A new report released by Costs of War sheds light on the devastating indirect toll of war on human health in Afghanistan, Iraq, Pakistan, Syria, Yemen, Libya and Somalia, countries which have experienced the most violent wars in which the U.S. has been involved in the name of counterterrorism since 2001.

The total death toll in the post-9/11 war zones of Afghanistan, Pakistan, Iraq, Syria, and Yemen could be at least 4.5-4.6 million and counting, though the precise mortality figure remains unknown. Some of these people were killed in the fighting, but far more, especially children, have been killed by the reverberating effects of war, such as the spread of disease. These latter indirect deaths – estimated at 3.6-3.7 million – and related health problems have resulted from the post-9/11 wars’ destruction of economies, public services, and the environment. Indirect deaths grow in scale over time. Though in 2021 the United States withdrew military forces from Afghanistan, officially ending a war that began with its invasion 20 years prior, today Afghans are suffering and dying from war-related causes at higher rates than ever.

This report examines the devastating toll of war on human health, whoever the combatant, whatever the compounding factor, in the most violent conflicts in which the U.S. government has been engaged in the name of counterterrorism since September 11, 2001, including in the above countries as well as Libya and Somalia. The report does not focus on attributing responsibility to particular warring parties over others, or to disentangling various intensifying factors, such as the actions of authoritarian governments, related political upheavals, global economic sanctions, climate change, environmental disasters, or the accumulating devastations of previous wars. Rather than teasing apart who, what, or when is to blame, this report will show that the post-9/11 wars are implicated in many kinds of deaths. In a place like Afghanistan, the pressing question is whether any death can today be considered unrelated to war. Ultimately, the impacts of the ongoing violence are so vast and complex that they are unquantifiable.

In laying out how the post-9/11 wars have led to illness and indirect deaths, the report’s goal is to build greater awareness of the fuller human costs of these wars and support calls for the United States and other governments to alleviate the ongoing losses and suffering of millions in current and former war zones. The report highlights many longterm and underacknowledged consequences of war for human health, emphasizing that some groups, particularly women and children, suffer the brunt of these ongoing impacts.

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