October 28, 2025 : A disease once nearly eradicated through routine vaccination — diphtheria — is now making a worrying comeback, especially in war-torn and unstable nations. Health experts warn that collapsing healthcare systems, widespread displacement, and disrupted immunization drives are allowing this deadly but preventable infection to resurface, threatening millions of vulnerable children.
According to the World Health Organization (WHO), global diphtheria cases have surged sharply in the past two years, with outbreaks reported in regions of Africa, the Middle East, and Southeast Asia. Conflict-affected countries like Sudan, Yemen, Afghanistan, and Myanmar are among the worst hit, where routine childhood immunizations have dropped to critical lows.
What Is Diphtheria?
Diphtheria is a bacterial infection caused by Corynebacterium diphtheriae. It primarily affects the throat and upper airways, producing a toxin that can lead to severe breathing problems, heart failure, and nerve damage. The disease spreads easily through respiratory droplets when an infected person coughs or sneezes.
While diphtheria once caused devastating global epidemics, the introduction of the DTP (diphtheria-tetanus-pertussis) vaccine in the 1940s reduced cases by over 90%. However, WHO experts caution that “decades of progress risk being undone” as conflicts and humanitarian crises erode vaccination coverage.
War and Disease: A Dangerous Combination
In war-torn regions, health systems often collapse under the pressure of conflict, leaving millions without access to vaccines, antibiotics, or clean medical facilities.
Dr. Maria Van Kerkhove, WHO’s technical lead on infectious diseases, said, “When health infrastructure breaks down, preventable diseases like diphtheria are among the first to re-emerge. Children in refugee camps and overcrowded shelters are particularly at risk.”
In Sudan, the ongoing civil conflict has displaced over 8 million people and destroyed major hospitals. Vaccination programs have been interrupted for months, with local health officials reporting a fivefold rise in diphtheria cases in 2024 compared to the previous year. Similarly, Yemen, already struggling with cholera and malnutrition, has seen hundreds of suspected diphtheria cases since the start of 2025.
Children Face the Greatest Danger
Children under the age of 10 remain the most affected, largely due to missed routine immunizations. The UNICEF regional health coordinator for the Middle East, Dr. Layla Hassan, emphasized that “each missed vaccine is a child left defenseless.”
In displacement camps, crowded conditions and poor hygiene make diphtheria spread rapidly. Malnutrition — another side effect of war — weakens immunity, making infections more severe and harder to treat.
Parents often face heartbreaking choices. Many are unable to reach functioning clinics or afford medical care. “We have families walking for days to find antibiotics or antitoxins, only to discover there are none available,” said a Red Cross health worker in Yemen.
Vaccine Shortages and Logistic Hurdles
Even when aid organizations manage to supply vaccines, delivering them safely is a challenge. Many areas lack refrigeration facilities to store vaccines, and transport routes are blocked or too dangerous.
Dr. Thomas Lemoine from Doctors Without Borders (MSF) explained, “Our teams often travel under fire to reach isolated populations. Sometimes, vaccines spoil before they reach children. In some regions, only 1 in 4 children have received full DTP doses.”
Moreover, misinformation and distrust — fueled by years of conflict — have made communities skeptical of vaccination campaigns. Rumors linking vaccines to foreign agendas or infertility have further reduced uptake.
The Global Implications
Public health experts warn that the diphtheria resurgence in conflict zones could spill over into neighboring countries. Refugee movements, porous borders, and weak disease surveillance systems make containment difficult.
In 2025, WHO reported diphtheria importations in India, Bangladesh, and Uganda traced back to conflict-affected regions. “No country is immune when vaccination gaps widen,” the WHO said in a recent briefing.
Rebuilding Trust and Health Systems
Experts stress that ending the diphtheria resurgence will require a multi-layered response:
- Emergency vaccination campaigns targeting unprotected children in conflict and border zones.
- Restoring health infrastructure, including cold chains and clinics.
- Training local health workers to identify and treat early symptoms.
- Combating misinformation through trusted community leaders.
UNICEF has launched mobile immunization units in parts of Africa and the Middle East to reach children in conflict areas. “Every shot counts,” said UNICEF’s Executive Director Catherine Russell. “If we fail to vaccinate now, we risk repeating the epidemics of the early 20th century.”
Hope Amid Crisis
Despite the grim statistics, some countries have shown progress. In Bangladesh and Ethiopia, emergency health programs supported by global partners have restored over 80% vaccination coverage in refugee camps. Community health volunteers are also helping educate families about the importance of routine immunization.
Dr. Hassan believes hope lies in global solidarity: “If the world acts quickly — by funding vaccine drives, supporting health workers, and prioritizing children — we can stop diphtheria’s return before it becomes a full-blown global crisis.”
Takeaway
Diphtheria’s resurgence is a reminder that diseases long thought defeated can return when health systems fail. For children trapped in war and poverty, vaccines are not just protection — they are a lifeline. Rebuilding trust, healthcare access, and international cooperation remains crucial to preventing another deadly epidemic.
Summary
Diphtheria, once nearly eradicated, is resurging in war-torn nations as conflict disrupts vaccination programs and healthcare systems, putting millions of children at risk of a preventable and deadly disease.