Humanitarian Health Action

Attacks on health care questions and answers

What is the Attacks on Healthcare project?

The WHO Attacks on Healthcare project has three outputs:

  • EVIDENCE
    Develop a body of evidence to better understand the extent and nature of the problem and its consequences to health care delivery

  • ADVOCACY
    Develop a strong advocacy campaign to end attacks on health care, the sanctity of health care in all circumstances, the delivery of health care unhindered by violence, and the application of International Humanitarian Law.

  • ACTION
    Develop and promote the implementation of best practice for the prevention of attacks and the mitigation of their consequences to health service delivery, particularly through the actions of WHO’s country offices, Member States and other health actors in countries facing emergencies.

The beneficiaries of this project are the health facilities, health workers and patients who are victims of violent attacks, and the emergency-affected populations who are deprived of health care due to the resulting disruptions to health care delivery.

Why has the WHO undertaken the Attacks on Healthcare project?

Violence against health care has sparked outrage at the WHO. The WHO’s Director-General has been an outspoken advocate for the right to health, making numerous statements to highlight WHO’s concern with the frequency of attacks on health care and their impact on health workers and service delivery.

Resolutions of the World Health Assembly reinforce WHO’s strong position against violence in health care settings, and WHA Resolution 65.20 (2012) specifically called on WHO’s Director-General to provide global leadership in the development of methods for systematic collection and dissemination of data on attacks on health facilities, health workers, health vehicles and patients in complex humanitarian emergencies, in coordination with other relevant United Nations bodies, other relevant actors, and intergovernmental and nongovernmental organizations.

What are attacks on health care?

Attacks on health care are any act of verbal or physical violence or obstruction or threat of violence that interferes with the availability, access and delivery of curative and/or preventive health services during emergencies.

Attacks on health can include bombings, explosions, looting, robbery, hijacking, shooting, gunfire, forced closure of facilities, violent search of facilities, fire, arson, military use, military takeover, chemical attack, cyberattack, abduction of health care workers, denial or delay of health services, assault, forcing staff to act against their ethics, execution, torture, violent demonstrations, administrative harassment, obstruction, sexual violence, psychological violence and threat of violence.

What are the consequences of attacks on health care?

Every attack on health care has a domino effect. Such attacks not only endanger health care providers; they also deprive people of urgently needed care. The full extent is presumed to be significant, negatively affecting short-term health care delivery as well as the longer-term health and well-being of affected populations. They affect health systems, the health workforce, and ultimately our global public health goals. Years of education and experience lost with the early and tragic death of each health care worker. It will take time and resources to train new nurses or doctors. Resources will be required to rebuild one hospital. We cannot accept these losses as normal.

What additional information do we need?

We need a standardized approach to gather and share information on attacks on health care and their consequences to health service delivery so that the information that is being collected is comparable.

The most significant knowledge gap is the consequences of attacks on health care delivery, on the health of affected populations, on health systems, on the health workforce, and on longer-term public health. This is a priority for data collection moving forward. The WHO is collaborating with academic institutions and Non-Governmental Organizations to develop a research agenda, which will help us to understand the extent and nature of the problem and to identify and implement concrete actions to reduce the risk and impact of attacks during emergencies.

What is the Surveillance System of Attacks on Healthcare (SSA)?

The SSA is a global standardized and systemic approach to collecting data of attacks on health care. This system utilizes the same methodology across countries to address the knowledge gap of the extent and nature of attacks on health care.

WHO Country Offices work closely with partners to ensure there is a wide and inclusive range of reporting contributors.

The SSA will allow for the production of regular reports with consolidated data, identify global and context-specific trends and patterns of violence and allow comparisons between regions and contexts.

To view the SSA please visit our dashboard or the online at http://ssa.who.int

What can be done to stop attacks on health care?

Priority actions include the following:

  • Gather and consolidate comparable data; establish national registries
  • Document the consequences of attacks to health care delivery and public health
  • Establish national legislation to uphold International Humanitarian Law
  • Implement risk reduction measures, including through WHO’s Safe Hospitals Programme
  • Engage communities in protecting health care
  • Inform emergency response plans with security risk analysis
  • Document and apply good practices
  • Promote and apply ethical principles in health care delivery
  • Speak out and advocate with zero-tolerance