Patients in Gaza with chronic conditions need urgent interventions
Authors: Yara Ashour, Abdallah Jlambo, Samer Abuzerr
Journal: The Lancet (2024)

The protracted conflict in Gaza has profound repercussions on the health of its residents, particularly those managing chronic conditions, such as diabetes and hypertension. We aim to highlight the struggles of these unaccounted victims of war and the compounded challenges they face due to medication scarcity and disruptions in primary health-care facilities. According to the Palestinian Ministry of Health in Gaza, an estimated 350 000 patients with chronic conditions are currently not receiving medications as a result of the Israel–Gaza war.1Aktas A Gaza's displaced Palestinians struggle as medication shortages worsen amid ongoing Israeli attacks.https://www.aa.com.tr/en/middle-east/gazas-displaced-palestinians-struggle-as-medication-shortages-worsen-amid-ongoing-israeli-attacks/3114038#Date: Jan 1, 2024Date accessed: February 12, 2024Google Scholar Alongside war injuries, non-communicable diseases (NCDs) are likely to remain the leading causes of excess morbidity and mortality in Gaza for the foreseeable future. The baseline prevalence of NCDs in Gaza was already alarmingly high before the start of the 2023 conflict. Recent statistics from the Palestinian Ministry of Health indicate that approximately 71 000 people are living with diabetes and 225 000 with high blood pressure.2Jewish Voice for Peace Health Advisory CouncilUrgent health update: health consequences of the war on Gaza—January 21, 2024.https://www.jvphealth.org/blog-1/urgent-health-updatehealth-consequences-of-the-war-on-gaza-january-21-2024Date: Jan 21, 2024Date accessed: February 12, 2024Google Scholar Previously, the majority of individuals could access medical care in Gaza. However, the UN reports that Gaza's fragile health system is now close to collapse, impacted by airstrikes, a surge in trauma patients, and dwindling supplies of medicines and fuel.3Chacar H Rigby J Gaza health crisis deepens for the chronically ill as war intensifies.https://www.reuters.com/world/middle-east/gaza-health-crisis-deepens-chronically-ill-war-intensifies-2023-11-08/Date: Nov 8, 2023Date accessed: February 12, 2024Google Scholar Patients with diabetes and hypertension rely on a consistent supply of medications to manage their conditions effectively. The conflict has disrupted the pharmaceutical supply chain, leading to shortages of essential drugs and exacerbating health risks for those requiring continuous medication. The conflict has also placed substantial strain on primary health-care facilities, which are essential for providing ongoing medical attention to prevent complications and ensure disease management for these patients. Overwhelmed by war-related injuries, these facilities struggle to deliver routine care for chronic conditions. Currently, only 13 (36%) of Gaza's 36 hospitals are partly functional, with just 17% of primary health-care centres operational and only 4 of 22 UN Relief and Works Agency for Palestine Refugees in the Near East health-care centres operational.4ReliefwebHostilities in the Gaza Strip and Israel—reported impact, 9 February 2024 at 22:00.https://reliefweb.int/report/occupied-palestinian-territory/hostilities-gaza-strip-and-israel-reported-impact-9-february-2024-2200Date: Feb 9, 2024Date accessed: February 12, 2024Google Scholar Moreover, the destruction of infrastructure and shortage of medical personnel further impede the delivery of essential services. Public health analysis indicated that if the war continues beyond 3 months, the burden is likely to increase further due to interrupted clinical and lifestyle-based management of cardiovascular disease (with hypertension exacerbating the issue) and type 2 diabetes, potentially leading to excess cases of pneumonia among patients with advanced diabetes. Deteriorating mental health is also likely to worsen NCD outcomes.5Checchi F Jamaluddine Z Campbell OM War in the Gaza Strip: public health situation analysis.https://www.lshtm.ac.uk/media/75901Date: Nov 6, 2023Date accessed: April 8, 2024Google Scholar As more than 6 months have passed since the start of the current conflict, urgent interventions are imperative to mitigate catastrophic consequences. Such interventions should establish dedicated and secure supply chains for essential medications to ensure a continuous flow for patients with diabetes and hypertension; allocate resources for the rapid rehabilitation of primary health-care facilities, including infrastructure repairs, recruitment of additional health-care personnel, and provision of necessary medical equipment; mobilise international aid and collaboration to support health-care infrastructure in Gaza, including financial assistance, medical supplies, and expertise to enhance the capacity of local health-care providers; and conduct targeted health education programmes to empower individuals with diabetes and hypertension to self-manage their conditions, emphasising lifestyle modifications and preventive measures. We declare no competing interests. Editorial note: The Lancet Group takes a neutral position with respect to territorial claims in published text and institutional affiliations.