Cancer care continuity under 2026 regional gulf conflict: experiences and a resilience framework from the Gulf States

Armed conflicts and geopolitical instability pose significant risks to healthcare systems, particularly for patients with cancer who rely on uninterrupted, resource-intensive care pathways. Disruptions to diagnostic services, pharmaceutical supply chains, infrastructure, and workforce capacity have repeatedly compromised oncology care in conflict-affected settings such as Gaza, Syria, Sudan, and Ukraine. While much of the existing literature focuses on system collapse, there remains limited attention to how continuity of cancer care can be preserved during ongoing crises. Recent regional tensions in the Gulf, including missile and drone attacks targeting critical infrastructure across several Gulf Cooperation Council (GCC) countries, have raised concerns about potential healthcare disruptions. Despite these challenges, oncology services in countries such as the United Arab Emirates, Bahrain, and Kuwait have continued to operate without major interruption. Invitations to contribute were extended to oncology representatives from all six GCC countries; comprehensive accounts were received from the United Arab Emirates, Bahrain, Kuwait, and Saudi Arabia. The absence of contributions from Oman and Qatar is noted as a limitation. This Perspective examines the factors that enabled the continuity of cancer care in the Gulf during the period of instability beginning in March 2026 and considers the potential risks if the situation persists for six to twelve months. Key contributors to resilience include advanced healthcare infrastructure, robust pharmaceutical supply chains, strong governance, a highly skilled workforce, and sustained public trust in healthcare institutions. These findings highlight that resilience in oncology extends beyond system survival and reflects the system's capacity to maintain high-quality, uninterrupted cancer care under prolonged stress. Understanding these enabling factors provides important lessons for strengthening health system preparedness and ensuring continuity of care in the face of geopolitical instability and other large-scale disruptions.