AUB at the UN: Academia should join international efforts to stop attacks on Health Care

Attacks on health professionals and facilities have significantly increased in armed conflicts across the world. Aid workers, hospitals, health centers, and ambulances are targeted regularly in a clear violation to basic human rights and the international humanitarian law, and despite United Nations’ (UN) resolutions condemning these attacks and international calls to stop them.


With the goal of advancing global efforts to protect health care in conflict areas, and in follow up to the UN Security Council Resolution 2286, the Permanent Missions of Canada, the Netherlands, Spain, and the United Kingdom to the UN organized in collaboration with the Lancet-American University of Beirut Commission on Syria and Safeguarding Health in Conflict Coalition, a High-Level Side Event entitled “Protecting Healthcare in Armed Conflict,” addressing the different aspects of this critical topic.


Held during the 72nd session of the UN General Assembly, on Friday, September 22 at the UN Headquarters in New York, the Side Event gathered more than 100 representatives and experts from Member States, NGOs, research and academic institutions, and the international civil society.


In their speeches, dignitaries and panelists urged further international cooperation in protecting health care, calling for tangible steps to prevent further attacks, ensure the implementation of existing resolutions and the respect of international conventions, and most importantly, save human lives.

In her opening speech, the Minister of Health of Canada, Ginette Petitpas Taylor, described the event as “a critical opportunity to demonstrate our leadership and our unwavering commitment to the implementation of the UN Resolution 2286.” Highlighting the role of governments in halting the threats faced by healthcare in armed conflicts, Petitpas Taylor stated “we must keep this issue front and center on global stage if we are to move from awareness to action, in order to meaningfully improve the situation on the ground.”

“Efforts taken by the international community to improve a child’s access to vaccine, a woman’s access to safe birthing environment are at risk of being reversed,” she added. 

Likewise, the Vice-Minister of Foreign Affairs of Spain, Ildefonso Castro, asserted that Resolution 2286 was a “great achievement.” “Having 84 co-sponsors was gracious.” 

Castro stressed the urgent need to implement the Resolution, noting that the “political will is the major obstacle” hindering the implementation. “If the Resolution 2286 is not reflected on the ground, we need to step up our efforts,” added the Vice-Minister.

The Vice Minister for International Cooperation of the Kingdom of the Netherlands, Christiaan Rebergen, considered the lack of “accurate and standardized information” one of the factors preventing the implementation of Resolution 2286. “Collection of data will help us establish accountability mechanisms for suspected perpetrators of war crimes, and other international crimes […] We look forward to the UN, The United Nations Office for the Coordination of Humanitarian Affairs (OCHA), and the World Health Organization (WHO) to set up a global system of data collection and to report annually to the United Nations Security Council (UNSC).”

The Vice Minister for International Cooperation of the Kingdom of the Netherlands, Christiaan Rebergen, considered the lack of “accurate and standardized information” one of the factors preventing the implementation of Resolution 2286. “Collection of data will help us establish accountability mechanisms for suspected perpetrators of war crimes, and other international crimes […] We look forward to the UN, The United Nations Office for the Coordination of Humanitarian Affairs (OCHA), and the World Health Organization (WHO) to set up a global system of data collection and to report annually to the United Nations Security Council (UNSC).”

Pointing out that the Kingdom of the Netherlands will be elected a member in the Security Council in 2018, Rebergen warned that “if the Security Council does not address the threat to the safety of the medical missions and ensures that perpetrators will be held accountable, we will risk more general erosion of respect of international humanitarian law.”

Ambassador and Permanent Representative of the United Kingdom to the UN, Matthew Rycroft in turn highlighted the attacks on health care in the ongoing Syrian conflict. “Syria sets a particularly dangerous global precedent. It represents the most severe death toll of health workers and the most widespread destruction of health on an unprecedented scale.” 

Addressing the reports about attacks on medical facilities in Syria’s Hama and rural southern Idleb, Rycroft said “one of the hospitals that was destroyed specialized in maternity and pediatric care.  On a monthly basis, the hospital was providing an average of 13,000 consultations, 2,300 admissions, 1,500 major surgeries and 1,500 war related trauma cases.  With one strike, the facility went completely out of service.”

“The impact of that one attack will have far reaching, potentially fatal, consequences for thousands of women and children - now and in the future.”

Rycroft also called for reporting the attacks on health care to the UN Security Council. “The Council needs to know that the attack happened, the impact of the attack, and what is known about alleged perpetrators.”

Representing the American University of Beirut (AUB), the Dean of the Faculty of Health Sciences (FHS) and the Co-Chair of the Lancet-AUB Commission on Syria, Dr. Iman Nuwayhid, underlined the role of academic and research institutions in the light of the ongoing targeting of health care in warzones. 

“As an academic institution rooted in the Arab region, AUB has utilized what it does best, research and education, to better understand war and conflict in the region and assess their impact on health and wellbeing. Towards this goal, the Lancet-AUB Commission on Syria aims to produce the best evidence possible on health in conflict for use in policy and practice.”

“Understanding conflicts, and analyzing its burden on health is not an easy task and goes beyond tallying the dead and injured. Such analysis requires an interdisciplinary approach that helps delineate the political factors from the economic, social, and environmental, construct the historical and political context of the war, and untangle the local from the regional and international.”

Nuwayhid condemned the weaponization of health care and its usage as a political mean: “health and healthcare became a political tool reflecting the interest of state and non-state actors at the local, regional, and international levels.”

Assuring the important role of academic and research institutions in addressing such critical issues, Nuwayhid stated that “most universities and academic institutions prefer to step away from an advocacy role, especially in contexts of political divisions, but this is beyond politics. The academe should join the tremendous international efforts to keep the pressure until such attacks stop, be it in Afghanistan, Iraq, Palestine, Syria, or Yemen. Perpetrators should be named and in many cases they are known. The UN Security Council Resolution 2286 is one tool in this direction but it needs concrete and clear steps to implement it.”

In his intervention, director of programs at Physicians for Human Rights, Dr. Homer Venters, spotlighted the problem from a global perspective stating that “Professional medical societies worldwide should stand together.”

Affirming that the situation of health care is worsening in armed conflicts, Venters stressed that “accountability must come from many directions. And it must involve new partners.”

President of the Syrian American Medical Society (SAMS), Dr. Ahmad Tarakji, and Chair of Safeguarding Health in Conflict Coalition, Leonard Rubenstein, discussed the response of the international society, highlighting the lessons learned in current wars and suggesting next steps to be taken by the international community to prevent future targeting of health care.

“In Aleppo, a city with over 300,000 inhabitants, only 29 doctors are able to operate,” said Tarakji.

In addition to the devastating emotional impact that family members experience when losing a husband, a father, a son, or a brother who’s a physician, they also have to deal with the financial consequences. Tarakji noted that “organizations or agencies do not offer any type of compensations or salaries for the families of health professionals who lost their lives on duty,” leaving the vast majority of them in critical conditions. 

Tarakji spotlighted in his speech three key steps that aim to halt further attacks on health facilities and personnel. First of which is to “create a preemptive clear mandate in every conflict since day one, involving collective efforts by members of the international community, particularly the Security Council.” As for the second step, Tarkaji called for the establishment of “concrete accountability measures” and enforcing them since “war lords have learned that there’s no accountability, and they continue to attack health care facilities and personnel to negotiate better political positions.” The third key step according to the President of SAMS is to “empower and strengthen local health system and workers. Many conflict are happening nowadays in poor countries. Health professionals there do not have access to any means enabling them to help their patients in times conflict, or bring perpetrators to justice.” 

On the other hand, and in the light of current violations to the international humanitarian law, Tarakji considered that “partnerships and networks between international agencies as well as local NGOs and academic institutions is the way to go forward to re-establish international humanitarian laws.”

“We are at a different place than we were five years ago, where global attention to the attacks on health care was almost non-existent,” Rubenstein stated. 

He pointed out that next step after the adoption of Resolution 2286 has been “virtual paralysis” instead of moving forward. “Paralysis, though, should not impede action by the many member states that deeply belief in the norms of civilian protection and the sanctity of health care.”  

Rubenstein outlined a set of concrete steps that states can take now to stop attacks on health care and ensure accountability “as you know the Council has not even adopted the extensive and sensible recommendations of the Secretary General to member states to reform their laws, improve their military practice, strengthen their investigations, and ensure accountability – and report on all of these actions.  And the failure to follow through reinforces impunity.”

Professor Naz Modirzadeh, Director of Harvard Law School Program on International Law and Armed Conflict (HLS PILAC), highlighted the significance of respecting the international humanitarian law in light of recent armed conflicts.

“One of the ways that international law can be developed progressively or can be destroyed is through statements and actions” of countries. “Every state, small or large, powerful or weak, involve in war or not, has the ability to develop, reaffirm, strengthen international law and its principles, or the ability, through silence, sitting back, or not speaking out to contribute to its degradation.”

Consequently, Modirzadeh stated that “in times of conflict, international law extends to protect the wounded and the sick who need medical care, those providing them with medical care, as well as the facilities and goods required to provide that medical care.” 

During the discussion, there were interventions from senior WHO staff, high-level dignitaries from several member states and civil society/non-governmental organizations that stressed the importance of collective action that brings together all concerned parties in addition to member states to stop attacks on health care.

Dr. Nuwayhid concluded the panel highlighting the key issues discussed, and some of the recommendations and next steps proposed by dignitaries, panelists and participants to scale up international cooperation to protect health care personnel and facilities in armed conflict.

Following the Side Event, the Commission and the Coalition hosted some of the participants at the AUB New York Office for a lunch and roundtable. Participants continued the discussion and explored concrete steps to implement some of the recommendations that emanated from the UN General Assembly Side event.​​