WHO / Sean Hawkey

WHO Global Health for Peace Initiative (GHPI)

Health and peace are interrelated. In the words of the Director-General of WHO, Dr Tedros, “there cannot be health without peace, and there cannot be peace without health”. Conflicts are a major obstacle to health, while a lack of access to health and basic social services can lead to feelings of exclusion, which are in themselves a major driver of conflict and violence. Delivering health care can help to prevent this vicious circle, if done so in a way that is specific to the context, sensitive to the triggers of the conflict, and both delivers health benefits and contributes to the peace process.

WHO’s Global Health for Peace Initiative (GHPI) involves WHO building on its technical competencies, legitimacy, relationships and convening power in health to develop innovative ways to address conflict, strengthen resilience to violence and empower people to (re)build peaceful relations with each other. It builds on WHO’s comparative advantage in delivering public health interventions, with the addition that these health interventions are at least context-specific and conflict-sensitive, and at best, peace responsive, while also delivering on both WHO's Triple Billion goals and the Sustainable Development Goals.

Health interventions are particularly well-suited for peacebuilding because caring for the sick and injured is considered both a neutral activity and a universal good. Health is often seen as a common goal for all sides of a conflict, capable of aligning warring factions towards a shared perspective. The fair and balanced delivery of health care and other social services is also crucial in conflict-affected settings, as inequitable access can be a key trigger or driver of conflict.

An innovative approach

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Paris Peace Forum presentation

What is new and innovative about the Health for Peace approach is that health programmes can be used not only to work in conflict (achieving health benefits in conflict situations) but also to work on conflict. At a minimum, Health for Peace programmes seek to “do no harm”, while striving “do more good”: avoiding unintentionally fuelling conflict and instead focusing on using health care to address some of a conflict’s underlying causes.

In this way, the Global Health for Peace Initiative (GHPI) builds on past WHO health programmes which looked at delivering health interventions with direct health benefits in conflict settings, such as the WHO Health as a Bridge for Peace projects in the 1980s and 1990s.

Peace-relevant health interventions can help improve the prospects for local peace in at least four ways:

As a minimum, by mainstreaming conflict-sensitivity into humanitarian analyses and assessments, recruitment, programming and monitoring and evaluation.
By working to improve trust and communication between citizens and the state by making health care more accessible and equitable.
By building collaboration between different sides in a conflict on common topics like health governance and the delivery of care.
By improving social cohesion at local level through community healing or inclusive, health promotion initiatives.

On this basis, the Global Health for Peace Initiative (GHPI)’s theory of change is articulated this way:

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Source: WHO (2020), Health and Peace Initiative

Some examples of WHO working in and on conflict

Sri Lanka, 2016: Psychosocial services in support of the reparation and reconciliation process

As part of the national Peacebuilding Priority Plan, WHO supports the government in leading a victim-centric process of accountability, truth-seeking, reparations for past violations and guarantees of nonrecurrence in line with international standards and obligations. As part of this plan, WHO provides psychosocial support to address the psychological impacts of the conflict on women, children and persons with conflict-related disabilities.

Colombia, 2016: Integration of health personnel into the health system

As part of the demobilization and reintegration programme linked to the peace agreements of 2016, some 200 young Colombians with health expertise — mostly former FARC members – were sent to medical school in Cuba. The student doctors were trained in accordance with the Cuban family medicine model and returned to Colombia to improve and strengthen primary health care for the underserved.

Tunisia, 2012-2014: Participatory mechanisms to develop a national health policy in Tunisia and build trust

In post-revolution Tunisia, policy reforms were required in several key public sectors, including health. To break with the past denial of citizen participation in public policy processes during the authoritarian regime, a “Societal Dialogue for Health System Reform” was launched to capture the needs, perceptions and ideas of Tunisians for a new national health system. The mechanism aimed genuinely to involve all segments of society in order to address the lack of confidence and misunderstandings between institutions and citizens which were legacies of decades of autocratic rule.

Three popular consultation methods were used. First, the “citizens’ meetings on health” gathered several thousands of people at governorate level and identified key challenges of the health sector and attitudes towards reforms. Second, focus groups with vulnerable and marginalized populations (e.g. patients living in poor urban areas, single mothers, families living in polluted industrial areas) helped capture group-specific challenges in access to health care which otherwise would not be heard in large gatherings. Third, a “citizens’ jury” composed of approximately 100 randomly selected persons from across the country was tasked with making decisions on specific issues related to the major topics emerging from the wider meetings and focus groups.

Health, Sustaining Peace and the Humanitarian-Development-Peace Nexus

VIDEO - Credits: Interpeace/Geneva Peace Week

The Global Health for Peace Initiative (GHPI) is WHO’s contribution to the growing architecture linking humanitarian assistance, long-term sustainable development (through the Sustainable Development Goals) and peacebuilding.

The Global Health for Peace Initiative (GHPI) furthers the Humanitarian-Development-Peace Nexus by reinforcing the key role of health as a driver of peace and sustainable development (through Universal Health Coverage and the rebuilding/strengthening of inclusive health care systems) in fragile, conflict-affected and vulnerable (FCV) settings. Through its engagement in the Inter-Agency Standing Committee (IASC), WHO played a central role in developing the inter-agency guidance on Collective Outcomes (country sustainable development priorities that unite humanitarian, development and peace objectives, as well as the efforts of government, UN/NGOs and civil society), and works to promote health as a Collective Outcome in all FCV settings.

The Global Health for Peace Initiative (GHPI) is also WHO’s contribution to putting the “peace” in the Humanitarian-Development-Peace Nexus, under its commitment to the United Nations Sustaining Peace Resolutions (A/RES/70/262 and S/RES/2282). These resolutions request all parts of the UN family and the World Bank to use their influence for mediation, conflict prevention and conflict resolution.

Through partnerships with traditional health partners, other UN entities and peacebuilding actors such as Interpeace, the UN Peacebuilding Support Office, Geneva Call, the Geneva Peace Platform and the Centre of Competence on Humanitarian Negotiation, WHO is playing an increasing role in FCV settings around the world to better understand the contexts in these areas and how health interventions will interact with them for the benefit of all communities.

Combating COVID-19 through peace

The COVID-19 outbreak has demonstrated that health emergencies, or the responses to them, can be a trigger or an aggravating factor for conflict. However, it has also demonstrated that health programs can be powerful enablers in the peace building process and carefully chosen health activities can deliver peace dividends in addition to health benefits. The Global Health for Peace Initiative (GHPI) brings this into focus and emphasizes that the connection between health and peace is real, powerful and essential to ensuring the effectiveness and sustainability of health programmes.

Through participation in fora such as the 2020 Paris Peace Forum and the 2020 Geneva Peace Week, WHO is working with partners to explore the intersections of conflict, peace and COVID-19, and how to incorporate lessons learned and best practices in the Global Health for Peace Initiative (GHPI). This has included collaborating with stakeholders such as the International Labour Organisation (ILO), Interpeace and the UN Peacebuilding Support Office of the Department of Political and Peacebuilding Affairs (DPPA) to look at key policy and programmatic considerations for health and employment inteventions responding to COVID-19 in conflict-affected countries, and which also mitigate the impacts of the pandemic.

Health for peace documents