Mitsuru Mukaigawara (Harvard)

Title

How Efforts to Contain Epidemics Intensify Civil Conflict: Application of Spatiotemporal Causal Inference to Outbreak- and Patient-Level Microdata

Abstract

Two-thirds of civil conflicts experience at least one epidemic, yet little is known about when, why, and how epidemics intensify conflict. I argue that severe epidemics in low-capacity regions (what I call “frontier plagues”) uniquely trigger a geographically concentrated surge of state capacity and redirect insurgent violence toward civilians. This intensification occurs in three stages. First, states send healthcare professionals and deploy security forces to epicenters for protection. Second, insurgents reallocate combatants to defend territorial control. Finally, as confronting reinforced state forces becomes costly, they shift from battles toward civilian targeting. I test this argument using microdata on 922 epidemics across sub-Saharan Africa and 87,994 patient records from the 2018-2020 outbreak in the Democratic Republic of the Congo. Using a spatiotemporal causal inference design, I show that frontier plagues significantly increase civilian targeting in outbreak epicenters.