The Intertwined Crisis: Global Health Challenges and the India-Pakistan Conflict’s Toll on Health in 2025

A Precarious Nexus in 2025

The year 2025 has emerged as a period of alarming convergence, marked by a significant military escalation between India and Pakistan set against a backdrop of intensifying global health crises. This report analyzes the synergistic impact of these concurrent threats on the health landscape of South Asia, with a particular focus on India and Pakistan. The analysis demonstrates how the conflict not only precipitates direct health emergencies but also acts as a potent amplifier of existing vulnerabilities related to climate change, antimicrobial resistance (AMR), mental health, and communicable diseases.

The global health landscape in 2025 is characterized by increasingly complex and interconnected challenges.¹ The confluence of the India-Pakistan conflict, which saw a rapid escalation following a terrorist attack in Pahalgam in April and India’s retaliatory “Operation Sindoor” in May 2025 ², and these prevailing global health issues has precipitated a multi-layered health emergency. This situation disproportionately affects vulnerable populations and strains already fragile health systems in the region. The rapid succession of the attack and the large-scale military retaliation suggests a breakdown of previous de-escalation mechanisms. This points towards a heightened risk of protracted conflict, creating a chronic stressor on health systems that extends beyond immediate battle damage, as diplomatic fallout includes visa cancellations, border closures, and treaty suspensions.² Furthermore, the timing of this acute conflict in early to mid-2025 coincides with critical global health assessments and discussions ⁶, potentially overshadowing or complicating international responses to broader, chronic health challenges in South Asia that require sustained global cooperation. This report posits that an urgent, integrated response is necessary, addressing both the geopolitical drivers of the conflict and the pressing public health imperatives.

The Tinderbox Ignited: India-Pakistan Conflict Dynamics in 2025

The primary catalyst for the 2025 escalation was a terrorist attack on April 22 in Pahalgam, Indian-administered Kashmir, which killed 26-28 civilians, predominantly Hindu tourists.² The Resistance Front (TRF), an alleged offshoot of the Pakistan-based Lashkar-e-Taiba, claimed responsibility for the attack, where assailants reportedly targeted non-Muslims.³

India’s response, codenamed “Operation Sindoor,” commenced in early May 2025, involving coordinated missile and air strikes on at least nine sites within Pakistan and Pakistan-administered Kashmir.³ India stated these strikes targeted “terrorist infrastructure” associated with groups like Jaish-e-Mohammed and Lashkar-e-Taiba.³ Pakistan denounced these actions as an “act of war,” reporting 31 civilian fatalities, including women and children, and damage to civilian structures such as a mosque and an educational complex incorporating a medical clinic.⁴ Pakistan also claimed to have downed Indian aircraft and launched retaliatory drone and missile attacks on Indian military and civilian locations.⁴

The ensuing military exchanges involved heavy artillery fire across the Line of Control (LoC), leading to civilian deaths and injuries on both sides; notably, at least 15 Indian civilians were killed in Poonch.⁴ The conflict’s escalation to include direct strikes deep within territories signifies a dangerous shift in engagement, rendering civilian areas and essential services, including health-related ones, more vulnerable than in prior border skirmishes. This is evidenced by strikes in mainland Pakistan (e.g., Bahawalpur, Muridke) and retaliatory attacks beyond immediate border areas, with collateral damage to civilian infrastructure.³

The diplomatic and economic repercussions were severe, including the expulsion of diplomats, visa suspensions, closure of borders (including the Attari-Wagah and Kartarpur corridors), airspace restrictions, trade suspensions, and, critically, India’s suspension of the Indus Waters Treaty.² The suspension of this crucial water-sharing treaty, governing flows vital to Pakistan, introduces profound potential long-term public health implications related to water scarcity, sanitation, and agricultural output, potentially leading to malnutrition and an increase in water-borne diseases far beyond the immediate conflict zone.² This action, impacting the Jhelum and Chenab rivers, could create a slow-burn health crisis for Pakistan.⁵

The conflict, described as the most severe since at least 2019 ², has heightened geopolitical instability, with international calls for restraint from the UN, US, and China, particularly given the nuclear capabilities of both nations.⁵ Compounding the crisis, pervasive disinformation campaigns and media sensationalism on both sides have fueled public anxiety and could hinder effective public health communication during this critical period.¹¹

Global Health Fault Lines: Amplified Threats in 2025

The 2025 India-Pakistan conflict unfolds against a backdrop of several acute global health threats, each of which is significantly amplified by the regional hostilities.

1. Climate Change: A Health Emergency Multiplier in South Asia

South Asia is exceptionally vulnerable to climate change, facing extreme heat, droughts, floods, and erratic rainfall, with January 2025 being the warmest on record.¹ These conditions directly cause heat stress, particularly for vulnerable populations like women in India’s informal sector, injuries, and fatalities.¹ Indirectly, climate change worsens communicable diseases, such as malaria due to altered weather patterns, and non-communicable diseases like respiratory conditions from poor air quality.¹ It also devastates agricultural production, leading to wage losses, food insecurity, and climate-driven migration, creating new health vulnerabilities, especially for the poor and marginalized communities in Southern Asia who possess limited adaptive resources.¹

The conflict compounds these climate-induced stresses. Displacement forces populations into areas potentially more vulnerable to climate extremes, while military activities and border closures disrupt agricultural cycles and food supply chains. The suspension of the Indus Waters Treaty, in particular, directly threatens water availability for agriculture and consumption in Pakistan, a stressor magnified by climate-induced droughts or floods, creating a severe double burden.² Furthermore, health systems in India and Pakistan, already struggling to build climate resilience (e.g., through community-led infectious disease surveillance ²¹), will see these efforts severely undermined by conflict-related resource diversion and damage to crucial infrastructure.¹

2. Antimicrobial Resistance (AMR): The Silent Pandemic’s Grip on the Region

Antimicrobial Resistance (AMR) is a colossal global health threat in 2025, with projections of 39 million deaths globally between 2025 and 2050.¹ South Asia is a critical hotspot, anticipated to suffer the highest number of AMR-related deaths—11.8 million directly due to AMR between 2025 and 2050.²² Factors driving AMR in Asia include limited healthcare infrastructure, unsustainable agricultural practices involving antibiotic misuse in livestock, inadequate water, sanitation, and hygiene (WASH) facilities, the impacts of climate change exacerbating disease spread, overuse of antibiotics in humans, and the prevalence of counterfeit drugs.¹ Older populations and those in low- and middle-income countries are disproportionately affected.¹ Key pathogens like MRSA and carbapenem-resistant Gram-negative bacteria show rising mortality.²²

The conflict environment—characterized by injuries, displacement into unsanitary conditions, and overwhelmed or damaged healthcare facilities—is poised to fuel a surge in antibiotic misuse and the spread of AMR. Trauma care often necessitates antibiotics, and compromised infection prevention and control (IPC) in crisis settings, coupled with potential disruptions to diagnostic capabilities and drug supply chains, will likely lead to inappropriate antibiotic use and incomplete treatment courses, accelerating resistance.¹ This will undermine AMR stewardship efforts. The economic strain of the conflict may also divert national and international funding from vital long-term AMR interventions, such as research and development for new antibiotics, strengthening surveillance, and improving WASH infrastructure, further entrenching South Asia as a global AMR hotspot.²²

3. The Pervasive Mental Health Crisis

Mental health is a key global priority in 2025, with a growing burden of illness, significant impacts on physical health, and substantial economic consequences.¹ In Asia, however, mental health awareness, support, and resources remain critically limited, with stigma posing a major barrier to care.²⁶ Geopolitical tensions, economic uncertainty, and climate anxiety—including trauma from extreme weather and “climate anxiety”—are recognized exacerbating factors.¹ Vulnerable groups, including refugees, migrants, and children, are at heightened risk for conditions like depression, anxiety, and PTSD.²⁸

The India-Pakistan conflict is creating a multi-layered mental health crisis. Direct exposure to violence, displacement, and loss inflicts severe trauma.³⁰ Even for those not directly in harm’s way, the constant barrage of conflict narratives, amplified by media and disinformation, generates pervasive fear and uncertainty.²⁰ Children are exceptionally vulnerable, with school closures and exposure to conflict potentially leading to long-term psychological scars and developmental issues.²⁹ The intersection of pre-existing climate anxiety and acute conflict-induced trauma creates a unique and severe psychological burden, particularly for youth in South Asia. This dual trauma could lead to long-term societal impacts, including disengagement, hopelessness, and increased rates of substance abuse, overwhelming the already scarce mental health resources in both nations.²⁶

4. Enduring Communicable Disease Risks and Strained Health Systems

Global preparedness for pandemics remains weak in 2025, despite lessons from COVID-19.¹ Communicable diseases such as polio (with WPV1 re-established in Pakistani reservoirs and a risk of cross-border spread ³⁷), cholera (experiencing a global resurgence exacerbated by conflict, displacement, and climate change ³⁸), dengue (with its approaching season in Pakistan requiring robust surveillance ⁴⁰), and tuberculosis continue to pose significant threats.

Health systems, particularly in low- and lower-middle-income countries, are already under pressure from cuts in Official Development Assistance (ODA), which disrupt emergency preparedness, surveillance, essential service provision (including for malaria, HIV, TB, and maternal and child health), and the health workforce—effects comparable to disruptions seen during the peak of the COVID-19 pandemic.⁴¹ Concurrently, medical costs in the Asia-Pacific region are rising due to post-pandemic chronic conditions, new medical technologies, and geopolitical events.⁴² While digital transformation in healthcare shows promise, its adoption is uneven.¹

Conflict-induced displacement and damage to WASH infrastructure create ideal conditions for outbreaks of diseases like cholera and typhoid, especially in temporary camps and overburdened host communities.²⁴ Simultaneously, these conditions cripple the already weakened surveillance and response systems. Polio eradication efforts in Pakistan, already contending with insecurity and vaccine hesitancy ³⁷, will be severely compromised in conflict-affected zones and areas with displaced populations. This increases the risk of WPV1 resurgence and cross-border transmission, potentially derailing global eradication goals, as inaccessible areas expand and population movement facilitates virus spread.³⁷

Table 1: Key Global Health Threats and Their Amplification in the India-Pakistan Context (2025)

Global Health Threat	General Global/South Asian Impact (2025)	Specific Amplification by 2025 India-Pakistan Conflict	Key Sources
Climate Change	Extreme weather (heatwaves, floods, droughts), vector-borne diseases, agricultural disruption, food insecurity, climate migration.1	Displacement into climate-vulnerable areas, disrupted adaptation efforts, increased food/water insecurity due to combined stress, damaged infrastructure hindering climate resilience (e.g., Indus Water Treaty suspension 2).	1
Antimicrobial Resistance	High mortality (39M deaths 2025-2050 globally 1), South Asia a hotspot (11.8M deaths 2025-2050 22). Driven by antibiotic misuse, poor WASH, agriculture.23	Increased antibiotic use for conflict injuries, poor sanitation in IDP camps, disrupted IPC in damaged/overwhelmed hospitals, compromised AMR stewardship programs, diversion of funds from AMR R&D and surveillance.8	1
Mental Health Crisis	Growing global burden, exacerbated by climate change, economic uncertainty.1 Limited resources in Asia.26	Mass trauma from violence, displacement, loss. Heightened anxiety from conflict narratives/disinformation. Overwhelmed mental health services. Unique stress from combined climate anxiety and conflict trauma, especially in youth.28	1
Communicable Diseases	Ongoing pandemic preparedness gaps.1 Risks from Polio (Pakistan endemic 37), Cholera (conflict-driven 38), Dengue.40	Displacement into unsanitary conditions favoring outbreaks (cholera, typhoid). Disruption of immunization campaigns (esp. polio in Pakistan 37). Weakened disease surveillance and response due to ODA cuts 41 and conflict damage.	1
Health System Strains	ODA cuts impacting LMICs.41 Rising medical costs in APAC.42 Uneven digital transformation.43	Direct damage to facilities 8, disrupted supply chains 45, health worker displacement/shortages, diversion of national budgets to defense 25, increased out-of-pocket expenditure for vulnerable populations.	8

Conflict as a Catalyst: Exacerbating Health Vulnerabilities in India and Pakistan

The 2025 India-Pakistan conflict acts as a powerful catalyst, directly and indirectly worsening a spectrum of health vulnerabilities across the region.

1. The Direct Blow: Healthcare Infrastructure Under Fire and Services Disrupted

The conflict has led to direct damage to healthcare-related infrastructure. Reports indicate a medical clinic within an educational complex was hit in Muridke, Pakistan.⁴ While India asserted that its strikes were designed to avoid civilian infrastructure ⁴⁷, collateral damage is evident. In Poonch, India, a Gurudwara and a school sustained damage.⁸ Such destruction, even if limited, degrades routine healthcare access for local communities, forcing residents to delay treatment or travel further, potentially worsening long-term health outcomes.

Medical supply chains are under duress. India’s Union Health Ministry has directed pharmaceutical companies to maintain emergency medicine stockpiles ⁴⁵, acknowledging that conflict inherently disrupts trade routes and the movement of essential goods, including medicines.⁴⁸ Border closures further sever any existing cross-border medical support.² Healthcare personnel in Indian border states are on high alert with cancelled leaves, indicating preparedness for mass casualty incidents and immense strain on the workforce.⁴⁵ Civilian casualties, such as the 44 injured in Poonch, are overwhelming local hospital capacities.¹² This creates a “double-whammy” for healthcare systems: surging demand from conflict-related injuries and stress-induced illnesses, concurrent with diminished capacity due to infrastructure damage, supply disruptions, and overwhelmed or unavailable staff.

2. Humanitarian Fallout: The Health Crisis of Internally Displaced Populations (IDPs)

Significant displacement has occurred on both sides. In Pakistan-administered Kashmir (AJK), dozens of families fled LoC villages, finding refuge with relatives or in public schools converted into temporary camps.²⁴ In India, thousands in areas like Poonch and Uri have been forced from their homes, with the government establishing shelter homes.³² These ad-hoc shelter solutions, such as schools, often lack adequate sanitation and space for the numbers displaced, creating conditions highly conducive to rapid disease transmission, including vaccine-preventable illnesses and those linked to poor WASH.²⁴

IDPs are among the world’s most vulnerable, often lacking adequate shelter, food, clean water, and healthcare.⁵¹ While relief efforts in Poonch camps provide some basic necessities like food and medicines ⁵², the overall conditions can increase susceptibility to infectious diseases like cholera, dysentery, and malaria.³⁸ The emergency focus on acute physical needs (injuries, dehydration) may lead to the neglect of chronic health conditions and essential maternal and child health (MCH) services. This can result in a silent health crisis among displaced women and children, with preventable deaths and long-term complications not immediately visible but contributing significantly to morbidity and mortality.⁴¹

3. Breeding Grounds for Disease: Conflict’s Impact on Surveillance and Immunization

Disease surveillance systems, already strained by ODA cuts ⁴¹, are further compromised by the conflict through direct disruption of information systems and access. The Rajasthan health department, for instance, is enhancing its disease surveillance specifically due to perceived bioterrorism threats from Pakistan stemming from the current tensions.⁵⁵ Cyberattacks have also targeted health-related government sites in both India (UIDAI) and Pakistan (Emergency Services Department), potentially disrupting data flow and service delivery.⁵⁶

Immunization campaigns, particularly for polio in Pakistan, face severe setbacks. Insecurity, operational gaps, and vaccine hesitancy already challenge these efforts in regions like Khyber Pakhtunkhwa and Balochistan, which are WPV1 transmission zones.³⁷ The conflict exacerbates these issues, making it harder to reach children and increasing the risk of cross-border polio spread via displaced populations.³⁷ This disruption could create “blind spots” where poliovirus circulates undetected, posing a significant risk of exporting WPV1 and threatening global eradication efforts. Furthermore, the heightened bioterrorism concern in border states like Rajasthan necessitates diverting scarce public health resources towards specialized preparedness, potentially at the expense of routine disease control and primary healthcare services.⁵⁵

4. The Psychological Scars: Trauma and Mental Well-being in Conflict Zones

The conflict has unleashed a profound mental health crisis. Civilians, even those distant from direct fighting, experience heightened anxiety, fear, and panic due to constant news updates, social media speculation, and the general atmosphere of instability.²⁰ Individuals with pre-existing mental health conditions see their symptoms worsen.³⁰

Children are particularly vulnerable. Exposure to violence, fear, and the disruption of routines, including widespread school closures in border areas, can lead to trauma, developmental regression, anxiety, depression, attention disorders, and lasting emotional scars.²⁹ Displaced populations face immense stressors, with limited access to mental health and psychosocial support (MHPSS).²⁸ The psychological distress, especially among children and youth in border regions already marked by decades of instability like Kashmir ⁵⁷, risks fostering long-term societal issues such as increased substance abuse, higher school dropout rates, and reduced economic productivity. This creates a cycle of socio-economic disadvantage and intergenerational trauma that existing scarce and often not trauma-informed mental health services are ill-equipped to handle.²⁶

5. Strained Lifelines: National Health Programs and Resource Allocation Under Pressure

The conflict imposes massive financial burdens, likely leading to increased defense spending at the expense of social sectors, including healthcare.²⁵ India’s defense budget for 2025-26 saw a 9.5% increase to ₹6.8 trillion ($79 billion).⁵⁸ While its health budget also nominally increased, its share of the total budget remains low (around 2%), and funding for primary care is insufficient.⁶⁰ Pakistan approved an 18% increase in defense spending to over PKR 2.5 trillion for 2025-26, directly citing tensions with India.⁴⁶ This fiscal pressure will inevitably de-prioritize long-term public health investments, such as strengthening primary healthcare and addressing social determinants of health, thereby perpetuating health inequities.

National health programs face significant strain. India’s Ayushman Bharat PMJAY has seen budget increases and expansion ⁶⁰, but underfunding of primary health centers (PHCs) and community health centers (CHCs) persists.⁶⁰ Pakistan’s Sehat Sahulat Program in Khyber Pakhtunkhwa faces sustainability challenges due to rising costs and economic instability, with its expansion often viewed as politically motivated.⁶³ In conflict zones, the effectiveness of such Universal Health Coverage (UHC) schemes is severely hampered by damaged infrastructure, provider reluctance to operate in insecure areas, and displacement of beneficiaries, potentially increasing financial hardship for health needs among affected populations.⁴¹ Hospitals near the India-Pakistan border are on high alert, with extra beds arranged and staff leave cancelled as precautionary measures.⁴⁵

6. The Indus Water Factor: Potential Health Repercussions

India’s suspension of the Indus Waters Treaty (IWT) on April 23, 2025, presents a grave, albeit indirect, health threat to Pakistan.² Reports indicate subsequent actions by India, such as unannounced water releases from the Uri Dam into the Jhelum River causing flooding in Muzaffarabad, and the closure of the Baglihar Dam on the Chenab River leading to significantly reduced water levels downstream in Pakistan.⁵

This weaponization of water can lead to severe water scarcity for drinking, sanitation, and agriculture in Pakistan. The long-term consequences include heightened food insecurity, malnutrition, an increased risk of water-borne diseases like cholera and typhoid (in a region already facing water quality challenges ⁶⁶), and potentially forced migration from affected agricultural areas. This degradation of primary freshwater resources could have cascading negative health outcomes for generations in Pakistan, far exceeding the immediate impacts of the armed conflict and potentially triggering further cross-border health security concerns if it leads to large-scale migration towards border regions.⁵

Table 2: Health Impacts of the 2025 India-Pakistan Escalation

Impact Category	Key Data/Observations from 2025 Conflict	Affected Areas (Examples)	Key Sources
Direct Casualties & Injuries	India: At least 15 civilians killed, 44+ injured in Poonch shelling.8 Pakistan: 31 civilians killed, 46+ injured from Indian strikes.4 Ongoing LoC firing causing casualties.4	Poonch, Uri (India); AJ&K, Punjab (Pakistan)	4
Healthcare Infrastructure & Service Disruption	Damage to medical clinic (Muridke, PK 4), Gurudwara, school (Poonch, IN 8). Hospitals on high alert, staff leave cancelled (India border states 45). Medical supply chain concerns.45 Cyberattacks on health/emergency service websites.56	Border districts India/Pakistan, Muridke (PK)	4
Displacement & Related Health Issues	Thousands displaced in India (Poonch, Uri 32), dozens of families in AJ&K.24 Shelters in schools.24 Poor WASH, overcrowding risk disease outbreaks (cholera, typhoid 38). Basic needs (food, water, medicine) provided in some camps.52	LoC areas (India & Pakistan), Poonch (IN), Haveli (PK)	24
Disease Surveillance & Immunization Disruption	Polio campaigns in Pakistan face greater insecurity, access issues in conflict zones.37 Risk of WPV1 spread via IDPs. Rajasthan preparing for bioterrorism.55 ODA cuts already weakened surveillance.41 Cyberattacks on health data systems.56	KP, Balochistan (PK), Rajasthan (IN), border areas	37
Mental Health Impact	Widespread anxiety, fear, PTSD risk.30 Children: trauma, developmental regression, school closures.34 IDPs: high stress, limited MHPSS.28 Media sensationalism fueling anxiety.20	General population, border residents, IDPs, children	20
National Health Program & Resource Strain	Increased defense spending (India 58; Pakistan 46) potentially cutting health/social budgets.25 India health budget growth modest, primary care underfunded.60 Pakistan’s Sehat Sahulat faces sustainability issues.63 UHC schemes at risk in conflict zones.	National level, impacting state/provincial allocations	25
Indus Water Treaty Suspension Impact	Reduced river flows to Pakistan (Jhelum, Chenab 5). Risk to water security, agriculture, sanitation. Long-term: food insecurity, malnutrition, water-borne diseases in Pakistan.5	Pakistan (esp. Punjab, Sindh dependent on Indus basin)	2

Charting a Course Through the Storm: Towards Health Security and Resilience

Addressing the multifaceted health crisis spawned by the 2025 India-Pakistan conflict and amplified by global health threats demands a robust, integrated strategy. An effective health response necessitates a “twin-track” approach: immediate humanitarian relief for acute needs (injuries, displacement, outbreaks) combined with simultaneous strengthening of underlying health systems and public health capacities to build long-term resilience against future shocks, be they conflict, climate change, or pandemics. Focusing solely on acute relief will perpetuate a cycle of recurrent crises.

Key areas for action include:

• Strengthening Health Systems in Fragile Settings: This requires investing in resilient health infrastructure, particularly in border areas, capable of withstanding shocks with backup power and pre-positioned supplies.⁸ A renewed focus on primary healthcare, currently underfunded in some areas ⁶⁰, is crucial as the first line of defense. Protecting and supporting the health workforce through incentives and mental health services is paramount.⁴¹ Flexible service delivery models like mobile clinics and telehealth should be expanded to reach isolated populations.²⁷
• Prioritizing Public Health Interventions: Rapid deployment of WASH facilities in IDP camps is essential to prevent water-borne disease outbreaks.²⁴ Enhanced disease surveillance in high-risk areas, coupled with targeted immunization campaigns for polio and measles among vulnerable groups like IDPs, must overcome access and security challenges.³⁷ Nutrition support for children and pregnant/lactating women among the displaced is critical to prevent malnutrition.⁵⁴
• Addressing the Mental Health Epidemic: MHPSS must be integrated into all humanitarian responses.²⁸ This includes training primary healthcare workers in psychological first aid, establishing safe spaces for children in affected communities, countering stigma, and developing long-term strategies for intergenerational trauma.²⁶
• International Cooperation, Humanitarian Aid, and De-escalation: Unimpeded humanitarian access to all affected populations is vital.²⁴ Increased international funding for health and humanitarian responses is needed to counter existing ODA shortfalls and meet new demands.³⁸ Diplomatic efforts by international actors to de-escalate tensions and facilitate dialogue are crucial.⁵ The current crisis also presents an opportunity for regional health diplomacy, potentially spearheaded by neutral international organizations, to establish localized deconfliction zones for health services or safe passage for medical personnel and supplies. While broader political de-escalation may be protracted, such health-focused agreements could serve as vital confidence-building measures. Independent investigations into attacks affecting civilians are also warranted.⁶⁸

Conclusion: An Urgent Call for Integrated Action to Avert Deeper Crisis

The events of 2025 have starkly illuminated the perilous intersection of regional conflict and global health vulnerabilities in South Asia. The India-Pakistan military escalation has not only resulted in direct casualties and displacement but has also dangerously amplified pre-existing threats from climate change, antimicrobial resistance, a pervasive mental health crisis, and systemic weaknesses in healthcare delivery. The human cost is already substantial and risks escalating further, disproportionately impacting the most vulnerable communities in border regions and among the displaced.

The analysis reveals that solutions cannot be uni-dimensional. A purely military or solely medical response will prove inadequate. What is urgently required is a multi-sectoral, integrated approach that concurrently addresses the geopolitical drivers of the conflict, strengthens public health infrastructure, ensures sustained humanitarian access and funding, invests decisively in long-term health security measures (including AMR control, climate adaptation in health, and pandemic preparedness), and elevates mental health to a core priority.

The failure to effectively manage this intertwined health and conflict crisis in South Asia will have devastating immediate consequences and set a dangerous precedent for how future regional conflicts might unfold in an era of accelerating global health challenges. True, sustainable health security in South Asia remains unattainable without addressing the root causes of the India-Pakistan conflict and fostering robust regional cooperation on shared health threats. Without such a paradigm shift, public health gains will remain fragile, perpetually at risk of being undone by political instability. Therefore, an immediate de-escalation of hostilities, backed by robust international support for comprehensive humanitarian and health responses, and a renewed commitment from both India and Pakistan to protect civilian lives and prioritize the health and well-being of their populations, are imperative to avert a deeper, more protracted crisis.

References

1. 2025 Health Radar: 6 Priorities, Issues and New Developments …, accessed on May 9, 2025, https://assist360.org/2025-health-radar-6-priorities-issues-and-new-developments/
2. India and Pakistan face a new crisis. Here’s a look at their history of armed conflict – AP News, accessed on May 9, 2025, https://apnews.com/article/india-pakistan-kashmir-pahlagam-loc-c657a7c7ad14440b03f5f75887922b0b
3. 2025 India–Pakistan border skirmishes – Wikipedia, accessed on May 9, 2025, https://en.wikipedia.org/wiki/2025_India%E2%80%93Pakistan_border_skirmishes
4. Pulling India and Pakistan Back from the Brink | International Crisis Group, accessed on May 9, 2025, https://www.crisisgroup.org/asia/south-asia/india-pakistan-india-pakistan-kashmir/pulling-india-and-pakistan-back-brink
5. 2025 India–Pakistan standoff – Wikipedia, accessed on May 9, 2025, https://en.wikipedia.org/wiki/2025_India%E2%80%93Pakistan_standoff
6. Launch of the Lancet commission report side event on adolescent health and wellbeing, accessed on May 9, 2025, https://www.who.int/news-room/events/detail/2025/05/21/default-calendar/launch-of-the-lancet-commission-report-side-event-on-adolescent-health-and-wellbeing
7. 2025 Lancet Report: Tracking progress on health and nutrition …, accessed on May 9, 2025, https://www.countdown2030.org/countdown-news/2025-lancet-report-tracking-progress-on-health-and-nutrition
8. 2025 India–Pakistan strikes – Wikipedia, accessed on May 9, 2025, https://en.wikipedia.org/wiki/2025_India%E2%80%93Pakistan_strikes
9. India fires missiles on Pakistan in what Islamabad calls ‘act of war’ – AP News, accessed on May 9, 2025, https://apnews.com/article/pakistan-india-missiles-border-tensions-21a2859557179f2b32d6b8d5628ac853
10. India-Pakistan tensions surge as both sides trade attack claims – Al Jazeera, accessed on May 9, 2025, https://www.aljazeera.com/news/liveblog/2025/5/9/live-india-pakistan-tensions-surge-as-both-sides-trade-attack-claims
11. Pakistan spreads lies on ATM closures, Air Force base attack & more: Here’s the truth you need to know – The Economic Times, accessed on May 9, 2025, https://m.economictimes.com/news/india/pakistan-spreads-lies-on-atm-closures-air-force-base-attack-more-heres-the-truth-you-need-to-know/articleshow/121018433.cms
12. Pakistani shelling devastates Jammu and Kashmir’s Poonch …, accessed on May 9, 2025, https://www.hindustantimes.com/india-news/pakistani-shelling-in-poonch-jammu-and-kashmir-border-districts-destroys-lives-homes-videos-101746782709386.html
13. Poonch Shelling: Villager Killed, 3 Injured in Pakistani Attack …, accessed on May 9, 2025, https://www.deccanherald.com/india/jammu-and-kashmir/villager-killed-3-injured-in-pakistani-shelling-in-poonch-evacuation-underway-3533000
14. PAHALGAM–India.Pakistan– After Action Brief, accessed on May 9, 2025, https://wp.nyu.edu/tischschoolofthearts-borderlands/loc001/
15. India Pakistan news highlights: Over 50 Pakistani drones shot down by air defence array across LoC, accessed on May 9, 2025, https://www.hindustantimes.com/india-news/operation-sindoor-live-updates-pakistan-terror-camp-latest-news-today-8-may-2025-pahalgam-attack-india-iaf-pm-modi-101746663263987.html
16. How It Fell to the Gulf States to Be India-Pakistan Peace-Brokers | TIME, accessed on May 9, 2025, https://time.com/7284375/india-pakistan-kashmir-conflict-gulf-states-diplomacy-peace-brokers-war/
17. Not taking India-Pakistan escalation seriously a ‘huge risk,’ warns conflict expert | Connecticut Public, accessed on May 9, 2025, https://www.ctpublic.org/2025-05-08/not-taking-india-pakistan-escalation-seriously-a-huge-risk-warns-conflict-expert
18. India-Pakistan Conflict: A Geopolitical Powder Keg with Global Implications – Discovery Alert, accessed on May 9, 2025, https://discoveryalert.com.au/news/india-pakistan-conflict-geopolitical-implications-2025/
19. Pak fires missiles by night, fake videos by day in coordinated social media war – India Today, accessed on May 9, 2025, https://www.indiatoday.in/india/story/india-pakistan-conflict-disinformation-fake-social-media-video-army-attack-sindoor-2721971-2025-05-09
20. War Fog and Unverified Claims Fuel India-Pakistan Tensions – The …, accessed on May 9, 2025, https://theraisinahills.com/war-fog-and-unverified-claims-fuel-india-pakistan-tensions/
21. Climate Adaptation in South Asia – The Salata Institute, accessed on May 9, 2025, https://salatainstitute.harvard.edu/projects/strengthening-resilience-in-south-asia/
22. The Lancet: More than 39 million deaths from antibiotic-resistant …, accessed on May 9, 2025, https://www.healthdata.org/news-events/newsroom/news-releases/lancet-more-39-million-deaths-antibiotic-resistant-infections
23. reports.weforum.org, accessed on May 9, 2025, https://reports.weforum.org/docs/WEF_Targeted_Action_and_Financing_the_Fight_Against_Antimicrobial_Resistance_in_Asia_2025.pdf
24. Humanitarian Situation Update: India-Pakistan Tensions (as of 7 …, accessed on May 9, 2025, https://reliefweb.int/report/pakistan/humanitarian-situation-update-india-pakistan-tensions-7-may-2025
25. Is India and Pakistan Financially Ready For A War In 2025? – Juris Hour, accessed on May 9, 2025, https://www.jurishour.in/columns/india-pakistan-financially-war/
26. Global Mental Health in Asia 2025 Symposium, accessed on May 9, 2025, https://www.duke-nus.edu.sg/sdghi/our-work/global-mental-health/global-mental-health-in-asia-2025-symposium
27. Southeast Asian Healthcare trends in 2025 – Blueprint Ventures, accessed on May 9, 2025, https://www.blueprint.vc/blog/southeast-asian-healthcare-trends-in-2025
28. Refugee and migrant mental health – World Health Organization (WHO), accessed on May 9, 2025, https://www.who.int/news-room/fact-sheets/detail/refugee-and-migrant-mental-health
29. Migrant Children Fleeing Violence Face New Dangers and Uncertainty at Mexico’s Northern Border, New Report Finds, accessed on May 9, 2025, https://www.savethechildren.net/news/migrant-children-fleeing-violence-face-new-dangers-and-uncertainty-mexicos-northern-border-new
30. Feeling anxious as India, Pakistan tensions escalate? How to calm yourself down, accessed on May 9, 2025, https://www.indiatoday.in/health/story/india-pakistan-tension-calm-yourself-down-feeling-anxious-depression-trauma-ptsd-2721999-2025-05-09
31. The psychological toll of a war-like situation on common man – India Today, accessed on May 9, 2025, https://www.indiatoday.in/lifestyle/wellness/story/the-psychological-toll-of-a-india-pakistan-war-like-situation-on-common-man-2721174-2025-05-09
32. ‘Don’t want war’: Kashmiri towns caught in deadly India-Pakistan crossfire – Al Jazeera, accessed on May 9, 2025, https://www.aljazeera.com/features/2025/5/8/dont-want-war-kashmiri-towns-caught-in-deadly-india-pakistan-crossfire
33. Fear, uncertainty, anxiety: Here’s how to keep calm amid border tension | Health News, accessed on May 9, 2025, https://www.business-standard.com/health/fear-anxiety-india-pakistan-border-mental-health-war-preparedness-125050701228_1.html
34. When Borders Silence Classrooms: The Impact of India-Pakistan …, accessed on May 9, 2025, https://reflections.live/articles/5673/when-borders-silence-classrooms-the-impact-of-india-pakistan-tensions-on-education-article-by-mannat-thukral-22004-mafmmsz7.html
35. ANCIPS 2025 – SYMPOSIA – PMC – PubMed Central, accessed on May 9, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC11932177/
36. Refugee health – the impact of recent global events | Medicine Today, accessed on May 9, 2025, https://medicinetoday.com.au/mt/2025/april/regular-series/refugee-health-%E2%80%93-impact-recent-global-events
37. Statement of the forty-first meeting of the Polio IHR Emergency Committee, accessed on May 9, 2025, https://www.who.int/news/item/10-04-2025-statement-of-the-forty-first-meeting-of-the-polio-ihr-emergency-committee
38. 2025 appeals – World Health Organization (WHO), accessed on May 9, 2025, https://www.who.int/emergencies/funding/health-emergency-appeals/2025/2025-appeals
39. Multi-country outbreak of cholera, external situation report #25 -22 April 2025, accessed on May 9, 2025, https://www.who.int/publications/m/item/multi-country-cholera-outbreak–external-situation-report–25–22-april-2025
40. KP health dept asks MTIs to appoint focal persons for sharing dengue data – Dawn, accessed on May 9, 2025, https://www.dawn.com/news/1899664
41. Countries are already experiencing significant health system …, accessed on May 9, 2025, https://www.who.int/news/item/10-04-2025-countries-are-already-experiencing-significant-health-system-disruptions—who
42. APAC to face 11.1% medical trend increase in 2025: report | Healthcare Asia Magazine, accessed on May 9, 2025, https://healthcareasiamagazine.com/healthcare/news/apac-face-111-medical-trend-increase-in-2025-report
43. 2025 Global health care outlook | Deloitte Australia, accessed on May 9, 2025, https://www.deloitte.com/au/en/Industries/health-care/research/global-health-care-outlook.html
44. Vaccination coverage witnesses increase in recent polio drive – Newspaper – DAWN.COM, accessed on May 9, 2025, https://www.dawn.com/news/1908441/vaccination-coverage-witnesses-increase-in-recent-polio-drive
45. Centre Reviews National Health Preparedness Amid Border Tensions, Cancels Medical Staff Leave – ABP Live, accessed on May 9, 2025, https://news.abplive.com/business/centre-reviews-national-health-preparedness-amid-border-tensions-india-pakistan-tensions-1771092
46. Pakistan to increase defence spending by 18 pc in budget: Report – The Economic Times, accessed on May 9, 2025, https://m.economictimes.com/news/defence/pakistan-to-increase-defence-spending-by-18-pc-in-budget-report/articleshow/120929266.cms
47. Tensions escalate as Pakistan calls India’s operation ‘an act of war’ – VPM, accessed on May 9, 2025, https://www.vpm.org/npr-news/2025-05-07/tensions-escalate-as-pakistan-calls-indias-operation-an-act-of-war
48. India-Pak Border Disputes De-Escalation: An Economic Imperative – Taxscan, accessed on May 9, 2025, https://www.taxscan.in/india-must-prioritize-de-escalation-with-pakistan-to-safeguard-economic-progress/515944/
49. Blackouts, curfews, no leave, no lapse: Full-scale emergency mode at borders | India News, accessed on May 9, 2025, https://timesofindia.indiatimes.com/india/blackouts-curfews-no-leave-no-lapse-full-scale-emergency-mode-at-borders/articleshow/121011035.cms
50. Uneasy calm in J&K as India-Pak tension escalates, border residents move to safer places, accessed on May 9, 2025, https://www.newindianexpress.com/nation/2025/May/09/uneasy-calm-in-jk-as-india-pak-tension-escalates-border-residents-move-to-safer-places
51. Internally Displaced People – UNHCR, accessed on May 9, 2025, https://www.unhcr.org/about-unhcr/who-we-protect/internally-displaced-people
52. DC Poonch enquires about wellbeing of injured civilians; reviews provision of amenities at public shelter – JK MONITOR, accessed on May 9, 2025, https://jkmonitor.org/index.php/local-news/dc-poonch-enquires-about-wellbeing-of-injured-civilians-reviews-provision-of-amenities-at-public-shelter
53. DC Poonch enquires about wellbeing of injured civilians | Kashmir Reader, accessed on May 9, 2025, https://kashmirreader.com/2025/05/09/dc-poonch-enquires-about-wellbeing-of-injured-civilians/
54. UNHCR: Funding cuts threaten the health of nearly 13 million displaced people, accessed on May 9, 2025, https://www.unhcr.org/news/briefing-notes/unhcr-funding-cuts-threaten-health-nearly-13-million-displaced-people
55. Raj health dept gears up for bio threats amid Indo-Pak tensions …, accessed on May 9, 2025, https://timesofindia.indiatimes.com/city/jaipur/raj-health-dept-gears-up-for-bio-threats-amid-indo-pak-tensions/articleshow/120909525.cms
56. Two Battlegrounds: India-Pakistan Conflicts and DDoS attacks – Security Boulevard, accessed on May 9, 2025, https://securityboulevard.com/2025/05/two-battlegrounds-india-pakistan-conflicts-and-ddos-attacks/
57. Conflict in the Indian Kashmir Valley II: psychosocial impact – PMC – PubMed Central, accessed on May 9, 2025, https://pmc.ncbi.nlm.nih.gov/articles/PMC2577626/
58. Defence Budget 2025 disappoints, lacks the firepower India needs – The Economic Times, accessed on May 9, 2025, https://m.economictimes.com/news/defence/budget-2025-defence-budget-allocation-hiked-to-rs-6-81-lakh-crore/articleshow/117813752.cms
59. Indian defense budget boosted 9.5%, but analysts say pensions hindering weapons spending, accessed on May 9, 2025, https://breakingdefense.com/2025/02/india-budget-boosted-9-5-but-analysts-say-pensions-hindering-weapons-spending/
60. Population, Health, And The Union Budget 2025-26, accessed on May 9, 2025, https://www.impriindia.com/insights/population-health-union-budget-25-26/
61. From Pandemic To Progress: Where Does India’s Health Budget Stand In 2025?, accessed on May 9, 2025, https://www.impriindia.com/insights/indias-health-budget-stand/
62. Budget 2025: Govt extends Ayushman Bharat health cover to 1 Crore gig workers, accessed on May 9, 2025, https://m.economictimes.com/wealth/insure/health-insurance/budget-2025-govt-extends-ayushman-bharat-health-cover-to-1-crore-gig-workers/articleshow/119642113.cms
63. Health card programme’s success depends on its financial stability: study – Dawn, accessed on May 9, 2025, https://www.dawn.com/news/1908051
64. Sehat Card Plus – Social Welfare Program or Political Campaign? – Paradigm Shift, accessed on May 9, 2025, https://www.paradigmshift.com.pk/sehat-card/
65. Operation Sindoor India Pakistan Live: All shops, restaurants in Chandigarh to close by 7 PM today – The Economic Times, accessed on May 9, 2025, https://m.economictimes.com/news/newsblogs/operation-sindoor-india-pakistan-war-live-updates-jammu-kashmir-rajasthan-punjab-blackout-high-alert-in-india-army-navy-war-preparation-india-pakistan-lahore-latest-news-updates/liveblog/121011915.cms
66. WHO EMRO | Improving health care for Afghan refugees and host communities in Pakistan, accessed on May 9, 2025, https://www.emro.who.int/pak/pakistan-news/improving-health-care-for-afghan-refugees-and-host-communities-in-pakistan.html
67. Pakistan: Climate disasters increasing risks of death and disease amongst children and older people – new report – Amnesty International, accessed on May 9, 2025, https://www.amnesty.org/en/latest/news/2025/05/pakistan-climate-disasters-increasing-risks-of-death-and-disease-amongst-children-and-older-people-new-report/
68. India/Pakistan: Urgent need to protect civilians amidst escalating hostilities, accessed on May 9, 2025, https://www.amnesty.org/en/latest/news/2025/05/india-pakistan-urgent-need-to-protect-civilians-amidst-escalating/
69. News & stories | Doctors Without Borders – USA, accessed on May 9, 2025, https://www.doctorswithoutborders.org/latest?id=7182&cat=voice-from-the-field&f%5B0%5D=article_country_filter%3A95399&page=0