Ten years ago, the UN Security Council unanimously adopted Resolution 2286 on health care in armed conflicts. The situation is even worse compared to 10 years ago. Today, we mark not an achievement – we mark a failure.  

As violence affecting medical facilities, transport and personnel continues unabated, the harm this resolution sought to prevent has not diminished. It has continued and, in many contexts, intensified.  As the heads of the International Committee of the Red Cross (ICRC), the World Health Organization (WHO), and Médecins Sans Frontières (MSF), we join others in the international community in issuing an urgent call for action.

Every day on the front lines of the world’s most devastating crises, our teams witness the catastrophic consequences when the sanctity of health care is compromised. Hospitals are reduced to rubble, ambulances face delays and obstruction, doctors, nurses and patients are too often caught in attacks that result in death and injury. Patients die from otherwise treatable wounds, women are sometimes forced to give birth without adequate 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 harm of war are breaking down. When hospitals and those who provide care come under attack, we face not only a humanitarian crisis, but a crisis of humanity.

States and all parties to armed conflict must comply with the rules protecting 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 conflict do the same.

The recommendations of the UN Secretary-General that accompanied Resolution 2286 remain a clear, actionable roadmap for states. The ICRC, WHO and MSF stand ready with our presence in conflict settings, medical expertise and operational capacity to support states in implementing these critical measures.

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

To  uphold and advance Resolution 2286’s demand “that all parties to armed conflicts fully comply with their obligations under international law… to ensure the respect and protection of all medical personnel and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical facilities”; and to prevent another decade of deteriorating norms and unjustifiable violence  affecting health care in conflict settings, we call upon all states to urgently implement the following measures:

• translate existing commitments into concrete action to implement Resolution 2286 and actively promote the positive efforts, including the outcome of the Global IHL initiative’s workstream on achieving meaningful protection for hospitals;
• integrate the protection of health care into armed and security forces’ doctrine, rules of engagement and operational guidance to give practical effect to IHL obligations;
• review, enact and strengthen domestic laws to protect health care in armed conflict;
• allocate adequate financial, technical and operational resources to implement measures that protect health care and promote respect for its provision;
• use all available means to influence other parties to conflict –  including those that states support in any form – to comply with their obligations to protect health care;
• conduct swift, transparent and impartial investigations into attacks on health care and support efforts to ensure accountability in line 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 that 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 being caught in attacks that result in death and injury. That is not a failure of the law. It is a failure of political will.

We urge world leaders to act and show the needed political leadership to end this violence. Health care must never be a casualty of war.