Richard Sullivan, Co-Director of the Centre for Conflict and Health Research, and Professor of Cancer and Global Health at King’s College London, shared a post on LinkedIn:
“Conflict is too often treated as an externality of health, in reality, it cuts across every major health agenda, shaping risks, responses and the feasibility of progress (Lancet 2026, Jan 3rd, 407:1).
A fair comment, but one that only captures part of the picture. Conflict is constantly evolving into new threats that require a more securitised agenda. The use of the dart frog biotoxin epibatidine to assassinate Alexi Navalny is just one form of hybrid threat in a long list (polonium-210, Novichok, etc.)
For over two decades, biotoxins have been a significant focus as potential weapons, and their increasing use poses serious challenges to national health system preparedness and response.
Many health systems around the world, particularly in the Western hemisphere, have little to no experience of conflict. ‘Hardening’ these systems is becoming a major pre-occupation for national planners. Health systems must expect to face complex hybrid assaults on physical, economic, psychological, and digital infrastructure. Normative preparedness planning for mass casualties will be insufficient.
Lessons from around the world reflect the need not only for better intelligence on health systems’ resilience but also for guidance on pre-emptive stress testing. We are not short of these lessons. The asymmetric attack targeting members of Hezbollah in Lebanon using booby-trapped pagers shines a light on how quickly accident and emergency departments over large areas can be overwhelmed. Ukraine is teaching countries about the cyber-bionexus vulnerabilities.
Our digital health services are exquisitely vulnerable to attack, and our populations to significant health disinformation. As digital warfare accelerates and the AI semantic web amplifies disinformation at scale, new expertise well beyond the standard orthodoxy of health systems planning will be needed.
Title: Building Resilient Health Systems Intelligence: Adapting Indicators of Compromise for the Cyber-Bionexus
Authors: Gemma Bowsher, Rose Bernard, Richard Sullivan
Conflict will create new securitised health challenges that need to be mainstreamed into health systems planning. ”
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