Sectoral impact:
The health sector continues to face profound challenges due to the protracted conflict, economic deterioration, and recent funding cuts. The disruption in the supply of medicines and medical equipment remains critical, with essential drugs for chronic diseases, NCDs, communicable diseases, mental health, and maternal care in short supply.
Access to and the functionality of basic and essential health services continue to face serious challenges in the Syrian health sector, primarily due to widespread damage and the non-operational status of numerous health facilities. As of May 2025, analysis from the Health Resources and Services Availability Monitoring System (HeRAMS) reveals that only 57 per cent of hospitals and 37 per cent of primary healthcare centres across the country are fully functional. Further, more than 452 health facilities that previously received formal support are now affected by funding cuts and face imminent closure, putting over 5 million people at risk of losing access to critical medical care and life-saving services. Additionally, the massive displacement in Syria continues to put enormous strain on the already fragile health sector, overburdening existing facilities and resources.
As the number of EO explosions have increased significantly in several locations in Aleppo, Idlib, and Deir-ez-Zor, resulting in increasing number of civilian deaths and injuries, including women and children, the health facilities' capacity (human and health resources) to address mass casualties remain very limited. These invisible threats of EOs have become the leading cause of child casualties in Syria.
Attacks on healthcare facilities in Syria severely undermine the already fragile healthcare system: Between January 2024 and May 2025, 96 attacks were reported resulting in 138 injuries and 61 deaths. 92 per cent of these incidents were reported since 27 November, resulting in damage to health facilities and ambulances, and injuries to healthcare personnel.
Increased risk of emerging and re-emerging infectious diseases and outbreaks including AWD/cholera and other water-borne diseases, as well as respiratory diseases, due to disrupted access to safe water, sanitation, poor shelter and overcrowding, as well as damaged water and sanitation infrastructure, congested displacement sites, and environmental pressures, have further exacerbated the deterioration of public health conditions.
There is a critical shortage of health workers, compounded by low salaries, which continues to severely impact access to health services. It is estimated that 50-70 per cent of the health workforce has migrated out of the country. As a result, eight out of Syria’s 14 governorates remain below the minimum threshold for the availability of health workers per 10,000 population, as defined by international standards.
A shortage of specialists persists, in trauma and emergency care, intensive care, orthopaedics, psychiatry, anaesthesia, oncology, and prosthetics.
Years of chronic underfunding in the health sector have significantly worsened the situation in Syria, deepening the suffering of an already vulnerable population and hindering long-term recovery efforts. The sector is currently facing acute shortages of essential medicines, medical supplies, and qualified personnel, driven by a substantial funding gap. Consequently, many health facilities have been forced to scale back operations or shut down entirely. At present, health partners are only able to provide humanitarian health assistance in 243 out of the 272 sub-districts in need. Further reductions in funding are expected to severely compromise the delivery of critical health services in these areas.
In Al-Hasakeh, Ar-Raqqa and Dier-ez-Zor, only one out of 16 public hospitals are fully functional as the health facilities rely entirely on humanitarian partners, many of which now face closure due to the recent stop-work order on USA foreign aid. More health facilities are projected by partners toll run out of fund by the end of June 2025.
Limited access to antenatal and postnatal care is evident, as only 1,327 (78 per cent) of 1,702 health facilities have functional basic emergency obstetric and new-born care services. In the most recent Rapid needs assessment by OCHA, 54 per cent of female IDPs interviewed reported unavailability of essential SRH services in their locations.
Non-communicable diseases contribute to 50-70 per cent of all mortality, exacerbated by limited access to services and treatments for these conditions. Further, the February 2025 WoS RNA indicates that 32 per cent of the people surveyed (the majority of whom are IDPs) across Syria need medicines and treatment for non-communicable diseases. Oncology patients face limited access to diagnosis, treatment, and palliative care, with a lack of oncology specialists and essential medicines, including chemotherapeutic drugs. Patients with end stage renal failure are struggling to access life-saving care due to shortages in dialysis sessions and supplies, recent damage to facilities and non-functioning dialysis machines.
Psychological effects of the conflict have raised demand for mental health services, which are already scarce and constrained by a shortage of mental health professionals and psychotropic drugs. Substance abuse especially among youth remains an escalating public health concern.
Critical shortage of specialist and inpatient health facilities for the treatment of severe acute malnutrition with medical complications has led to increased child mortality rates.
Immediate needs:
- Ensure provision of essential life-saving health services including primary healthcare (PHC), maternal and child health, and communicable and non-communicable disease.
- Support provision of secondary health services including specialised services such as kidney dialysis, oncology care, blood banks and clinical management of severe acute malnutrition with medical complications.
- Strengthen disease surveillance for infectious diseases, particularly waterborne, respiratory and vector-borne illnesses, as well as vaccine-preventable diseases, to ensure quick detection and response to disease outbreaks including strengthen Rapid Response Teams (RRTs), and enhanced laboratory testing capacities.
- Enhance the referral mechanism to ensure continuum of care, particularly for critically ill cases from camp settings.
- Increase access to health services and provision of emergency trauma care, including deployment of emergency medical teams.
- Support the establishment of stabilisation centres within hospitals for treatment of children suffering from severe acute malnutrition with medical complications especially in Al-Hasakeh, Ar-Raqqa, and Deir-ez-Zor where there is acute shortage of inpatient centres.
- Improve access to mental health and psychosocial services, including community-based support as well as psychotropic medicines, to affected populations and healthcare workers.
- Ensure efficient supply chain of emergency medicines and medical supplies including trauma, sexual and reproductive health kits, non-communicable disease (NCD) medicines, AWD kits and dialysis sessions.
- Enhanced preparedness action for acute watery diarrhoea including providing clean water supplies, water purification systems, oral rehydration solutions, and establishing emergency medical facilities in affected communities especially in camps and camplike settings
- Support immunization efforts for routine childhood vaccinations and priority diseases with special focus on the Al-Hasakeh, Ar-Raqqa and Deir-ez-Zor, where immunization coverage has been historically low.
- Implement training for healthcare providers including community healthcare workers on emergency response, disease management, and psychosocial support.
Priority activities:
- Ensure continuity of essential life-saving and life sustaining mobile, primary and secondary health services to the affected population. This includes referral mechanisms to emergency and secondary care, including trauma care; treatment of severe acute malnutrition with complications; treatment of critical NCDs/chronic diseases; and enhancing access to mental health and psychosocial response services, including outreach teams.
- Strengthen routine vaccination and campaigns.
- Provide emergency medicines and supplies such as trauma kits and enhance emergency preparedness by sustaining stockpiles of medicines. This includes the procurement of reagents, lab/testing kits and consumables for specimen collection and diagnosis of water-borne diseases, and respiratory diseases.
- Strengthen outbreak prevention, control, and response capacity throughout Syria; including enhancing surveillance, lab capacities, and the capacity of rapid response teams.
- Respond to ongoing cholera transmission, including conducting oral cholera vaccine campaigns in areas with active cases.
- Expand access to sexual and reproductive health services through strengthening the basic emergency obstetric and new-born care and comprehensive emergency obstetric and new-born care service facilities, and response to violence against women and children.
- Strengthen the capacity of health care providers and community health care workers to provide essential health services and ensure risk communication and community engagement activities.
- Light rehabilitation and re-equipping of critical infrastructure in 5 per cent of the health facilities that are non-or partially functional.
- Conduct a rapid assessment to identify the most urgent health needs and risks among the affected population, as well as available resources and key gaps.
- Strengthen leadership, coordination and information management to ensure effective management and monitoring of the public health emergency.
Response strategy:
- The health sector will deliver agile, efficient and people-centered health response through varying modalities to ensure access to health services delivery including use of fixed health facilities, mobile medical and outreach teams, and referral services. This enables health sector partners to reach newly displaced, rural, or access-constrained populations without access to static health facilities.
- Health partners will support the operation of ambulances to move and refer patients between healthcare levels. The health sector partners will ensure critical rehabilitation and refurbishment of health facilities as well as availability of essential medicines and supplies to maintain the functionality of primary and secondary care health facilities, as well as support immunization services for IDPs and host communities.
- The health sector will continue to strengthen preparedness capacity to detect and deliver a timely response to disease outbreaks, including enhanced surveillance, laboratory testing and diagnostic capacities, rapid response teams, and the provision of essential medical supplies.
- Through effective coordination, the health sector and partners will ensure streamlined planning and standardization of service delivery to enhance equitable access to essential health services and strengthen the overall resilience of the health system in Syria.
- The health sector supports a multi-layer response: community engagement, early warning, health security measures, clinical care, and specialized services with integrated MHPSS, GBV services, and physical rehabilitation. Partners will incorporate PSEA into response programming, ensure AAP and monitor its implementation.
- The health system is impacted by insufficient WASH and power supply infrastructure, and health outcomes are affected by social and environmental determinants. Thus, the health sector will maintain strong collaboration with WASH, nutrition, protection, and GBV for integrated response including multisectoral interventions for diseases prevention and response. The health sector also enhances AAP by including affected people in health program design and implementation, including health needs, priorities, and preferred service delivery modalities.