Joint invitation of the President of the ICRC, the Director General of WHO and the International President of MSF

Ten years ago, the UN Security Council unanimously adopted Resolution 2286 on health care in armed conflicts. The situation is even worse than 10 years ago. Today we don’t celebrate achievement – we celebrate failure.

As the violence affecting medical facilities, transportation and staff continues to abate, the harm this resolution seeks to prevent has not diminished. It continued and, in many contexts, intensified. As leaders of the International Committee of the Red Cross (ICRC), the World Health Organization (WHO) and Doctors Without Borders (MSF), we join others in the international community in issuing an urgent call to action.

Every day on the front lines of the world’s most devastating crises, our teams witness the catastrophic consequences when the sanctity of healthcare is threatened. Hospitals are reduced to rubble, ambulances face delays and obstructions, doctors, nurses and patients are too often caught up in attacks that result in death and injury. Patients die from wounds that could otherwise be treated, women are sometimes forced to give birth without proper care, and entire communities lose access to life-saving services. When health care is no longer safe, it is often the clearest warning sign that the rules and norms intended to limit the damage of war are breaking down. When hospitals and those who provide care are attacked, we face not only a humanitarian crisis, but also a crisis of humanity.

States and all parties to armed conflict must adhere to rules that protect health care. The obligation under international humanitarian law (IHL) to “respect and ensure respect…in all circumstances” requires states not only to abide by these rules themselves, but also to use all possible influence to ensure that other states and parties to the conflict do the same.

The UN Secretary General’s recommendations that accompanied Resolution 2286 remain a clear, actionable plan for states. The ICRC, WHO and MSF are ready with their conflict presence, medical expertise and operational capacity to support States in implementing these critical measures.

We also remind Resolution of the World Health Assembly 65.20adopted in 2012, which introduced the systematic documentation and reporting of health care attacks by the WHO. Strengthening consistent and transparent reporting is critical to building the evidence base, informing prevention and response, and supporting accountability.

Support and advance the request of Resolution 2286 “that all parties to armed conflicts fully fulfill their obligations under international law… to ensure respect and protection of their medical personnel and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical institutions”; and to prevent another decade of deteriorating standards and gratuitous violence affecting health care in conflicts, we call on all States to urgently implement the following measures:

• translate existing obligations into concrete actions for the implementation of Resolution 2286 and actively promote positive efforts, including the outcome of the work of the Global International Humanitarian Law initiative to achieve significant protection for hospitals;
• integrate health care protection into armed and security forces doctrine, rules of engagement and operational guidelines to achieve practical consequences under IHL;
• revise, enact and strengthen domestic laws to protect health care in armed conflict;
• allocate adequate financial, technical and operational resources for the implementation of measures that protect health care and promote respect for its provision;
• use all available means to influence other parties to the conflict – including those supported by the state in any form – to comply with their obligations to protect health care;
• conduct prompt, transparent and impartial investigations into health care attacks and support efforts to ensure accountability in accordance with applicable legal frameworks; and
• regularly and transparently report on the implementation of Resolution 2286, including progress, challenges, good practices and lessons learned to support its full implementation.

Ten years ago, the international community reaffirmed that the laws of war must be respected and the wounded and sick, as well as those who care for them, must be protected. Today, health facilities continue to be damaged or destroyed. Medical workers and patients are still caught in attacks that result in death and injury. It is not a failure of the law. It is a failure of political will.

We call on world leaders to act and show the necessary political leadership to end this violence. Healthcare must never be a victim of war.