Ten years after the UNSC passed Resolution 2286 and committed to protect health care in conflict zones, combatants have attacked health care at least 18,000 times around the world – with attack totals on the rise each year. On this decade anniversary, Physicians for Human Rights (PHR) calls on the UN Secretary-General and UN Member States to:
- Confront the polycrisis facing health care in conflict, by responding to mounting attacks coming amid declining health resources, new technologies, and widespread impunity for attacks;
- Establish a time-bound UN expert group to assess progress and failures since Resolution 2286, as the lack of cohesive UN response to attacks on health care has fueled impunity;
- Factor in the full scope of harm caused by attacks on health care beyond immediate casualty counts, including their reverberating impacts on health systems and civilian populations; and
- Ensure accountability for attacks on health care under international law and enhance protections for patients and health care workers under fire.
“Resolution 2286 was meant to protect health workers and hospitals in war zones,” said Sam Zarifi, JD, PHR’s executive director. “Instead, we are at an inflection point where international law is respected less and less. States and armed groups continue to attack health care because the political, legal, and economic costs of doing so remain far too low. In the 10 years since 2286, there has been only one major international case that has held a perpetrator accountable for violation of the protection of health care in conflict. From Gaza to Ukraine to Sudan, impunity for bombing hospitals, torturing clinicians, or shelling ambulances is the norm.”
“As humanitarian aid shrinks, health systems come under extreme pressure, multilateral institutions face political attacks, and new technologies like drones and AI become increasingly accessible to perpetrators with limited oversight, the Security Council, the UN Secretary-General, and Member States must now address this crisis that threatens public health, human rights, and international security. They must deliver on the unfulfilled promises of Res. 2286 and end attacks on health care,” added Zarifi.
Resolution 2286 emerged from the horrors of the conflict in Syria, where Physicians for Human Rights has extensively documented the assault on health care, with over 600 attacks on 400 health care facilities since the Syrian conflict began in March 2011, the vast majority perpetrated by the Syrian government and its Russian allies. The months after the adoption of the resolution in May 2016 were among the deadliest for health care workers in Syria.
Since then, in armed conflicts around the world, attacks on hospitals, health care workers, medical transport and supplies have become part of broader strategies to undermine civilian life. In 2024, the Safeguarding Health in Conflict Coalition (SHCC) documented 3,623 incidents of violence against or obstruction of health care across 36 countries and territories. This is the highest annual total since global monitoring began in 2014, and a 62% increase from 2022. In 2024 alone, 972 health workers were killed, and 1,111 medical facilities were damaged.
In Ukraine, PHR, eyeWitness to Atrocities, Media Initiative for Human Rights, Truth Hounds, and the Ukrainian Healthcare Center working with Insecurity Insight, which monitors and compiles data on these incidents, have documented more than 2,500 attacks on health since Russia’s full-scale invasion in 2022. These include direct attacks on hospitals and ambulances, occupation and repurposing of health care facilities, looting of medical supplies, detention and killing of health care workers, and attacks on energy infrastructure that have severely disrupted health care delivery.
In Gaza, PHR has documented the devastating consequences of attacks on health care, restrictions on medical supplies, and the destruction of reproductive health services, including severe harms to pregnant people and newborns, preventable suffering, and deaths. Insecurity Insight identified at least 3,239 incidents of violence against or obstruction of access to health care in the occupied Palestinian territory between October 7, 2023 and the end of March 2026.
Since the adoption of the resolution, UN investigative bodies have increasingly examined attacks on health care as part of broader patterns of violations. International courts have also begun to address harms to health and humanitarian access, including the International Court of Justice’s 2024 provisional measures in the Gaza case requiring steps to ensure the provision of urgently needed basic services and humanitarian assistance, including medical supplies. Human rights bodies are increasingly clarifying how the right to health is in jeopardy in armed conflict. Yet this progress has not translated into adequate deterrence or accountability.
As a member of the Safeguarding Health in Conflict Coalition (SHCC), PHR joins the Coalition’s call for urgent action by the UN and Member States to end violence against health care in conflict and ensure accountability for violations. This includes stronger reporting by the UN Secretary-General; public identification of perpetrators; rejection of legal interpretations that weaken protections for health care; coordinated diplomatic and economic pressure on violators; strengthened systematic evidence collection; support for international courts’ and universal jurisdiction investigations; integration of health care protection into military doctrine and targeting processes; restrictions on arms and dual-use technology transfers where there is a risk of misuse; and sustained funding for health systems, humanitarian actors, and civil society organizations working to document, prevent, and respond to attacks.
“Resolution 2286 remains a vital framework. But ten years after its adoption, the measure of its success is whether doctors and patients trust hospitals to be safe and whether those that undermined that trust are held accountable. Today many health care workers in war zones feel more at risk than ever – and perpetrators around the world are emboldened by the impunity to date,” said Zarifi.
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.