In post-war Homs, most residents say they cannot reliably get medicines

Years of war do not end when the fighting stops; they persist in the pharmacy. In a survey of 1,042 residents of Homs conducted in spring 2026, only 10.9% said medicines had been easy to access during the war, the most commonly reported barrier was high prices, and more than half of respondents said they knew of deaths they attributed to medication shortages [s1]. The study is a snapshot of what a collapsed health economy leaves behind: not an acute emergency, but a chronic inability to obtain the drugs that manage everyday illness.

Its findings are self-reported perceptions rather than verified clinical outcomes, and that limit matters — but the pattern it describes is well documented across conflict settings, and it points to where post-conflict recovery money is most needed.

What the survey found

The cross-sectional study enrolled 1,042 participants in Homs between 29 March and 22 April 2026 using convenience sampling [s1]. The median age was 26 years (interquartile range 22-42), and 62.0% were women [s1]. Respondents reported a sharp economic slide: those describing their economic status as poor rose from 10.8% before the war to 30.3% during it [s1].

Access tracked that decline. Only 10.9% said medicines were easy to obtain during the war [s1]. The researchers built a seven-item barrier score ranging from 7 to 35, on which the median was 22 (interquartile range 20-26) — toward the high-barrier end of the scale [s1]. High medication prices were the most frequently endorsed barrier, cited by 69.7% of respondents [s1].

The perceived consequences were serious. Some 68.5% reported health deterioration because they could not access medications, and 53.2% said they were aware of deaths attributed to medication shortages [s1]. In adjusted analysis, worse wartime economic status, being a student, and living farther from the nearest medication provider were each associated with higher barrier scores; having less than a high-school education was associated with lower scores [s1].

Why the numbers should be read carefully

Two features of the design limit how far the results generalise. Convenience sampling — recruiting whoever is reachable rather than a random sample — can over- or under-represent groups in ways that skew prevalence estimates, so the exact percentages are best read as indicative rather than precise population figures. And the most striking figures — health deterioration and deaths from shortages — are respondents' perceptions, not verified medical records [s1]. A person's belief that a shortage caused a death is meaningful evidence of how the system is experienced, but it is not the same as an attributed cause of death.

What survives those caveats is the direction and the magnitude. When roughly seven in ten people name price as a barrier and only one in ten found medicines easy to get, the problem is structural, not anecdotal.

The pattern is not unique to Syria

The mechanisms behind medicine shortages in conflict zones are consistent enough to have been catalogued elsewhere. A qualitative study in conflict-affected Mali, drawing on 28 interviews with pharmaceutical-sector stakeholders in the Mopti and Bamako areas, grouped the failures into four interlinked themes: insecurity and instability disrupting transport routes and supply chains; market dysfunction generating price instability and recurrent shortages; technical and infrastructural weaknesses compromising storage; and poor coordination among the actors meant to keep the system running [s2]. Together, the authors found, these had weakened the supply chain's capacity to deliver quality-assured medicines continuously and equitably [s2].

Homs is the demand side of that same failure — what patients experience when the supply chain described in Mali breaks down. The recurrence of the pattern across two very different conflicts is the point: this is a systems problem with recognised causes, not a run of local bad luck. It also compounds the displacement-driven disease risks documented among Syrians who fled the war, which we covered in our review of the Syrian crisis and infectious disease in Lebanon.

What to watch

Whether post-conflict reconstruction plans treat medicine affordability and supply continuity as core health-system tasks rather than afterthoughts. The Homs data suggest that the affordability of essential drugs — not their nominal availability on a shelf — is the binding constraint, and that is a different, and cheaper, problem to fix than rebuilding hospitals.

Sources

• Medication access barriers and perceived health consequences in post-war Syria: a cross-sectional study in Homs — Global Health Action, 2026-09-04
• Systemic challenges in the supply and distribution of medicines in conflict-affected areas — Global Health Action, 2026-06-03