The Dirty War Index: A Public Health and Human Rights Tool for Examining and Monitoring Armed Conflict Outcomes

Documentation, analysis, and prevention of the harmful effects of armed conflict on populations are established public health priorities [1–5]. Although public health research on war is increasingly framed in human rights terms [6–13], general public health methods are typically applied without direct links to laws of war. Laws of war are international humanitarian laws and customary standards regarding the treatment of civilians and combatants, mainly described in the four Geneva Conventions of 1949 and their Additional Protocols I and II regarding international and civil conflicts [14]. With notable exceptions [11,15–17], absolute numbers are usually reported (e.g., number of persons killed), without systematic description of the proportional effects of armed conflict, thereby limiting the utility of findings and scope of interpretation. In this paper, we introduce the “Dirty War Index” (DWI): a data-driven public health tool based on laws of war that systematically identifies rates of particularly undesirable or prohibited, i.e., “dirty,” war outcomes inflicted on populations during armed conflict (e.g., civilian death, child injury, or torture). DWIs are explicitly linked to international humanitarian law to make public health outcomes directly relevant to prevention, monitoring, and humanitarian intervention for the moderation of war’s effects. After choosing the particular outcome to be measured, a DWI is calculated as: