In March 2011, unrest from the Arab Spring found its way to Syria, interrupting over 40 years of political stability and igniting a civil war that continues to ravage the country with no end in sight [1]. Beyond direct casualties, war, particularly civil war, provides ideal conditions for outbreaks of infections, and Syria's ongoing three-year civil war has been no exception to this rule [2]. Measles, hepatitis A, leishmaniasis, poliomyelitis, meningitis, and scabies have spread through vulnerable populations in Syria and refugee camps in neighboring countries, creating a health crisis that will require immense resources to address (Table 1) [3]. Concurrently, the shattered medical infrastructure, the exodus of health care workers, and the deterioration of immunization programs have created a dangerous vacuum in essential health care provision [4]. In the context of Syria's devastated health care infrastructure, we will discuss the spread of infectious diseases, particularly poliomyelitis, measles, and cutaneous leishmaniasis, among Syrian civilians, refugees, and citizens of neighboring countries, to examine what is nothing short of a regional, and arguably global, public health emergency. Table 1 Reported cases of communicable diseases per year between 2011 and 2014 in Syria, Lebanon, and Jordan. NUMBER OF COMMUNICABLE DISEASE CASES REPORTED PER YEAR Syrian Arab Republica Lebanese Republicc Syrian Refugees in Lebanonc Hashemite Kingdom of Jordand 2011 2012 2013 2014∧ 2011 2012 2013 2014* 2013 2014* 2011 2012 2013 2014 Poliomyelitis 0 0 35b 1b 0 0 0 0 0 0 0 0 0 n/a Measles n/a 13 n/a n/a 9 9 1760 219 232 92 30 24 205 n/a Cutaneous Leishmaniasis n/a 52,982 n/a n/a 5 2 1033 381 998 364 136 103 146 n/a Hepatitis A n/a 2203 n/a n/a 448 757 1551 738 220 127 418 509 1082 n/a Typhoid Fever n/a 1129 n/a n/a 362 426 407 102 21 7 2 4 4 n/a Open in a separate window aData obtained from the Syrian Ministry of Health website in the Quarterly Report of Communicable Diseases [30]. bData obtained from the Global Polio Eradication Initiative website [16]. cData obtained from the Epidemiologic Surveillance Department of the Lebanese Ministry of Public Health [26]. dData obtained from the Communicable Diseases System on the Jordan Ministry of Health Website [25]. ∧2014 Data last reported on 08/13/14 from the Global Polio Eradication Initiative website [16]. * 2014 Data last reported on 08/01/14 from the Epidemiologic Surveillance Department of the Lebanese Ministry of Public Health [26]. The War on Health Care Prior to the conflict, the health care system in Syria consisted of a government-run public system that provided mostly primary care services, with the private sector concentrated in urban areas providing the majority of advanced care services [1]. The past three decades were characterized by an improved capacity of the health system, as well as rapidly improving national health indicators such as a falling infant mortality rate and an increased child immunization rate. Yet the onset of the civil war led to the complete deterioration of the health infrastructure through the wide destruction of facilities, the shortage in health care personnel and medicines, and a lack of secure routes and transportation. Rather than providing a safe place of care and refuge, the Syrian health care system has been integrated into the civil war battlefield. Both the regime's military forces and antigovernment armed groups have attacked and appropriated medical facilities as a tactic of warfare [5]. According to the World Health Organization (WHO), 40% of Syria's ambulances are destroyed and 57% of public hospitals are severely damaged, with 37% remaining out of service [6]. At least 160 doctors have been killed and hundreds jailed, leading to the emigration of an estimated 80,000 doctors [4]. The 90% of pharmaceutical needs that were locally produced prior to the conflict has now been reduced to only 10%, contributing to significant drug shortages in essential medications [1]. Such shortages, power outages, and the lack of security and mobility to seek care all contribute to the growing humanitarian crisis in Syria. This health care crisis has extended beyond Syria's borders with one of the largest refugee crises since World War II [2]. Millions have entered the neighboring countries of Lebanon, Jordan, and Turkey in search of security. In Lebanon, over a million Syrian refugees currently represent a quarter of the country's population, residing among the local population in over 540 sites, as refugee camps are yet to be built [7]. In Jordan, there are 3,500 Syrian refugees crossing the border each day, with 20% residing in the Al Zaatari camp and the remaining 80% living in urban areas in the north of Jordan [8]–[10]. In both countries, Syrian refugees utilize local health care resources. This has significantly strained local health care systems with insurmountable demands ranging from continued chronic care to the management of spreading communicable diseases [11]. The underfunding of UNHCR (United Nations High Commissioner for Human Rights) and other humanitarian organizations has reduced the medical subsidies to refugees, leading many to forgo necessary yet unaffordable treatment [12]. In Syria and its neighboring countries, critical gaps in essential health care delivery continue to aggravate what has been described as the worst humanitarian crisis of the 21st century [6].