This Perspective examines how the destruction of healthcare systems in armed conflict produces enduring public health harm and broad human insecurity. Drawing on social medicine, sociological theory, governance scholarship, and field observations from Afghanistan, it argues that attacks on healthcare infrastructure and personnel result in not only the loss of clinical services but also in the erosion of social and moral worlds of care. The paper advances three interrelated claims: first, that healthcare institutions function both as clinical and social infrastructures; second, that their destruction generates disproportionate psychosocial, gendered, and intergenerational harms extending far beyond immediate morbidity and mortality; and third, that the persistence of such attacks reflects abject failures in international protection and accountability mechanisms. Particular attention is given to the consequences for women and children, including preventable death, disability, and psychosocial distress with constrained possibilities for recovery and social ways of belonging. These harms are compounded by weakened international accountability, which has increasingly normalised attacks on healthcare as a feature of war rather than a violation demanding intervention.
Keywords: war and health, structural violence, health systems in conflict, Responsibility to Protect, health and human security Citation: Madan A. The destruction of healthcare in armed conflict: policy implications and accountability. Academia Medicine and Health 2026;3. https://doi.org/10.20935/AcadMedHealth8372
