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Armed conflict causes serious and widespread consequences for public health. It accounts for much injury, disease, disability, and premature death and damages the health-supporting infrastructure of society. It contaminates the air, water, and soil and harms the physical environment. It forcibly displaces people and violates human rights and international treaties. It diverts human and financial resources away from healthcare, public health, and social services; it often leads to more violence.1


The Uppsala Conflict Data Program (UCDP), a data-collection program on organized violence that is based at Uppsala University in Sweden, divides organized violence into three categories: state-based conflict, nonstate conflict, and one-sided violence. It defines state-based armed conflict as: “A contested incompatibility between two parties—at least one of which is the government of a state—that concerns government or territory or both, where the use of armed force by the parties results in at least 25 battle-related deaths in a calendar year.”2 It defines war as “a state-based conflict that results in [at least] 1,000 battle-related deaths in a year.”2 The UCDP further divides state-based conflict into the following three categories:

  • “Interstate conflicts are fought between two or more governments of states;

  • Intrastate conflicts are fought between a government of a state and one or more rebel groups; and

  • Internationalized intrastate conflicts are intrastate conflicts in which one or both sides receive troop support from an external state.”2

Among these three categories, intrastate conflicts (“civil wars”) are the most frequent, generally accounting for more than 80% of all conflicts globally, and interstate conflicts are the least frequent, although they lead to a very large number of deaths.2

According to the World Health Organization (WHO), there are three categories of violence: collective violence; self-directed violence, such as suicide; and interpersonal violence, such as intimate partner violence.3 Collective violence includes armed conflict; state-sponsored violence, such as genocide and torture; and organized crime, such as gang warfare and banditry.3 WHO defines armed conflict as “the instrumental use of violence by people who identify themselves as members of a group—whether this group is transitory or has a more permanent identity—against another group or set of individuals in order to achieve political, economic, ideological, or social objectives.”3

Number of Armed Conflicts

During 2018, there were active armed conflicts in 27 countries: 11 in sub-Saharan Africa, 7 in the Middle East and North Africa, 7 in Asia and Oceania, 1 in Europe, and 1 in the Americas. Most of these conflicts were intrastate conflicts occurring within a country between one or more armed nonstate groups and government forces. One of the conflicts was between countries (between Pakistan and India). Two of the conflicts were waged between armed groups that aspired to statehood and government forces (conflicts between the Palestinian and Israel, and between the ...

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