In a stark indictment of the current state of global warfare, the leaders of the world’s most prominent humanitarian and health organizations have issued an urgent joint call for action. The heads of the World Health Organization (WHO), the International Committee of the Red Cross (ICRC), and Médecins Sans Frontières (MSF) are warning that the protection of health care in armed conflict has reached a breaking point, transforming a humanitarian crisis into what they describe as a “crisis of humanity.”
The joint statement arrives at a somber milestone: the tenth anniversary of the UN Security Council’s unanimous adoption of Resolution 2286, which was designed to ensure the safety of medical facilities and personnel in conflict zones. Rather than celebrating a decade of progress, the leaders mark the occasion as a failure, stating that the situation has actually worsened in the ten years since the resolution was passed.
As a physician and journalist, I have seen how the collapse of medical neutrality doesn’t just affect those in the line of fire; it dismantles the very foundation of public health for entire populations. When hospitals are no longer safe havens, the ripple effects—from untreated chronic conditions to the loss of maternal care—create a generational health deficit that persists long after the ceasefire is signed.
The core of the issue is not a lack of legal framework, but a catastrophic lack of political will. The laws of war are clear, yet the reality on the ground tells a different story—one of rubble, obstruction, and avoidable death.
A Decade of Deterioration: The Legacy of Resolution 2286
Ten years ago, the international community stood together to reaffirm that the wounded and sick, and those who care for them, must be protected under all circumstances. Resolution 2286 was intended to be a shield, providing a clear mandate for the respect and protection of medical personnel, humanitarian workers, transport, and equipment.
However, the joint call from the WHO, ICRC, and MSF asserts that the harm this resolution sought to prevent has not only persisted but has intensified in many contexts. The leaders argue that the failure to uphold these norms is a warning sign that the broader rules and norms intended to limit the harm of war are breaking down globally.
This deterioration is not merely a statistical trend; We see a systemic erosion of International Humanitarian Law (IHL). IHL mandates that states “respect and ensure respect” for the laws of war in all circumstances. This obligation is twofold: states must abide by these rules themselves and use their influence to ensure that other parties to a conflict—including those they may support—do the same.
The Human Toll: When Hospitals Become Battlefields
The consequences of ignoring these protections are catastrophic. On the front lines of the world’s most devastating crises, medical teams are witnessing the direct results of compromised sanctity in health care. The joint statement paints a harrowing picture of the current landscape: hospitals reduced to rubble and ambulances facing systematic delays and obstruction.
For the patients, this means that otherwise treatable wounds become fatal. For women, it means being forced to give birth without adequate care, risking both maternal and neonatal lives. When a community loses access to life-saving services, the impact extends beyond the immediate casualties of war to the total collapse of the local health infrastructure.
Doctors, nurses, and patients are too often caught in attacks that result in death and injury. This environment of fear creates a “brain drain” in conflict zones, as medical professionals are forced to flee for their own safety, leaving behind populations with no one to treat them. This cycle of violence and medical deprivation ensures that the vulnerability of the civilian population increases with every destroyed clinic.
A Seven-Point Roadmap to Protect Medical Neutrality
To prevent another decade of deteriorating norms, the ICRC, WHO, and MSF have called upon all states to urgently implement a series of concrete measures. These are not mere suggestions, but essential steps to translate existing legal commitments into operational reality.
The leaders urge states to take the following actions:
- Concrete Action: Translate existing commitments into tangible steps to implement Resolution 2286 and promote positive efforts, such as the Global IHL initiative’s work on the protection of hospitals.
- Military Integration: Fully integrate the protection of health care into the doctrine, rules of engagement, and operational guidance of armed and security forces to give practical effect to IHL obligations.
- Domestic Legislation: Review, enact, and strengthen domestic laws to ensure that the protection of health care in armed conflict is codified and enforceable within national legal systems.
- Resource Allocation: Allocate the necessary financial, technical, and operational resources to implement protective measures and promote the respect of medical provision.
- Diplomatic Influence: Use all available means to influence other parties to a conflict—including those supported by the state in any form—to comply with their obligations to protect health care.
- Accountability: Conduct swift, transparent, and impartial investigations into attacks on health care to ensure accountability in line with applicable legal frameworks.
- Transparent Reporting: Regularly and transparently report on the implementation of Resolution 2286, sharing progress, challenges, and lessons learned.
By integrating these protections into the “rules of engagement”—the internal directives that tell a soldier or a pilot when and how to use force—states can move the protection of health care from a theoretical legal obligation to a practical field requirement.
From Documentation to Accountability: The Role of Resolution 65.20
A critical component of this fight is the ability to prove that attacks are happening. The joint call recalls World Health Assembly Resolution 65.20, adopted in 2012. This resolution introduced the systematic documentation and reporting of attacks on health care by the WHO.
Strengthening this consistent and transparent reporting is essential for three reasons. First, it builds an evidence base that makes it harder for perpetrators to deny attacks. Second, it informs prevention and response strategies by identifying patterns of violence. Third, it supports legal accountability, providing the necessary data for future prosecutions of war crimes.
Without rigorous documentation, attacks on hospitals are often dismissed as “collateral damage.” Systematic reporting transforms these events from anecdotes into evidence, forcing the international community to confront the reality of the violence.
The Path Forward: A Call for Political Will
The overarching message from the ICRC, WHO, and MSF is that the current crisis is not a failure of the law. The legal frameworks—from the Geneva Conventions to UN Resolution 2286—are robust and clear. Instead, Here’s a failure of political will.
The leaders are urging world leaders to show the necessary political leadership to end this violence. The mandate is simple: health care must never be a casualty of war. When the neutrality of the medical mission is respected, the most vulnerable people in the world have a fighting chance. When it is ignored, the cost is measured in countless avoidable deaths.
As we look toward the next year of implementation and monitoring, the focus must shift from adopting resolutions to enforcing them. The world cannot afford another decade where the laws of war are treated as optional suggestions rather than mandatory protections.
The next critical checkpoint will be the continued monitoring and reporting of attacks on health care under the framework of Resolution 65.20, with global health bodies continuing to pressure states to integrate these protections into their military doctrines.
Do you believe international law is sufficient to protect medical workers in today’s conflicts, or is a new approach needed? Share your thoughts in the comments below.