Health impacts of the Aral Sea disaster: Current state, research gaps, and mitigation perspectives in the North Aral Sea region

The North Aral Sea (Kazakhstan) has been the focus of restoration efforts to counter the desiccation of one of the world’s largest lakes. As restoration ultimately aims to improve human well-being, monitoring population health is essential. This review synthesizes health issues reported in the region in 2015–2025. Findings indicate multifactorial adverse outcomes, including cardiovascular, endocrine, reproductive, and nutritional disturbances linked to historical contamination, dietary deficiencies, psychosocial stress, and limited healthcare access. Although partial restoration has reduced some environmental hazards, residual risks persist, particularly in southern desiccated zones. Integrated preventive actions are recommended, including environmental management, strengthened healthcare, improved nutrition, education, and infrastructure. Any future industrial expansion, including resource extraction, must be paired with sustainable community engagement. The North Aral case provides broader lessons for environmentally stressed dryland basins, highlighting how coupled ecological and social disruptions can compound health risks across generations and underscoring the need for equity-focused recovery strategies.