WHO's Resolution by Consensus on Health and Humanitarian Access in the Palestinian Territories
WHO's Resolution by Consensus on Health and Humanitarian Access in the Palestinian Territories
Newsletter Edition #204 [The Files In-Depth]
Hi,
Health has got ensnared in geopolitics. Not for the first time. It is only fitting that as the lead technical agency of the UN, WHO member states come together to acknowledge, take note and take action in the unraveling humanitarian disaster in the Palestinian territories.
In today’s edition, we bring you a brief update on the significant Special Session of the WHO Executive Board held earlier this week.
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I. STORY OF THE WEEK
WHO's Resolution by Consensus on Gaza's Health and Humanitarian Access
By Yiyao Yang & Priti Patnaik
In a rare special session of the WHO Executive Board, the first such session on an active conflict, member states on December 10th, adopted a politically significant resolution on Health conditions in the occupied Palestinian territory, including east Jerusalem. It was initially proposed by Afghanistan, Morocco, Qatar and Yemen.
Although the resolution was adopted by consensus, the path towards adoption was fraught with difficult negotiations as was evident in the webcast of the session where countries made several statements reflecting complicated geopolitics and the sensitive conditions in Palestine.
“This is a meeting that we would rather not have,” DG Tedros said in his opening remarks. “Health needs [in the occupied Palestine territory] have increased dramatically and the capacity of the health system has been reduced to one-third of what it was.” He urged countries to use health as a bridge to peace.
Delegates of both Palestine and Israel had several statements during the proceedings. The Palestinian Ministry of Health began by condemning the Israeli military occupation forces, asserting that they have "ruthlessly targeted every aspect of life in Gaza." The representative emphasized the catastrophic health situation in Gaza, stating, "Almost 1.9 million people in Gaza, or nearly 85% of the population, are forcibly displaced." In shelters, "160 people share the same toilet, and 700 people share each shower unit, with less than 3 litres of water available per day per person", she added. Following Palestine's statement, the Israeli representative condemned Hamas for militarizing hospitals and abusing healthcare facilities.
The expansive four-page resolution begins with “noting the role of WHO within its mandate as directing and coordinating authority on international health matters.” The resolution acknowledges the current crisis; attacks on health facilities; loss of lives of health care workers; the need for specialized health care needs including of newborn babies, and those with severe conditions; refers to the “public health management implications of the existence of thousands of corpses of victims in the Gaza Strip buried under the rubble”; the increasing risks of infectious diseases. It emphasizes obligations under international humanitarian law and cites the appeal for a humanitarian ceasefire called by U.N. Secretary-General, on December 6 2023 by invoking Article 99 of the United Nations Charter.
In its operational paras, the resolution states:
“1. CALLS FOR the immediate, sustained and unimpeded passage of humanitarian relief, including the access of medical personnel, the entry of humanitarian equipment, transport and supplies in the occupied Palestinian territory, in particular the Gaza Strip, and the granting of exit permits for patients in need of medical treatment outside the Gaza Strip, and stresses the need for the unhindered and safe passage of ambulances at checkpoints, especially in times of conflict [based on A/HRC/Res/52/3];
2. CALLS UPON all parties to fulfill their obligations under international law, including international humanitarian law and international human rights law to ensure, to the fullest extent of the means available to it, the supply and replenishment of medicine and medical equipment to the civilian population, and reaffirms that all parties to armed conflict must comply fully with the obligations applicable to them under international humanitarian law related to the protection of civilians in armed conflict and medical personnel [GC IV, article 55; SC Res 2286];
3. DEMANDS that all parties fully comply with its obligations, in particular its obligations under the Geneva Conventions of 1949 and the obligations applicable to it under the Additional Protocols, 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 [based on OP 2, SC Res 2286];
4. DEMANDS further a sustained, orderly, unimpeded, safe and unobstructed passage for medical personnel and humanitarian personnel exclusively engaged in medical duties, their equipment, transport and supplies, including surgical items, to all people in need, consistent with international humanitarian law [SC Res 2286], calls for the passage for ambulances and medical evacuations of critically injured and sick patients as well as respect and protection of the wounded, sick and injured, and ensuring the safety, security and safe movement of all Palestinian patients to receive medical needs and treatments, and calls for the human treatment of all persons deprived of their liberty and their access to medical treatment in compliance with international humanitarian law, including the Geneva Conventions and their Additional Protocols;”
THE POSITION BY THE U.S. AND OTHERS
The US expressed significant reservations and dissociated from two paragraphs of the resolution text, including the language on “ceasefire” in a preambulatory paragraph.
The US recalled the UN Security Council (UNSC) session on Friday, 8 December, where it voted against a proposed resolution calling for an immediate ceasefire in Gaza. This followed the UN Secretary-General Antonio Guterres’ invocation last week of Article 99 of the UN Charter to formally call on the Security Council to “press to avert a humanitarian catastrophe in Gaza and unite in a call for a full humanitarian ceasefire between Israel and Palestinian militants”.
At the WHO, the US stated that “calling for a ceasefire is not only unrealistic but also dangerous. A ceasefire would simply leave Hamas in place, able to regroup and repeat what it did on October 7”, although it did “not block the consensus of the text”.
Bathsheba Crocker, the US Permanent Representative to the United Nations and Other International Organizations in Geneva, said, at the end of the special session, that “A few days ago, a senior Hamas official again stated that the group intends to repeat the vile acts of October 7, ‘again and again and again.’”
She also expressed disappointment that the resolution text does not mention that “Hamas’ terrorist attack killed over 1,200 people, the sexual violence Hamas has perpetrated, or that more than 200 hostages were taken by Hamas, and many continue to be held”.
A statement by the U.S. said (excerpts):
“…The United States is grateful for the efforts of so many members of the Executive Board who worked to reach a consensus text. We agreed not to block consensus on the text, but we must be explicit about our significant reservations.
The United States does not agree with the language in preambulatory paragraph 8 and dissociates from it. As we expressed at the Security Council on Friday, calls for a ceasefire are not only unrealistic but dangerous – for a ceasefire would simply leave Hamas in place, able to regroup and repeat what it did on October 7. Hamas does not dispute this. A few days ago, a senior Hamas official again stated the group intends to repeat the vile acts of October 7, “again and again and again.”
The United States also does not agree with the language in operative paragraph two and dissociates from it. While the United States continues to underscore the imperative of making available medicine and medical equipment to civilian populations and recognizes that certain relevant obligations under international humanitarian law could apply in certain circumstances, there is no general international humanitarian law or international human rights law obligation to ensure the supply and replenishment of medicine and medical equipment.
As a point of clarification, the United States does not recognize the terminology of “Occupied Palestinian Territories, including East Jerusalem.” Rather, sovereignty issues need to be negotiated between the two parties going forward.
Additionally, the United States considers this resolution and the focus of our discussions today to apply solely to the current situation in Gaza.
No part of this resolution, including references to obligations under international humanitarian law, should be understood to alter the current state of conventional or customary international law or create rights or obligations under international law….”
Canada sees this resolution as a “compromised resolution”. It called for acknowledging the role of Hamas, its taking hostages and use of human shields. Australia is also among the countries which expressed concerns over the absence of language on “Hamas” in the resolution text.
THE WAY FORWARD
Recognising the significance of the first consensus resolution among member states on the ongoing conflict in Israel and Occupied Palestinian Territories, which “has not been achieved in other international fora”, Tedros reiterated that it is “a starting point”.
WHO resolutions, though significant, are not legally binding.
The resolution asks the DG to “coordinate with donors, prior to the Seventy-seventh World Health Assembly, to secure the funding for the immediate health needs as well as the rehabilitation and rebuilding of the health system in the occupied Palestinian territory, including east Jerusalem”.
The resolution demands all parties 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”.
Healthcare facilities continue to be a target. Since 7 October, WHO has verified “more than 449 attacks on healthcare in Gaza and the West Bank, and 60 attacks on healthcare in Israel”.
According to the WHO’s report as of 7 December, there have been 17,487 Fatalities in the Gaza Strip, 70% of which are women and children, with 46,480 injured. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) OCHA, “265 Palestinians, including 69 children, have been killed by Israeli Security Forces (ISF)” in the West Bank, including East Jerusalem, since 7 October.
On Tuesday 12 December, two days following the WHO EB’s move, the Kamal Adwan Hospital, as the only remaining health facility within the northern part of Gaza, was reportedly “raided” by the Israeli forces. “We call on the United Nations, the World Health Organization and the International Committee of the Red Cross to act immediately to save the lives of those in the hospital,” said a Palestinian Ministry of Health spokesperson to Al Jazeera.
At the EB session, a representative from Afghanistan said that the attack on healthcare facilities in Gaza is “a common story we hear”, which started years ago in Afghanistan, in Syria, and in Ukraine. He proposed to include this agenda item in the upcoming EB meeting in January 2024 for an “extensive discussion” and a “possible solution”.
“Without a ceasefire, there is no peace. And without peace, there is no health,” Tedros said in his closing remarks.
The WHO Global Health and Peace Initiative (GHPI), jointly launched by Oman and Switzerland in 2019, proposes to use health as a starting point for promoting peace. The WHO is developing the roadmap, with a report by the director-general scheduled to be made at the World Health Assembly (WHA) in 2024.
Also see this: New York Times “The U.N. General Assembly counters a U.S. veto with a mass vote for a cease-fire.”
II. PODCAST CORNER
Dialogues: a conversation with Vidya Krishnan
Dialogues is a new series from the Global Health Matters podcast where with interviews featuring fresh perspectives on global health issues. The goal of each Dialogue is to break through our echo chambers that exist in global health through in-depth, thoughtful conversations.
In this episode of Dialogues, host Garry Aslanyan speaks with Vidya Krishnan, a health-focused Indian investigative author. Vidya’s book, “ The phantom plague: how tuberculosis shaped history” (PublicAffairs Books, 2022), is about how history shaped tuberculosis, especially in India, and how tuberculosis transmission persists because of conditions such as poverty, crowding, a lack of political commitment and poor public policies. She notes in her book that “poverty is the disease, tuberculous is the symptom.” This conversation reminds us, as global health professionals, of many challenges on the long road ahead toward the ultimate goal of tuberculosis elimination and the importance of community engagement.
Garry Aslanyan is the host and executive producer of the Global Health Matters podcast. You can contact him at: aslanyang@who.int
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