At first glance, the answer appears to be nothing.
The conflict between the United States and Iran is thousands of kilometres away. The missiles, military calculations, diplomatic negotiations and tensions around the Strait of Hormuz may seem like matters for presidents, generals, foreign-policy analysts and oil traders. Yet somewhere in Northern Nigeria, there is a pregnant woman who may never have heard of the Strait of Hormuz and may not know exactly where Iran is on a map. What happens there can still affect her.
It can reach her through the price of petrol, the cost of food, the transport fare to her nearest health facility, the price of medicines or the diesel required to keep a health centre running. This is the part of geopolitics we often fail to see. Global conflicts do not remain confined to battlefields. They travel through energy markets, supply chains and household budgets until, eventually, they reach people's health.
The current conflict offers a powerful illustration. Renewed hostilities have again disrupted shipping through the Strait of Hormuz, a critical artery for global energy supplies. Oil prices have responded sharply to concerns about prolonged supply disruptions, with Brent crude reaching about $95 per barrel earlier this week. For Nigeria, an oil-producing country, this creates an important paradox. Higher crude prices can strengthen government revenues and improve foreign-exchange earnings, but what may provide fiscal relief at the national level does not automatically translate into relief for households.
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Consider a woman living in a rural community several kilometres from the nearest comprehensive health facility. She may already face barriers that have little to do with whether healthcare technically exists. There may be poor roads, unreliable transportation, insecurity, distance, limited household income and shortages of essential medicines. If transport costs rise, reaching the health facility becomes harder. If food prices increase, the household may reduce the quantity or quality of food it consumes. If the family must choose between paying for transport to the hospital and putting food on the table, the decision may not reflect ignorance of the importance of healthcare. It may simply reflect the economic reality confronting the household.
A woman does not necessarily miss antenatal care or arrive late at a referral facility because she does not understand the importance of healthcare. Public-health professionals can design protocols, establish referral pathways and strengthen skilled birth attendance, but these systems only work when women can physically and financially navigate them. When transportation becomes unaffordable, roads are impassable or a household must choose between food and a trip to the hospital, the best-designed referral pathway can exist on paper while remaining inaccessible in practice.
This is why public health cannot afford to look at geopolitical events only through the lens of economics. The pathway from an international conflict to a maternal or neonatal health outcome may be indirect, but it is real. Energy prices affect transportation. Transportation affects access to healthcare. Energy costs affect the operation of health facilities. Food prices affect household nutrition. Household income affects healthcare-seeking behaviour. When several of these pressures occur simultaneously, the resilience of already vulnerable households begins to disappear.
Northern Nigeria makes this particularly important. Many rural and hard-to-reach communities are already contending with insecurity, poverty, weak infrastructure and limited access to essential services. Food insecurity adds another layer of vulnerability, particularly for pregnant women, children and households dependent on daily income. In such an environment, a new economic shock does not arrive on a blank page. It lands on top of existing vulnerabilities and can push households that were already struggling further away from essential services.
This raises a more important question than how much the price of crude oil has increased: what happens to a household when the cost of surviving increases faster than its ability to earn? This is where macroeconomics meets public health. A government may record stronger oil revenues, economic growth may improve and fiscal indicators may become healthier, but public health asks another set of questions. Can the mother afford transport to the hospital? Can the family afford nutritious food? Can the primary healthcare centre maintain reliable electricity? Can a health worker travel to conduct outreach in a remote settlement? Can the facility maintain essential medicines? Can a woman in labour get to a referral hospital at night?
These are not separate from the economy. They are the economy experienced at household level. For those of us who have worked in rural and hard-to-reach communities, these connections are not theoretical. We know that a functioning health system does not begin at the hospital gate. It begins much earlier, with whether a woman can afford to leave her community, whether a road is passable, whether a vehicle is available, whether the health worker can reach her and whether her household has enough food to sustain a pregnancy.
This is also why Nigeria's response to global energy shocks should not stop at celebrating higher oil prices. Periods of increased oil revenue should be used to build resilience against the next shock. That means strengthening domestic energy security, improving rural roads and transportation, protecting food systems and investing deliberately in primary healthcare. A country cannot claim to have a resilient health system when the communities it serves are economically fragile and the facilities themselves remain vulnerable to disruptions in electricity, transportation and essential supplies.
We also need to rethink how we define health interventions. A road can be a maternal-health intervention because it determines whether a woman reaches a facility in time. Reliable electricity can be a health intervention because it allows health facilities to function safely. Affordable transportation can be a maternal-health intervention because distance means little if a woman cannot afford to travel it. Food security is a maternal and child health intervention because nutrition before and during pregnancy influences both maternal wellbeing and child survival.
When oil prices rise in global markets, what happens to the cost of transportation in Kano? When shipping routes are disrupted in the Middle East, what happens to the price of food in Kaduna? When fuel becomes more expensive, what happens to the cost of reaching a primary healthcare centre in Zamfara? When household purchasing power declines, what happens to the nutrition of a pregnant woman? And when these pressures accumulate, what happens to her newborn? These questions deserve to sit alongside our discussions about geopolitics because they reveal the human consequences hidden behind economic indicators.
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The most important consequence of a war is not always visible on a battlefield. Sometimes it is visible in an antenatal register, in a mother who arrives at a health facility too late, in a child whose diet becomes less nutritious because the family can no longer afford it, or in a health worker who cannot reach a community because transport has become too expensive. The pregnant woman in Northern Nigeria may never hear the names of the politicians negotiating the conflict or understand the dynamics of global energy markets, yet decisions made thousands of kilometres away can still shape the choices available to her.
That is the interconnected world we live in. For Nigeria, the lesson is not that we should fear every global crisis, but that we must build a country resilient enough that a crisis thousands of kilometres away does not become a crisis inside our homes. The true measure of economic resilience is therefore not simply what happens to the price of a barrel of oil. It is whether, when the next global shock arrives, a woman in a remote Nigerian community can still afford to get to the care she needs.
