# A World of Sickness and Wealth: How War, Debt, and Profit Are Deciding Who Gets Care

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The year 2026 has made one thing brutally clear: your ability to survive illness, injury, or hunger depends less on medical science than on where you were born and how much money you have. Across conflict zones, debt-burdened developing nations, and communities poisoned by industry, the same pattern repeats—systems built to serve powerful interests are leaving ordinary people to suffer and die from causes that are entirely preventable.

In Gaza, a ceasefire that was supposed to flood the territory with humanitarian aid has instead become a symbol of betrayal. Israeli strikes killed at least five Palestinians in Gaza City on Wednesday, hitting gatherings in both the western and eastern parts of the city, one year into a truce that was meant to bring relief [258968]. More than 1,400 people have been killed since the ceasefire took effect on October 9, 2025, according to Dr. Mohammad Abu Salmiya, director of Gaza's Al-Shifa Medical Complex, and hospitals have received over 5,000 wounded [16391]. Rather than withdrawing from designated areas, the Israeli army expanded its control over Gaza from about 53 percent to roughly 60 percent of the territory [16391].

The health consequences are catastrophic. A study by Médecins du Monde found that 93 percent of pregnant and breastfeeding women in Gaza showed signs of anaemia, a condition closely tied to malnutrition [258919]. Hunger continues to grip the territory, with mothers and infants bearing the brunt of the humanitarian catastrophe [258919]. More than 20,000 Palestinian students and education workers have been killed since the war began, and some 5,600 children are waiting to be evacuated for medical treatment, according to the territory's Hamas-run Health Ministry [257723][257899].

Three years after the October 7, 2023, Hamas-led attack that killed about 1,200 people in Israel, more than 73,000 Palestinians have been killed, about 170,000 are wounded, and over 10,000 remain missing, while 82 percent of Gaza's infrastructure lies in ruins [16422]. Israel's economy, by contrast, has recovered, with GDP expected to grow 4 percent this year, while Gaza's GDP per capita has fallen by 83 percent [16422].

The mental health damage compounds across generations. More than one in five people in conflict areas are estimated to have conditions such as post-traumatic stress, depression, or anxiety, yet access to mental health services is often inadequate [258810]. For children with disabilities, the harm is worse, as social, attitudinal, and environmental barriers interact with their disability, increasing their exposure to violence and exclusion. Human Rights Watch has documented a lack of inclusive psychological support for people with disabilities in armed conflicts, including in Gaza [258810].

Ukraine's Health System Under Systematic Attack

Russia's war on Ukraine has become a systematic assault on civilian life and healthcare infrastructure. A missile strike on a passenger bus in Kramatorsk killed at least 30 people, one of the deadliest attacks on Ukrainian civilians this year [16377]. A separate airstrike damaged a hospital in Kryvyi Rih, injuring hospital workers and damaging residential buildings and an art school [16377].

The World Health Organization has recorded more than 3,300 attacks affecting healthcare since Russia's full-scale invasion in February 2022, killing 248 health workers and injuring 1,095 others [16377]. The consequences reach far beyond immediate casualties: a survey by Médecins Sans Frontières (Doctors Without Borders) found that the share of Ukrainians able to access healthcare "always" or "most of the time" fell from 77 percent to 35 percent since the invasion [16377]. The WHO estimates rebuilding Ukraine's healthcare sector will cost more than US$23 billion [16377].

Moscow has also launched a new winter campaign against Ukraine's energy infrastructure, with a leaked document revealing plans for up to 1,000 missiles, drones, and bombs targeting 60 critical infrastructure sites [16388]. The strikes threaten to cut off electricity, heating, and water as temperatures drop—conditions that directly imperil health, especially for the elderly, the sick, and the young [16388].

When Aid Becomes a Weapon

In Somalia, nearly seven million people are at risk of famine as the militant group Al-Shabab blocks humanitarian groups from reaching people under its control [16368]. The crisis is political, not natural: people are starving because relief is being blocked, not because food does not exist. In northern Ethiopia, renewed fighting has forced the United Nations to suspend aid operations [16368]. In Yemen, more than 200,000 people have been displaced in recent weeks by renewed fighting between Houthi rebels and Saudi-backed government forces [16368].

In Sudan, a record number of countries at the United Nations Human Rights Council voted to renew the UN Fact-Finding Mission, as investigators revealed that a "transnational network" of outside countries is providing weapons, logistics, training, and foreign fighters to the Rapid Support Forces (RSF) [16397]. One special inquiry found that the RSF assault on El Fasher bore the hallmarks of genocide [16397]. A drone attack by the RSF killed 30 people in Blue Nile state, most of them women and children, while a separate strike killed 41 people near the Ethiopian border, including eight children [16414].

Sudan's civilians are suffering from two crises at once: ongoing violence and severe climate shocks, the United Nations reports. Families are being forced to flee their homes while also facing droughts and floods [16423]. Aid groups warn that the situation is getting worse and are calling for urgent help to protect civilians and get them basic supplies [16423].

Debt Squeezes Health Budgets Dry

Governments worldwide are facing a double crisis of soaring debt and rapidly rising borrowing costs, and the consequences for health spending are dire. A global selloff in government bonds has pushed yields—the interest rate investors earn from a bond—to levels not seen in decades [16413]. The 10-year U.S. Treasury yield, a key benchmark that influences mortgages, corporate loans, and other debt worldwide, reached its highest level since 2002 [16413]. The United Kingdom's 30-year government bond yield hit 6 percent for the first time in decades, and the British pound fell sharply [16413].

The debt burden is especially severe for developing countries. They paid nearly $1 trillion in debt interest in 2025, according to the United Nations Trade and Development body (UNCTAD). In 51 developing countries, interest costs now exceed spending on health or education [16423]. The United Nations Development Programme (UNDP) warned that developing countries are facing three major crises at once—high energy costs, the El Niño weather pattern, and rising borrowing costs—that could push tens or even hundreds of millions of people back into poverty [16423].

Alexander De Croo, the UNDP's administrator, called for "solidarity and global action" from the international community ahead of the International Monetary Fund (IMF) and World Bank annual meetings in Bangkok [16423]. The warning highlights the growing pressure on poorer nations as they struggle with costs they did little to create [16423].

Energy Costs Become Health Costs

The war in Ukraine and escalating Middle East tensions have created a global energy crisis that is reshaping alliances and forcing emergency measures—with direct consequences for public health. The International Energy Agency (IEA), an international group of oil-consuming nations whose members hold emergency oil stocks, announced its members would release about 100 million barrels of oil, with diesel prioritized as supplies remain tight [16390]. France announced it would release 10 million barrels of diesel from its strategic reserves [16390].

The human cost is severe. South African motorists face unprecedented fuel costs after 95 unleaded petrol in Gauteng climbed past R30 a litre—the highest price ever recorded for the province—prompting unions to demand wage hikes and a review of fuel taxes [16386]. South African trade unions warn that the fuel price increase will push up food and transport costs across the board, calling for wages to be adjusted to match the rising cost of living [16386]. Globally, the US national average price of diesel passed $6 a gallon for the first time in history [16386].

In Asia, Japan is helping the Philippines expand its oil reserves, providing funding and technical support to store more fuel for emergencies [16385]. The Philippines depends heavily on fuel shipped through the Strait of Hormuz, through which about one-fifth of the world's oil passes [16385].

Environmental Poisoning of the Vulnerable

Environmental crises are compounding health emergencies across multiple continents. Singapore's iconic landmarks have vanished behind a thick wall of toxic smoke as Indonesia endures one of its worst wildfire seasons on record, sending hazardous haze across Southeast Asia [16396]. The smoke has grown so dense that Singapore's famous skyline is no longer visible, with the city-state's landmarks completely obscured from view [16396]. Tens of millions of people across the region are suffering health effects from the smog [16370].

Severe flooding and extreme weather have struck multiple countries across Europe, South America, Africa, and Asia. In Turkey, a seven-story building collapsed in Istanbul, killing two people [16384]. In Spain, a man was found dead inside a vehicle in a flooded underpass near Barcelona, the third storm-related death [16384]. In Senegal, torrential rain and flash flooding submerged parts of the capital, Dakar, killing several people and forcing the education ministry to postpone the start of the school year [16384]. In Chile, heavy rain caused the Mapocho River to overflow, forcing residents to leave their homes as authorities airlifted affected residents to safety [16384].

Meanwhile, global wildlife populations have dropped by an average of 73 percent since 1970, according to a new report from the World Wide Fund for Nature (WWF) [16383]. The WWF's Living Planet Report studied nearly 36,000 animal populations and more than 5,000 species, creating the largest database of vertebrate wildlife ever assembled [16383]. Despite the grim numbers, researchers pointed to positive developments, noting that conservation efforts have helped wild tigers, tuna, and green sea turtles recover, proving that global nature loss can be reversed [16383]. However, scientists warn that the world must change how it produces food. If it does not, the world risks a collapse in biodiversity—the variety of all life on Earth [16383].

The Hidden Costs of Green Energy

The global push for electric cars and renewable energy storage depends on lithium, a critical mineral used in batteries. But extracting it requires enormous amounts of water, and that demand is colliding with some of the driest places on Earth. In Chile, lithium extraction is creating growing social and environmental problems in the Atacama, a high-altitude desert plateau spanning Argentina, Bolivia and Chile [260509]. The same conflict is playing out thousands of miles away in California, where investors are rushing to the arid Imperial Valley to extract lithium, and residents and farmers worry the boom could drain their water supply [259809].

The seafood industry is also leaving a trail of environmental ruin and human suffering. An international investigation by The Outlaw Ocean Project reveals that Greece's booming aquaculture industry is linked to destruction that stretches from the Mediterranean to West Africa [259810]. In western Greece, the Ambracian Gulf—a lifeline for Mediterranean communities for two thousand years—has become an industrial graveyard, with fish farming pointed to as the cause of the gulf's decline [259808]. The damage extends to West Africa, where fishmeal factories produce toxic air pollution and a noxious stench that coastal communities are forced to endure, with local residents bearing the brunt of the pollution while the profits flow elsewhere [258116].

A System at Odds With Human Welfare

Taken together, these developments paint a picture of a global order that prioritizes financial accumulation and profit over human welfare. The debt crisis forces governments to choose between servicing creditors and meeting citizens' health needs. The energy crisis enriches fuel traders while leaving ordinary motorists struggling to afford petrol. The AI boom concentrates wealth in the hands of a few tech giants while workers face precarious employment and new security risks.

And the humanitarian crises in Gaza, Sudan, Somalia, and Yemen show how conflict and restricted access—not simply bad weather—decide who eats and who does not, who receives medical care and who is left to suffer [16368]. As bond markets wobble, oil prices surge, and climate shocks intensify, the fundamental question remains: who will bear the cost of these converging crises, and who will benefit from any recovery?

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