Abstract
Global health supply networks face growing threats from geopolitical tensions such as export controls, economic penalties, and regional disputes, which interrupt flows of critical pharmaceuticals, immunizations, and diagnostic tools, thereby undermining clinical services worldwide. This analysis investigates the mechanisms through which such tensions compromise health logistics integrity and evaluates evidence-based countermeasures drawn from real-world examples. Employing a structured literature synthesis (PROSPERO CRD42025AB5892)" CRD42025AB5892 aligned with PRISMA 2020 standards, sources from PubMed, Scopus, Web of Science, WHO documentation, Global Fund evaluations, and World Bank analyses spanning 2019–2024 were examined, yielding 38 studies for integrated qualitative and quantitative assessment focused on metrics like interruption rates, delivery extensions, and financial burdens. Findings reveal that these tensions extended delivery periods by 110–150%, escalated purchasing expenses by 20–45%, and triggered shortages persisting 6–9 weeks, with illustrations from the COVID-19 crisis, Russia-Ukraine hostilities, and shifts in international aid underscoring issues like overdependence on few providers, inflexible regulations, and funding reliance. Countermeasures such as broadening vendor bases, fostering local production hubs, deploying predictive analytics, maintaining reserve inventories, and enhancing multilateral partnerships effectively lessen these vulnerabilities. Health logistics networks qualify as vital public health infrastructures demanding unified approaches in purchasing reforms, regulatory adjustments, and technology integration to protect service continuity amid international volatility.