More than 4,000 attacks on health workers, facilities and transport since 2016 underscore the need for action to protect health care in times of conflict

Five years after the United Nations (UN) Security Council passed a landmark resolution calling on countries to prevent attacks on health care and hold perpetrators to account, violence against health workers and facilities is causing rage relentlessly.

New report and interactive map released today by the Safeguarding Health in Conflict Coalition (SHCC), based on data compiled by coalition member Insecurity Insight, highlights a global wave of violence against health workers , establishments and transport from 2016 to 2020, in particular:

• 4,094 attacks and threats to healthcare reported during conflict
• 1,524 health workers injured
• 681 health workers killed
• 401 health workers kidnapped
• 978 incidents where health facilities were destroyed or damaged

The numbers – taken from credible media reports as well as reports from intergovernmental organizations, states, non-governmental organizations and aid agencies – are likely a significant undercount, due to the undercount. statement in many places around the world.

On May 3, 2016, the UN Security Council unanimously adopted Resolution 2286, which required member states to take specific action to end – or at least improve – violence against healthcare. The SHCC report released today takes stock of violence against health care from 2016 to 2020 and governments’ inaction to respond effectively to the crisis.

The data highlights the dismal failure of the Security Council and UN member states to take meaningful action to prevent attacks or hold those responsible to account.

Violence against healthcare also increased during the COVID-19 pandemic, as patients and community members attacked healthcare workers and mounted violent responses to public health measures. While most of the violence against healthcare from 2016 to 2019 occurred in areas of conflict, the pandemic has led to waves of attacks on healthcare in countries not at war, such as India. and Mexico.

The SHCC report highlights the many forms of violence against healthcare, from airstrikes on clinics to looting of hospitals. Health workers around the world have been kidnapped, arrested, injured and killed while providing medical care. Violent interference has kept patients from accessing care and emergency responders, vaccinators and other health workers from providing life-saving services.

Over the five-year period, more health workers were killed in Syria (243) than in any other country, according to available data. Health workers were most often kidnapped in Nigeria (68 health workers were kidnapped). More health facilities were destroyed or damaged in Syria (442 incidents) than anywhere else, while the Democratic Republic of the Congo experienced the highest number of armed entries into health facilities (43 incidents). Some 690 emergency medical responders were injured in the occupied Palestinian territories and 73 emergency medical responders were arrested in Sudan, the highest rates of any country from 2016 to 2020. Healthcare vehicles were the most often diverted to Mali (24 incidents). High-income countries were not immune to attacks on healthcare, especially amid the COVID-19 pandemic which saw violence against healthcare in the US, UK and Australia in 2020.

UN Security Council Resolution 2286 included 14 guidelines to end or reduce violence against healthcare, such as:

• Ensure that the military “integrate practical measures for the protection of the wounded and sick and medical services in the planning and conduct of their operations.”
• Adopt national legal frameworks to ensure compliance with health care, in particular excluding the act of providing impartial health care from punishment under national counterterrorism laws.
• Participate in the collection of data on obstruction, threats and physical assaults on health care.
• Undertake “prompt, impartial and effective investigations in their jurisdictions into violations of international humanitarian law” in the area of ​​health care and, “where appropriate, take action against those responsible in accordance with national and international law”.
• The Security Council refers cases where there is evidence of war crimes related to violence against health care in Syria and elsewhere to the International Criminal Court.
• Member States that sell weapons that have been used to inflict violence in healthcare terminate such sales.

In all of these engagements, with few exceptions, the United Nations Security Council and Member States have made no progress.

“The lack of follow-up to the commitments made by member states shows that to date they have offered only rhetorical support for Resolution 2286 and the obligation to protect health care,” said Leonard Rubenstein, founder and chairman of SHCC and professor at the Johns Hopkins Bloomberg School of Public Health and Center for Public Health and Human Rights.

“The pandemic is another reminder that the world’s health workers are essential and that when we fail, we all fail,” Rubenstein said. “After five years of inaction, the Secretary-General of the United Nations must mobilize to report each year on the actions taken by States to implement the resolution. To facilitate this process, the Secretary-General should appoint a special representative to monitor and report on the performance of the State, conduct country visits and make recommendations to ensure better compliance with resolution 2286. “

“More than 4,000 attacks and threats against healthcare between 2016 and 2020 is a minimum estimate – the true extent of the violence is unknown, as many countries, health facilities and organizations do not report their experiences. Beyond the startling data we have, every incident represents the loss of family members and colleagues, of livelihood, of homes and, at times, of a way of life, ”said Christina Wille, Director of ‘Insecurity Insight, SHCC member who leads data collection and analysis. “The true cost of the attacks also includes the lasting effects on the physical and mental health of health workers, as well as on the ability of communities to respond to the pandemic, to access care for chronic illnesses, to have a safe delivery. , vaccination, etc.

“Ultimately, the international community has done little in the past five years to prevent ambulances from being hijacked, to protect clinics from bombing or doctors from shootings,” said Susannah Sirkin, director of policy at Physicians for Human Rights, coalition member. “Impunity prevailed for these flagrant violations of international humanitarian law. Unless the UN Security Council and member states act now, we risk enshrining the dismal “new normal” in which once-banned doctors and hospitals have become regular targets. “

Today’s report highlights data included in five annual reports (2016-2020) of the SHCC. The 2021 annual report will be published on May 24 at the Graduate Institute of Geneva during the World Health Assembly. At this event, the SHCC, the Swiss Federation, the Minister of Health of the Central African Republic, Pierre Some, and a health worker representing Doctors Without Borders, will talk about the reported violence and ways to address the issues.

The Coalition for Safeguarding Health in Conflict is a group of international non-governmental organizations working to protect health workers, services and infrastructure.

The SHCC 40+ member steering committee includes: Johns Hopkins Bloomberg School of Public Health Center for Public Health and Human Rights, IntraHealth International, Human Rights Watch, Insecurity Insight, International Council of Nurses, International Federation of Medical Students’ Associations, Johns Hopkins Center for Humanitarian Health, Management Sciences for Health, Medact, Office of Global Health, Drexel Dornsife School of Public Health, Physicians for Human Rights, Syrian American Medical Society, Watchlist on Children and Armed Conflict, and Human Rights Center, University of California, Berkeley School of Law.