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Dear Editor
An important challenge facing persons with disabilities (PWDs) during armed conflicts is no longer the recognition of their vulnerability; it is the translation of this knowledge into effective emergency preparedness and response. Over the past decade, international humanitarian literature has consistently documented that PWDs encounter disproportionate barriers to evacuation, rehabilitation, assistive technology, healthcare and continuity of support during armed conflicts. Yet similar findings continue to emerge across diverse humanitarian settings, suggesting that documenting unmet needs alone has had limited influence on emergency practice [1–4].
Recent armed conflicts have highlighted this persistent gap. During the war in Ukraine, rehabilitation services and assistive technology provision were disrupted, requiring emergency rehabilitation pathways to be established after the conflict had already compromised existing services. Rapid assessments also indicated that delays in evacuation were often associated with the absence of practical mechanisms for identifying and prioritizing individuals requiring disability-specific assistance rather than a lack of awareness of their needs [3]. Similar barriers have been consistently documented across diverse armed conflicts and humanitarian settings, including disruptions in rehabilitation, inaccessible humanitarian services, and inadequate disability-inclusive coordination [1, 2]. 
Because the recent war in Iran occurred only a short time ago, published evidence remains limited. The available literature has primarily focused on the broader public health impacts of the preceding 12-day war in Iran [5], while evidence specifically addressing the experiences, challenges, and needs of PWDs during the recent conflict remains scarce. Nevertheless, the rapid needs assessment conducted by the Islamic Parliament Research Center of Iran currently provides the most comprehensive available evidence on PWDs’ experiences and priority needs during the recent conflict. The report documented disruptions in access to rehabilitation services, medicines, assistive devices, transportation services, accessible shelters, and psychosocial support [6]. Its findings are broadly consistent with evidence from other recent armed conflicts, including documented disruptions in rehabilitation services, access to medicines and assistive products, and accessible shelter provision in Ukraine and other humanitarian settings [1–3]. This consistency suggests that many of the challenges experienced by PWDs in Iran are similar to those documented in other humanitarian settings. Beyond documenting these needs, the report also emphasized the importance of developing a coordinated National Program for Supporting PWDs During Natural and Human-Made Crises, encompassing rehabilitation services, uninterrupted access to medicines and essential supplies, targeted livelihood support, accessible accommodation, psychosocial support and effective intersectoral coordination. The recent national needs assessment highlighted the importance of strengthening coordinated mechanisms to define institutional responsibilities, enhance intersectoral collaboration, and support continuity of rehabilitation and disability services in Iran [6]. 
These priorities are consistent with recent policy analyses, which emphasize that disability-inclusive humanitarian action should be supported by coordinated governance, intersectoral collaboration, and the meaningful participation of PWDs in planning and implementation [7, 8]. Building on these recommendations, a national program should ensure continuity of rehabilitation and other essential services and supports during emergencies. Successful implementation will require sustained collaboration across the health, rehabilitation, social welfare, and disaster management sectors, along with adequate institutional and financial support.
Importantly, such a program should also be informed by evidence from the lived experiences of PWDs and developed in partnership with PWDs organizations. Meaningful participation and community inclusion are essential for developing disability-inclusive emergency policies and services [9]. 
Implementing such a program may face practical challenges, including resource constraints, coordination across multiple responsible agencies, and sustainable financing for disability-inclusive emergency preparedness. In Iran, these challenges may be further compounded by the effects of conflict and international sanctions on access to essential medicines, medical technologies and broader health system capacity [5]. Addressing these challenges will require context-specific implementation strategies, sustained intersectoral coordination and mechanisms for monitoring disability inclusion.
International frameworks, including the Convention on the Rights of Persons with Disabilities (CRPD) and the Inter-Agency Standing Committee (IASC) guidelines on inclusion of PWDs in humanitarian action, provide useful guidance for disability-inclusive emergency planning and response [4, 10]. Accordingly, the proposed national program should incorporate disability-inclusive principles reflected in these frameworks, including continuity of essential services and meaningful participation of PWDs, while adapting their application to Iran’s existing health, rehabilitation, governance and emergency management structures.
Future implementation and health systems research should therefore examine how these frameworks can be operationalized within Iran’s health, rehabilitation and disaster management systems and inform the design, implementation and evaluation of such a national program. Previous implementation research has similarly highlighted the importance of generating policy-relevant evidence to support disability-inclusive humanitarian action [10]. 
The recent war in Iran should therefore be viewed not only as a humanitarian emergency but also as a catalyst for strengthening disability-inclusive emergency preparedness. Translating the recommendations of the national needs assessment into an evidence-informed, coordinated national program would be a crucial step toward ensuring continuity of rehabilitation services, protecting the health and dignity of PWDs, and promoting equitable access to support during future armed conflicts and other humanitarian emergencies. The design, implementation, and evaluation of such a program should be informed by future implementation research and adapted to Iran’s health system and emergency management context. Ultimately, the success of such a program will depend on co-design with meaningful participation of PWDs and on being informed by their lived experiences, thereby helping build emergency systems that are both inclusive and responsive.
 

References

1. Priddy A. Disability and armed conflict. Geneva: Geneva Academy of International Humanitarian Law and Human Rights; 2019. [Link]
2. Breitegger A. Increasing visibility of persons with disabilities in armed conflict: Implications for interpreting and applying IHL. International Review of the Red Cross. 2023; 105:99-134. [DOI:10.1017/S1816383122000935]
3. United Nations Development Programme. Rapid assessment of the experience of evacuating people with disabilities in Ukraine due to the war. Kyiv: UNDP Ukraine; 2023. [Link]
4. Mugabi IK. An analysis of the adequacy of protection afforded by the convention on the rights of persons with disabilities (CRPD) in situations of armed conflict. Societies. 2018; 8(2):28. [DOI:10.3390/soc8020028]
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9. Kienzler H, Mitwalli S, Cicek M. The experience of people with psychosocial disabilities of living independently and being included in the community in war-affected settings: A review of the literature. International Journal of Law and Psychiatry. 2022; 81:101764. [DOI:10.1016/j.ijlp.2021.101764] [PMID]
10. Dijkzeul D, Dempf S, Göker S, Funke C. Implementing the inter-agency standing committee guidelines on inclusion of persons with disabilities in humanitarian action: A scoping review. Journal of International Humanitarian Action. 2026; 11(1):12. [DOI:10.1186/s41018-026-00190-7]