posted on Tue 27 Sep 2016 4:23 PM
Protection of Health Care in Armed Conflict

Tomorrow (28 September), the Security Council will hold a briefing, followed by closed consultations, on the protection of health care in armed conflict. The focus of the discussion will be on the Secretary-General’s recommendations regarding measures to prevent attacks on health care in armed conflict, as requested by resolution 2286 of 3 May. Among other things, the Secretary-General called for: the reinforcement of national legislation related to the protection of medical care in armed conflict; guarantees that medical personnel engaged solely in medical duties can act in accordance with medical ethics without being punished for doing so; and the adoption, review, revision and implementation of operational precautionary measures by parties to armed conflict.

The briefers will be Secretary-General Ban Ki-moon, ICRC President Peter Maurer (via VTC), and Médecins Sans Frontières (MSF) President Joanne Liu. They are expected to underscore the need for states to uphold international humanitarian law, in light of the continuing high number of attacks on health workers, facilities and equipment in armed conflict. An underlying message of the briefings will most likely be that there needs to be enhanced effort to implement resolution 2286, as recent events in Syria, Yemen and elsewhere have highlighted the ongoing threats to health care in armed conflict.

There had been some discussion of just convening a briefing, without closed consultations to follow, as several members maintained that they would be comfortable stating their views in public. However, closed consultations will be held, at least in part to allow those states that might have reservations about the Secretary-General’s recommendations to speak frankly in a private setting. While several members are supportive of the recommendations, one controversial issue is expected to be the Secretary-General’s reference to the ICC as an accountability mechanism to prosecute violations of international law in cases where health care is targeted, if national accountability mechanisms are inadequate or insufficient. At press time, more than half of the Council members have elected to speak in the open chamber, although this number could increase by tomorrow.

Conscious of the unrelenting attacks on health care since the adoption of resolution 2286, members will probably emphasise the importance of implementing the resolution and the Secretary-General’s recommendations. Some members may point out that while resolution 2286 conveys an important political signal, its ultimate success will be measured by its impact on the safety and security of health care workers and facilities in conflict zones. A practical discussion on how to translate those aspects of the Secretary-General’s recommendations broadly acceptable to Council members into concrete action would be a useful focus during the consultations. This could include, for example, a discussion of how to improve data collection and analysis on attacks on health care and how to ensure that parties to armed conflict take all the necessary precautionary measures to protect medical workers, facilities and equipment in conflict situations.

The protection of health care in armed conflict is an issue of growing concern to several Council members and the wider UN membership. This is largely because of the high number of medical and humanitarian personnel subjected to violence, the damage to medical facilities in numerous conflict settings and the negative implications of these attacks on the lives of civilians in need of medical care and humanitarian assistance. Furthermore, there appears to be a rising perception that parties to conflict in many contexts show little respect for international humanitarian law, which includes protections for the wounded as well as aid workers and facilities.

This issue is a delicate one for the permanent members. In the 3 May briefing on protection of health care, MSF President Liu pointed out that: “four of the five permanent members…have, in varying degrees, been associated with coalitions, responsible for attacks on health-care structures,” including in Afghanistan, Yemen and Syria. Tomorrow’s briefing takes place at a politically charged moment. The US has accused Russia of conducting airstrikes against a UN/Syrian Arab Red Crescent (SARC) humanitarian convoy and a SARC warehouse on 19 September, which contributed to the recent collapse of the cessation of hostilities on Syria negotiated by Russia and the US. While the US, the UK and several others have been highly critical of Russia for attacks on health care personnel and facilities in Syria, Russia has criticised the Saudi-led coalition—which has received advice from the UK and logistical support from the US—for damaging MSF hospitals in Yemen.

The Council initiative on the protection of health care in armed conflict is spearheaded by five elected members – Egypt, New Zealand, Spain, Japan and Uruguay – who led the process of drafting and negotiating resolution 2286 over a period of several months. According to that resolution, in addition to providing recommendations, the Secretary-General is expected to brief the Council every twelve months on the implementation of the resolution. In one of the early discussions among the five co-leads in preparation for tomorrow’s meeting, Uruguay expressed interest in holding the Secretary-General’s first annual briefing during its presidency in May 2017. With two of the co-leads on this issue (New Zealand and Spain) leaving the Council at the end of the year, a continued focus on this issue may be dependent on active participation of some of the remaining co-leads and incoming elected members.