Arab Spring’s harmful impact on health will be felt across the world ‘for many years’

The increased mortality rates seen in Syria, Yemen, Libya, Tunisia and Egypt since 2010 particularly threaten to “jeopardise health gains [made] over the past two decades” in the Middle East and wider region, a new study says.

Egyptians celebrate the resignation of president Hosni Mubarak in Tahrir Square in February 2011. Tara Todras-Whitehill / AP Photo

MARSEILLE // The Arab Spring, a wave of protests and uprisings that supporters believed would improve the lives of millions, has instead proved seriously harmful to health, according to a study for a British medical journal.

Life expectancy has been lowered in several countries in the Middle East and the wider detrimental effects will be felt across the region and worldwide for many years, says the Global Burden of Disease Study 2013 published by The Lancet Global Health on Wednesday night.

The authors warn that the increased mortality seen in Syria, Yemen, Libya, Tunisia and Egypt since 2010 particularly threatens to “jeopardise health gains [made] over the past two decades” in the Middle East and wider region.

Although some analysts believe it may be some years before an accurate appraisal of the Arab Spring is possible, the current outlook is bleak.

The uprisings started in Tunisia in December 2010 with mass demonstrations quickly spreading to other Arab countries. A year later, amid a backlash of hardline official responses and signs of growing extremism, the protests had given way to conflict in Syria and Libya.

The Lancet’s report on the consequences for health adds to the impression of a movement that has largely failed.

The finding that just two years into civil war the expected lifespan of Syrians had already been cut by several years will surprise few given the scale of the fighting and the violence of all parties involved.

But what is perhaps more shocking is the finding that by 2013 Syria had fallen behind sub-Saharan African countries in reducing child mortality.

“Life expectancy decline is traditionally regarded as a sign that the health and social systems are failing,” said Ali Mokdad, professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle, United States, who led the research.

“Recent conflicts have shattered the basic infrastructure in a number of countries. As a result, millions of people are facing dire water shortages and poor sanitation that will lead to disease outbreaks, which must be controlled.”

The effect on life expectancy varies across the 22 countries studied in the Middle East and wider region, with the Syrian example by far the most serious. By 2013, Syrian men expected on average to live to 69, compared with 75 three years earlier. The life expectancy of women also fell significantly, from 80 to 75 in the same period.

In Yemen, Egypt and Tunisia, the fall was less striking, about three months in each case, although Prof Mokdad pointed out that before the Arab Spring people in the Middle East had been living longer year on year.

“This region has historically seen improvements in life expectancy and other health indicators, even under times of stress,” Prof Mokdad said. “But the Arab uprising has evolved into complex wars that have killed hundreds of thousands of people and displaced millions.

The analysis also found evidence of infant mortality rates rising in some countries in the Middle East. This was again most striking in Syria where infant deaths fell annually by an average of six per cent in the decade before 2010 but rose by just over nine per cent a year between then and 2013.

The study does not look at what has happened in the Middle East since the start of 2014 beyond acknowledging that new or growing conflicts and unrest means the problems can only have escalated in several countries in the region, especially Yemen, Lebanon, Afghanistan, Iraq and Somalia.

“Along with population growth and ageing, these ongoing conflicts have dramatically increased the burden of chronic diseases and injuries and many health workers have fled for safer shores,” said Prof Mokdad.

He warned that deteriorating health conditions were consequently likely to continue in many countries across the region for several years, adding to the strain on already scarce resources.

People across the Middle East were found by the study to face increasing threats from chronic diseases. The leading causes of premature death and health loss changed between the 1990s – a decade chosen for comparative purposes – and 2013 from communicable conditions such as diarrheal diseases or tuberculosis to non-communicable diseases, notably heart disease, diabetes and strokes.

This latest study is not the first time academics have identified unwelcome consequences of the Arab Spring.

In a 2013 study on the Arab Spring for the American University of Beirut, Shaden Khallaf, a lecturer on migration and refugee studies, said that some of what had taken place in the Middle East since the end of 2010 had shown the limits of what can be achieved in terms of democratic reform.

“Democracy is not synonymous with human rights and democratically elected governments or authorities do not necessarily guarantee greater respect for the rights and dignity of all,” she wrote.

“It is possible that democratically elected postrevolutionary parliaments pass legislation which negatively impacts human rights according to international standards.”