HEALTH CARE IN DANGER: PROTECTING THE MEDICAL MISSION

A) Objectifs de l’engagement

This pledge aims to contribute to strengthening the protection of health personnel and assets in situations of armed conflicts and other situations of violence.

Violence against health care in armed conflicts constitutes one of the greatest challenges for International Humanitarian Law. As a consequence, serious problems arise such as insecurity and stigmatization of health personnel and obstacles to humanitarian access, with their consequent impact on the care received by the wounded and sick in contexts of armed conflicts and other related situations of violence.

In recent years, attacks on health care in armed conflicts have been characterized by their persistence and repetition, as well as by the severity of the deliberate violence and of the  direct and indirect harm to individuals. As a result, national and local health personnel are particularly affected, both physically and mentally.

In 2016 and at the joint proposal of the Kingdom of Spain, Egypt, Uruguay, Japan and New Zealand, the United Nations Security Council approved Resolution 2286, on the protection of the wounded and sick, and of medical, health and humanitarian personnel in armed conflicts.

Despite the various initiatives launched to strengthen the protection of healthcare in armed conflicts in the last years, medical and health personnel and health facilities have remained a military target, in flagrant violation of International Humanitarian Law. Attacks on health facilities, means and personnel have a disastrous impact, not only in armed conflicts, with a multiplying effect on the treatment of wounded people, but also in post-conflict phases due to the reduction of health care capacities, which is a serious obstacle to the recovery and dignity of people.

B) Plan d’action

We, the subscribers to this pledge, commit ourselves to:

1. Strengthen the training of the Armed and Security Forces on the rules protecting the provision of healthcare and on the applicable sanctions, as well as the rights and responsibilities of all healthcare personnel, including ethical principles, especially personnel participating in peacekeeping missions outside national territory and members of the military health corps.
2. Promote diffusion and awareness actions on the protection of the medical mission, aimed at the population in general.
3. Ensure that the Armed Forces continue efforts to integrate practical measures for the protection of the wounded, sick and health care services into the planning and conduct of their operations, especially in the Rules of Engagement.
4. Support and promote in the international sphere a more effective implementation of UN Security Council Resolution 2286 (2016), in particular efforts aimed at strengthening reliable data collection mechanisms on attacks on medical and healthcare personnel – such as the existing one within WHO – in the context of armed conflict and in other situations of violence, including the development of common standards for data collection and their systematic analysis as a basis for the adoption of effective public policies on the protection of health in armed conflict.
5. Support the establishment of independent international investigative mechanisms, as well as the work of those already in place, enabling the circumstances under which strikes on medical facilities occur to be determined, with a view to enhancing accountability.
6. Adopt legislative measures to ensure respect for the provision of health services in armed conflict and other situations of violence, including provisions sanctioning the misuse of the Red Cross and Red Crescent emblem in peacetime.
7. Promote measures to prevent the stigmatization of healthcare workers, in line with the humanitarian principles of neutrality, impartiality, humanity and independence and with International Humanitarian Law. Likewise, to promote measures to prevent their criminalization, excluding the provision of health care from the scope of application of anti-terrorist legislation.
8. Increase efforts to support the provision of health care in armed conflict by operationalizing humanitarian exemptions in domestic legislation, in accordance with the standard established by UN Security Council Resolution 2664.
9. Strengthening the training of health personnel in peacetime, in order to enhance resilience and preparedness for action in situations of armed conflict, and put in place mechanisms for adequate mental health care and psychosocial support for health personnel in the context of armed conflict.
10. Work together with local actors, in particular with National Societies of the Red Cross and the Red Crescent, to campaign for improved access to health care in armed conflicts.
11. Promote the establishment of an informal group or other coordination mechanisms to share best practices on health protection in armed conflict and other situations of violence, in order to better comply with UN Security Council Resolution 2286.

C) Indicateurs permettant de mesurer les avancées:

• Number of training actions on IHL for members of the Armed Forces and Security Forces.
• Number of dissemination and awareness-raising actions on the protection of the medical mission and humanitarian access, aimed at the population and Red Cross members, including those carried out jointly with National Societies.
• Number of confirmations that practical security measures are included in the planning of operations.
• Number of measures undertaken in support of the effective implementation of UN Security Council Resolution 2286, especially the collection of data on attacks, including the percentage of health facilities that remain operational in contexts of armed conflict or other forms of violence.
• Number of actions undertaken to support the implementation of international accountability mechanisms.
• Number of measures taken to prevent the misuse of the Red Cross and Red Crescent emblem in peacetime.
• Number of measures taken to prevent the stigmatization and criminalization of health workers for the provision of health services in the context of armed conflict and other situations of violence, in particular by excluding them from the application of anti-terrorist legislation for these activities.
• Number of measures adopted to adapt national legislation to United Nations Security Council Resolution 2664 on humanitarian exemptions.
• Establishment of informal coordination mechanisms between countries to share best practices on health protection in armed conflicts and other situations of violence and compliance with United Nations Security Council Resolution 2286.

D) Ressources nécessaires:

Human resources from the Government of the Kingdom of Spain and the Spanish Red Cross will work together in different working groups to monitor and report on the final pledge. Likewise, for the fulfilment of the indicators, appropriate financial resources will be made available.