Public health research priorities 

Introduction: 

Syria’s protracted conflict (2011–2025) and recent disasters (e.g. the February 2023 earthquake) have devastated the health system and resulted in one of the world’s worst humanitarian crises. Over 7 million Syrians are internally displaced as of 2023, and 16+ million require humanitarian health assistance. The war has fragmented health services and destroyed infrastructure – as of 2025 only 57% of hospitals and 37% of primary health centers are fully functional. More than 50% of health facilities have been damaged or destroyed, and up to 70% of the health workforce has left the country. Despite these challenges, a growing body of research during the conflict has shed light on Syria’s health needs; however, significant geographic and thematic gaps remain. Existing studies have focused heavily on communicable diseases and mental health, often in accessible areas like Damascus or the northwest, while critical topics (e.g. NCDs, injury epidemiology, health system governance) and certain regions (northeast, besieged areas) are under-researched. This national research agenda is a strategic roadmap to guide post-conflict and post-disaster health research in Syria, emphasizing population health and the needs of internally displaced persons (IDPs), returning populations, and the general public. It aligns with policy-oriented goals for recovery and is intended to inform international donors, academic institutions, humanitarian agencies, and Syrian health authorities. Each theme below outlines key evidence to date, identifies gaps, and proposes forward-looking research priorities to rebuild a resilient, equitable Syrian health system.  

1. Infectious Diseases

Syria’s fragile post-conflict landscape has witnessed recurrent outbreaks of cholera, measles, polio, and leishmaniasis, largely driven by collapsed WASH systems, low immunization coverage, and fragmented disease surveillance. Research should prioritize harmonizing early warning systems, restoring vaccination programs, and evaluating community-based epidemic response models in underserved and displaced populations.

2. Non-Communicable Diseases (NCDs)

NCDs represent a silent crisis in Syria’s health system, with disrupted continuity of care, medicine shortages, and a near absence of chronic disease registries. Priorities include mapping the burden of NCDs, piloting chronic care delivery models in insecure areas, and rebuilding decentralized oncology services beyond Damascus.

3. Mental Health and Psychosocial Support

Prolonged exposure to war, displacement, and loss has left millions with PTSD, depression, and anxiety, especially among IDPs and children. Research must shift toward intervention trials, scalable psychosocial support programs, and integration of mental health services into primary care using task-shifting and mhGAP-aligned models.

4. Maternal, Newborn, and Child Health (MNCH)

Maternal and child health services have deteriorated severely, with rising maternal mortality, poor immunization coverage, and acute child malnutrition. Research priorities include evaluating emergency obstetric care access, rebuilding neonatal and vaccination services, and strengthening reproductive health support for displaced and returning populations.

5. Disability and Rehabilitation

The war has created an unprecedented burden of disability—particularly amputations and spinal injuries—yet rehabilitation services remain scarce and centralized. Urgent research is needed to map needs, test scalable community-based rehabilitation approaches, and evaluate the effectiveness of assistive technology in post-conflict, low-resource settings.

6. Emergency and Trauma Medicine

Mass trauma and repeated disasters exposed critical gaps in Syria’s emergency response and prehospital care. Research should assess trauma system capacity, design formal EMS systems, and extract lessons from the 2023 earthquake and war-era mass casualty events to inform future disaster preparedness.

7. Health System Integration and Resilience

Syria’s health system remains fragmented by political divisions, aid asymmetries, and mistrust. Research must evaluate pathways to integrate parallel systems, build local governance structures, and test models for equitable, decentralized service delivery under conditions of fiscal constraint and ongoing instability.

8. Surveillance and Health Information Systems

Dual disease surveillance networks (EWARS and EWARN) remain functionally siloed, undermining early outbreak detection. Research priorities include piloting merged systems, standardizing case definitions and alert thresholds, and strengthening local capacity for data collection, validation, and real-time use in health policy.

9. Environmental Health and WASH

Environmental degradation, unsafe water, and poor waste management have led to large-scale public health risks, including Syria’s 2022 cholera outbreak. Research should evaluate the health impact of WASH interventions, investigate war-related pollution exposure, and integrate climate risk into post-disaster health system planning.

10. Digital Health and AI Innovations

Digital and AI tools offer potential to overcome workforce and infrastructure deficits, particularly through telemedicine, EHRs, and predictive analytics for outbreak control. Research must identify which technologies are context-appropriate, cost-effective, and scalable in fragile settings with intermittent connectivity and low digital literacy.

11. Capacity-Building and Health Workforce

The depletion of Syria’s health workforce remains a central bottleneck to recovery. Priority research areas include evaluating training models for rapid upskilling, strategies for diaspora re-engagement, and partnerships that build sustainable in-country research and academic capacity to lead Syria’s health transformation.

Conclusion:
Syria’s protracted conflict has not only decimated its health infrastructure but has also fractured its research systems, resulting in a dangerous vacuum of data-driven decision-making. The research priorities outlined in this agenda offer a pragmatic and context-sensitive roadmap to rebuild the health sector with evidence at its core. From re-establishing surveillance systems and chronic care models to integrating digital health and addressing the mental scars of war, each theme reflects urgent, actionable gaps that demand investment. Importantly, this agenda centers the voices of Syrian professionals and promotes local research leadership as essential to sustainable recovery. For donors, academic institutions, and policymakers, the path forward is clear: Syria’s health recovery must be guided not by assumptions or political expediency, but by robust, inclusive, and nationally grounded research.

Author: MHD Bahaa Aldin Alhaffar