health workers out | ||||
| of the US labor force alone (WHO, 2021; Guilford, | ||||
| 2022). Nearly 20% of 1000 American allied health | ||||
| workers (nurses, assistants, etc.) who responded | ||||
| to the survey stated that the pandemic was one of | ||||
| the main reasons they quit their jobs (Poon et al., | ||||
| 2022). According to a cross-sectional study | ||||
| conducted by the US Bureau of Labor Statistics | ||||
| and the University of Minnesota Data Service, | ||||
| pandemic-induced physician turnover was four | ||||
| times that of allied professionals (Frogner & Dill, | ||||
| 2022). Lack of PPE, medical supplies, and | ||||
| adequate compensation have been reported in | ||||
| several studies. | ||||
| (f) Humanitarian crisis over treatment guideline | ||||
| adherence and drug misuse | ||||
| Migration | and | displacement | are | social |
| determinants of health problems for refugees and | ||||
| other migrants | ||||
| Schaer, 2019; Noack, 2021; Harding, 2022; | ||
| Horowitz, | 2022) | (Figure |
| accompanied by a precipitation of both chronic Africa was fueled by commercial greed, | accessibility of insecticides necessary to control | ||
| and contagious disease burdens. The territorial ambition, and political rivalry (BBC | vector-borne disease (Claborn, 2020), are just | ||
| non-cooperation of two major polluters at World Service). They encouraged Africans to | a few examples of such problems. | ||
| COP-27 may be associated with trade fight each other in order to gain power | 5. Both conflict and climate crises cause | ||
| war-related privations, an economic crisis due (Selassie, 2019; Wong, 2022). | displacements, which bring not only food and | ||
| to the pandemic, and fuel and power crisis. Gutiérrez-Romero, 2022, stated that a 10% | health crises but also unhealthy competition | ||
| Rather, the pandemic and the fuel crisis forced increase in the local price index is associated | and newer conflicts. Pandemics, climate crisis, | ||
| major polluters to return to fossil fuel energy with a 0.7 percentage point increase in violence | and economic downturns poses major hit | ||
| production. against civilians in Africa. The Ukraine crisis | during and/or after a major conflict. | ||
| 3. Climate disasters are not under human control contributes 25% of their food insecurity, | Environmental pollution would not cause 26% | ||
| but are not completely beyond human reach. according to the UN and Red Cross. | of mortality in Afghanistan if it had not been a | ||
| Much less of the money spent on war could Furthermore, Christian Aid claims severe | war zone for the last 20 years. The Vietnam | ||
| have been spent on innovation, food, and the economic stagflation will multiply conflicts in | War lasted some 30 years and killed three | ||
| health system (Ikegami & Wang, 2022). The the future (Pearce & Andrijevic, 2022). Their | million people or more (Shivakumar, 1995). | ||
| world's medical system is still lacking (Kaiman health system is also a terrible mess. They may | Following the war, Vietnam was completely | ||
| et al., 2014; Rahman et al., 2020), facing newer never get rid of this position unless there is a | dedicated to an economic revolution and did | ||
| types of diseases and challenges and will face solution to their conflict. | not engage in any significant conflict. Violence | ||
| London Journal of Research in Management and Business | more in coming days (Cazzolla Gatti, 2021; Koumoundouros, 2022; Geddes, 2022). Many cancer types, HIV, autoimmune diseases, genetic disorders, antibiotic resistance-solutions of many vexing problems remain to be found. 4. Russia's invasion of Ukraine threatens to exacerbate the global inflationary surge, unbalancing oil demand and investment. The triple whammy of pandemic, fuel price shock, and currency depreciation causes economic and financial turmoil in low-and middle-income countries. Medical care and health spending generally increase faster than general inflation (Goss, 2022). Also, rising inflation is associated with infant mortality rise (Bao et al., 2022); child and maternal health compromise (Cader & Perera, 2011); hospital labor expenses per patient (American Hospital 7. Approximately 450 terrorist attacks on healthcare facilities, mostly by bomb explosion, have been registered in more than 60 countries over the last five decades. It also raises the question of the credibility of these data, given that over 430 attacks on healthcare facilities in Palestine (WHO, Occupied Palestine Territory, 2019) and more than 800 attacks on medical facilities in Ukraine have already been reported (Bisset et al., 2022; ??????, 2022; uacrisis, 2022; Vikhrov, 2022). Also, it is of great concern that victims of oppression are not even safe in hospitals, as are the caregivers and health providers. 8. For whatever reason, the total number of displaced persons exceeded 100 million, and there were 32.5 million refugees worldwide as of mid-2022, according to the UNHCR's refugee data finder. They are posing healthcare | was much lower after the Taliban took over, but it is now increasing as the Taliban fights two insurgencies. Azerbaijan and Armenia could resist more against a pandemic induced 5% GDP drop and $1.2 billion in healthcare damage. A noticeable fact is that 700 medical institutions were destroyed at the cost of the Nagorno-Karabakh conflict, and the water crisis in Azerbaijan was a key factor, driven by the climate crisis (O'Lear & Gray, 2006; Kuyumjian, 2021). Medical advances in Iran have boosted the country both domestically and internationally; the country was once known for producing 80% of the world's medicinal herbs (Samadikuchaksaraei & Mousavizadeh, 2008). Conspicuous sanctions and spiraling unrest worsen their health situation, make life-saving drugs unavailable, and make it home to nearly half of the MENA | London Journal of Research in Management and Business |
| Association, 2022); depression, anxiety, and economic burden to the already stressed | region's injecting drug addicts. | ||
| frustration and stress (Guerra et al., 2022); host countries. Like Sub-Saharan Africa, which | 6. 80% of all humanitarian needs are also | ||
| cost burdens of chronic illnesses (Jung et al., is facing multiple viral disease outbreaks due to | influenced by conflicts. Up to two-thirds of the | ||
| 2022); less access to assisted-living and the climate crisis, an intolerable food crisis | world's extreme poor will reside in unstable | ||
| independent-living facilities for the elderly partially due to the Ukraine war and triple | and conflict-affected areas by 2030 (Cieslik, | ||
| population (Ansberry, 2022); low-income drought, and vaccine discontinuation due to | 2020; World Bank, 2022). If the food crisis, | ||
| Present health system sustainability challenges households to compromise food quality the COVID-19 outbreak, it is now hosting | many other nefarious things are common inflation, economic stagflation prevails, | ||
| in conflict zones and in rest of the world (Jimenez Rincon et al., 2022); decline refugees who have become half of its Hepatitis | among war or conflict zone (Birn et al., 2017; healthcare will be less focused. And above all, | ||
| 1. Food crisis, malnutrition, lack of health facility insurance coverage (Chernew & Keenan, E population. | Daw, 2021; Quinn et al., 2022; Wells & people below the poverty line, facing any sort of | ||
| access, attacks on health facility structures or 2005); worsening clinical labor shortage, lack | Scheibein, 2022). discrimination or crisis can easily be engaged | ||
| medicinal personnel, harder hit by pandemics, of potential educators and high turnover | 2. Climate-related challenges have escalated 30 in crime, conflict, and chaos by shrewd | ||
| violent extremism, violence against women and (Fleron et al., 2022); lack of clinically necessary | times compared to 20 years ago, which will cost opportunists. It will further decline the public | ||
| children, displacements, discriminations and pharmaceuticals and supplies, as well as the | the global economy $224 billion in 2021 alone, health facilities. The European race to conquer |
| COP27: 27th Conference of the Parties to the |
| United Nations Framework Convention on |
| Climate Change |
| Abbreviations ADB: Asian Development Bank AFP: Agence France-Presse AIDS: Acquired Immune Deficiency Syndrome AMD: Advanced Micro Devices, Inc. API: Active Pharmaceutical Ingredient BBC: British Broadcasting Corporation CDC: US Centers for Disease Control and Prevention COVID-19: Coronavirus disease of 2019 global health workforce stock and distribution in 2020 and 2030: a threat to equity and 'universal' health coverage?. BMJ YOY: The CRED: Centre for Research on the Epidemiology of Disasters, Brussels CNBC: Consumer News and Business Channel EU: The European Union GDP: Gross Domestic Product GP: General Practitioner GTD: Global Terrorism Database HIV: Human Immunodeficiency Virus HP: Hewlett-Packard H&M: Hennes & Mauritz AB HSBC: Hongkong and Shanghai Banking Corporation ICU: Intensive Care Units IEA: International Energy Agency IMF: International Monetary Fund JPMorgan Chase: JPMorgan Chase & Co. MENA: Middle East and North Africa MSF: Médecins Sans Frontières MOPIC: Ministry of Planning and International Cooperation OECD: The Organization for Economic Co-operation and Development MOPIC: Physicians for Human Rights' PLI: Production Linked Incentive PPE: Personal Protective Equipment PTSD: Post-Traumatic Stress Disorder QUAD: Quadrilateral Security Dialogue SMEs: Small and Medium-sized Enterprises STDs: Sexually Transmitted Diseases TBS: The Business Standard TDF: Tigrayan Defense Force TSMC: Taiwan Semiconductor Manufacturing Company Limited UAE: United Arab Emirates UNESCO: United Nations Educational, Scientific and Cultural Organization UNHCR: United Nations High Commissioner for Refugees UNICEF: United Nations Children's Fund WFP: World Food Programme WHO: World Health Organization WWF: World Wildlife Fund global health, |
| COVAX: COVID-19 Vaccines Global Access |
| CNN: Cable News Network |