Equitable Access in Conflict Settings

Recent global health emergencies – from COVID-19 to Mpox and the re-emergence of polio – have exposed systemic failures in achieving timely and equitable access to Medical Countermeasures (MCMs), including vaccines, therapeutics, and diagnostics. These challenges are particularly acute in fragile and conflict-affected settings, where health systems are degraded, supply chains disrupted, and public health governance often weak or contested – all of which severely constrain the timely deployment and delivery of MCMs.

Across the end-to-end value chain – from upstream Research and Development (R&D) to downstream delivery – fragile and conflict-affected settings are often not taken into account or structurally invisible. Barriers include the absence of these settings from global manufacturing strategies, fragmented governance structures that hinder coordinated deployment, or security risks for health actors.

These are not merely operational difficulties – they represent questions of global design, governance, and cooperation. As the Pandemic Agreement has been adopted by the World Health Organization (WHO) Member States in May this year and as new mechanisms like the WHO interim Medical Countermeasures Network (i-MCM-Net) grow to strengthen pandemic preparedness and response, there is a critical opportunity to structurally integrate realities of fragile and conflict-affected settings.