Following Iranian missile attacks on Dubai,  a major global logistics and humanitarian hub, WHO is struggling to revive the traffic of medicines and health care supplies in and around the Middle East and African regions most served by the hubs, a WHO official said on Wednesday. 

“We have managed to do a pharmaceutical shipment to Africa yesterday using commercial air transport, and we have started to receive inbound replenishment through alternative ports,” said Paul Molinaro, head of WHO Operations Support and Logistics, speaking at a WHO briefing on Wednesday. 

“And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can.” 

But he warned that the ripple effect of the conflict on Gulf countries like the United Arab Emirates, one of the world’s leading hubs for trade in fertilizer and pharma supplies, is only just beginning to be felt. And beyond the immediate shocks to emergency deliveries of humanitarian relief, the crisis is likely to translate into higher longterm prices for fertilizer, foods and pharmaceutical supplies – hitting hard at low and middle-income regions. 

“When it comes to WHO, I think we’re more like the canary in the coal mine, given the vulnerability and the fragility and the conflict areas that we operate on,” said Molinaro. “And certainly there we start to feel the effects of shortages as a provider of first response, and in many cases, unfortunately, as a provider of last resort.” 

However, it is the mid and short-term consequences that he is even more worried about. 

“The longer this goes on, I think the more we’ll be receiving an education just on how dependent some of our processes are on this part of the world.”

World Food Programme warns of growing hunger    

His comments came in the wake of a World Food Programme report Tuesday that warned nearly 45 million more people could fall into acute food insecurity, or worse, if the current Gulf conflict does not end by the middle of the year, and if oil prices remain above $100 a barrel. 

“These would add to the 318 million people around the world who are already food insecure,” stated the WFP in a press release, warning that the Middle East crisis could push the number of food–insecure people to levels last seen in 2022 at the start of the Ukraine war. .  

When the Ukraine war began in 2022, triggering a cost of living crisis, global hunger reached record levels with 349 million people impacted, WFP noted, adding that “during the 2022 period, food prices were fast to spike but slow to come down. This meant that vulnerable families already struggling with hunger were priced out of staple food items almost overnight, and for extended periods of time.”

While in 2026, the conflict involves a global energy hub and not a breadbasket region, the potential impact is similar because energy and food markets are tightly correlated, the WFP warned.

Fertilizer, food, and pharma trade all impacted 

Molinaro’s remarks echoed similar concerns.

“Something to keep an eye on is phosphates and its input into fertilizer,” he said. “Some countries are 50-60% reliant on products from this region for fertilizer and then, obviously, for medical equipment, plastics.  This hasn’t necessarily been felt yet, because, again, that will take time to come through the system. 

“Another question we’ve been looking at is around vaccines and biologicals,” he added. “It is not necessarily an issue around the production, but certainly the Gulf region and the carriers are critical components of international logistics, particularly in air freight. 

“We have a lot of life sciences based in the region, and carriers dealing with time-sensitive and temperature-controlled [products].”

Logistic pressures will lead to price rises – even if short-term solutions are found 

With the development of alternative logistics routes, WHO’s capacity for delivering urgent humanitarian relief is slowly coming back online, Molinaro said.

“We are working with the Dubai humanitarian hub and other partners like WP, UNICEF and the Red Crescent to consolidate our shipments. And hopefully we’ll start putting out the mix of air charter, road, sea, particularly to Lebanon to Afghanistan, to Sudan and to Gaza, and get that back on track as soon as we can.  

“With these kinds of systems, it takes time to reboot and to jumpstart the engine, but I’m pretty confident, given the creativity we’ve shown with the humanitarian community and the different organs of the UAE that we will manage to circumvent this in the short term.”

But the ongoing war pressures on logistics will inevitably lead to price rises, he warned.

“Obviously you have different alternative routings. What happens there is you will get congestion, and you will get price rises. 

“Now I’m sure pharmaceutical companies and other medical companies have been doing in the last week or two exactly what our teams have been doing and scrambling to find out what we have at sea, what’s inbound, what our pending orders, and then trying to find solutions to that.

“Certainly…wealthier, more developed countries will have a buffer, of course, least developed countries may have issues.

Sub-Saharan Africa and Asia most vulnerable 

According to WFP’s analysis, countries in sub-Saharan Africa and Asia are the most vulnerable due to a reliance on food and fuel imports. Projections indicate an increase of 21% in food-insecure people for West and Central Africa and 17% for East and Southern Africa. An increase of 24% is forecast for Asia.

Sudan, for example, imports around 80% of its wheat – a higher price for this staple will push more families into hunger. In Somalia, a country in the midst of severe drought, the price of some essential commodities has risen by at least 20 percent since the conflict began, according to local reports. Both are countries with high levels of food insecurity that have also experienced famine in recent years. 

 “If this conflict continues, it will send shockwaves across the globe, and families who already cannot afford their next meal will be hit the hardest,” said WFP Deputy Executive Director and Chief Operating Officer Carl Skau, who met reporters at a UN press briefing in Geneva Tuesday following a recent tour of Lebanon. “Without an adequately funded humanitarian response, it could spell catastrophe for millions already on the edge.”

Growing toll of the conflict 

In the third week of the war that began with a joint US-Israeli attack on Iran’s Islamic regime, killing the longtime Supreme Leader Ayatollah Khameini, more than 1400 civilian deaths have been reported by Iran’s government, almost 900 in Lebanon and 20 in Israel. Three West Bank Palestinians were also killed when an Iranian missile hit there home near Hebron on Wednesday night, media reports said. Thousands of people have also been injured in all three countries. 

Up to 3.2 million Iranians have been displaced and over 1 million people in Lebanon. Tens of thousands of Israelis, mainly living along the northern border with Lebanon, have also left their homes since the Lebanese Hezbollah militia, an Iranian ally, joined in the hostilities on 2 March. Displaced Lebanese are living in overcrowded conditions in shelters, while millions of Israelis also are spending long hours camped in parking garages and shelters underground sheltering from the more than 1000 Iranian missiles and Hezbollah rockets fired since the war began.

Crowding associated with displacement has the potential to rapidly increase health risks, WHO said. 

And in Syria, more than 100 000 people have recently arrived from Lebanon – a striking reverse migration after years of Syrian civil war.  

In Lebanon, WHO has verified 28 attacks, with 30 deaths and 25 injuries. In Iran, WHO has verified 20 attacks, with nine deaths. And in Israel, WHO has verified two attacks on health care. 

WHO denied, however, reports that East Jerusalem’s Al Makassad Hospital, the leading referral hospital for the Occupied West Bank had been put out of operations following a missile strike near the facility on 1 March.

 

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Responding to a question from Health Policy Watch, a WHO spokesperson said, “According to Al-Makassed Hospital, fragments landed near the hospital and not within the premises. The incident caused fear and anxiety among staff and patients. The hospital remains fully operational, functioning at full capacity, and services have not been disrupted.”

Image Credits: World Food Programme , Mohammed Jamal / UNICEF.