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The health of millions of people across the Eastern Mediterranean region is under siege. From Gaza to Sudan, war has torn through hospitals, displaced health workers and left civilians without access to the most basic services.

Across the region, attacks on healthcare are shattering records — accounting for nearly two-thirds of all incidents worldwide last year and 93 percent of all deaths documented this year. Health workers, facilities and patients are being deliberately targeted, undermining the very systems meant to save lives.

Children are missing vaccines, mothers are giving birth in bombed-out clinics and health workers are risking — and too often losing — their lives simply by showing up.

These horrors must not be allowed to stand.

Health — like peace — is a political choice. At every turn, we must choose peace. And we must choose health.

Yet even amid brutality, there is also progress — and hope. Ministries of health, communities and World Health Organization teams are driving reforms and innovations that save lives.

Health — like peace — is a political choice. At every turn, we must choose peace. And we must choose health

Dr. Hanan Balkhy

In 2024, Egypt was certified malaria-free, the third country in the region to reach that milestone. Pakistan launched an ambitious hepatitis C elimination program, while Jordan achieved global recognition for eliminating leprosy. And Sudan, despite its civil war, became the first country in Africa to introduce the malaria vaccine, protecting vulnerable children in high-risk areas.

The contrast is striking: on one side, hospitals reduced to rubble; on the other, breakthroughs in disease elimination and prevention.

This shows that progress is possible — even in the toughest circumstances — if we protect health systems and the people who sustain them.

Mental health tells the same story. Nearly one in six people in the region live with a mental disorder and needs are soaring in conflict zones. Yet regionwide suicide rates are falling; Libya has launched its first national mental health strategy; and 14 countries are scaling up community-based care. The challenge is to sustain these gains in the very places where trauma runs deepest.

Last year, three of the 10 deadliest extreme weather events — including heat waves and severe winter conditions — struck in the Eastern Mediterranean. Air pollution, unsafe water and food insecurity account for almost a quarter of the region’s disease burden. Still, 15 countries have pledged to build climate-resilient health systems and more than 120 cities are monitoring air quality. Progress is happening — but it must be accelerated.

Our communities deserve systems that can protect the vulnerable and give future generations a chance to thrive

Dr. Hanan Balkhy

Next week, health ministers will gather in Cairo for the 72nd session of the WHO Regional Committee, known as RC72, to take stock of progress on health in our part of the world. Member states face a defining choice: allow conflict and crisis to erode decades of health gains or commit to resilience, equity and long-term investment in health — including in emergencies.

Our region carries 37 percent of the world’s humanitarian burden, despite being home to just 9 per cent of its people. The world’s displacement crisis is also concentrated here: 57 percent of all refugees come from our region and 40 percent of all internally displaced people live within it.

Western countries’ recent reductions in foreign aid threaten to further deepen this strain, with their full impact only now starting to emerge.

Our communities deserve more than survival. They deserve systems that can withstand shocks, protect the vulnerable and give future generations a chance to thrive.

The real cost of inaction is measured not only in lives lost, but also in hope extinguished.

Even under siege, we can choose health. And at RC72, we must.

• Dr. Hanan Balkhy is the World Health Organization’s Regional Director for the Eastern Mediterranean.