About this report
Healthcare is clearly protected under the Geneva Conventions. However, increasingly, we are witnessing disregard for these safeguards in conflicts around the world. The Safeguarding Health in Conflict Coalition (SHCC) recorded 3,623 attacks on or obstruction of healthcare in 2024, the highest number of incidents they have ever documented.
Doctors, nurses and allied healthcare professionals have been beaten, arbitrarily arrested, kidnapped, tortured, and killed. Patients have been shot in their beds or dragged away to detention centres, while others have been forced out of hospitals to make space for injured combatants. Hospitals have been deliberately bombed and raided. They have been illegally re-organised as centres of military operations instead of care. Ambulances have been destroyed and hijacked. Medical supplies have been looted, destroyed, or blockaded to deny crucial resources to those who need them most.
All of these incidents are not only illegal, but also violate the principle of medical neutrality which states that doctors must practise – and be permitted to practise – medicine fairly and justly without interference from belligerents, and under their obligations of impartiality (without bias or discrimination on the basis of nationality, class, gender, ethnicity, religion, belief, or other features of identity not directly linked to clinical need).
This new report from the BMA’s medical ethics committee analyses these trends and their impact on population health. Chapters cover:
- the international humanitarian law framework
- healthcare workers in conflict
- medical facilities, transport, and patients
- humanitarian aid
- the evolving nature of warfare and its impact on healthcare.
Recommendations
The report also offers a number of recommendations to rectify the situation. The recommendations include:
Governments should:
- reinvest political and financial capital into compliance with IHL as a priority
- recommit to the protection of healthcare, including but not limited to patients, medical personnel, and facilities
- hold other nation states accountable when medical units protected under IHL are attacked as demanded of them by IHL. This could include calling out perpetrators, taking cases to the International Court of Justice (ICJ) or utilising their own courts, ending arms sales, and imposing suitable sanctions.
The United Nations (UN) should:
- establish a UN Special Rapporteur on the Protection of Health in Armed Conflict.
The World Medical Association (WMA) should:
- proactively engage with state actors which are implicated in health-related human rights abuses
- use its voice to raise awareness of such abuses, including with supranational organisations such as the UN
- continually and repeatedly express solidarity in situations where medical personnel are facing such abuses and reiterate that parties in conflict must respect IHL, medical impartiality, and medical neutrality
- call to account any national medical association which is implicated in such human rights abuses.
Medical representative organisations should:
- highlight attacks on healthcare in conflict zones, expressing solidarity with those affected
- pressurise their national governments to take action where the rights and protections afforded to healthcare have been violated in conflict zones
- collaborate with organisations working to protect healthcare in conflict
- build coalitions with similar organisations to raise awareness and lobby appropriate actors
- offer support to members who work in conflict zones, including appropriate mental health support for those who may have suffered trauma such as Post Traumatic Stress Disorder (PTSD) or moral distress.
The full list of recommendations can be found in the report.