ResourcesOpen Letter

Stop Attacks on Health in Ukraine: Open Letter to Dr. Tedros Adhanom Ghebreyesus

March 23, 2022

His Excellency Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization

Your Excellency:

The undersigned leaders of organizations active in global health in areas of conflict express our appreciation for the WHO’s rapid confirmation of attacks on health care in Ukraine through the Surveillance System for Attacks on Health Care (SSA) and your strong joint statement with UNICEF and UNFPA about these attacks. We also welcome your speaking about the attacks on hospitals in Ukraine, as well those in Tigray, and elsewhere in your recent press briefings and at the Security Council. 

Your continued and expanded leadership is essential to protect the people of Ukraine and in other areas of conflict from the damage and destruction of hospitals and assaults on ambulances, health workers, and patients. Toward that end, we urge you and the WHO to take the following additional steps to increase pressure to stop attacks on health care in Ukraine and in other countries and territories.

1. Issue a fact sheet and hold a special press briefing to explain to the international media–and therefore the world–the location and a detailed description of confirmed attacks on health in Ukraine. As you know, the source of the WHO’s reports, the Surveillance System for Attacks on Health Care, provides only general categories of attacks (e.g., object of attack, weapons used) and resulting injuries and deaths. It provides no information on the facility subjected to the attack, the conduct involved, or where the attack took place. As a result, Member States, health workers organizations, and the broader public have only an abstract understanding of the violence occurring and none on where it occurs. Information made available through a fact sheet and press briefing would help the global community understand the dynamics of the violence and have the potential to increase pressure on perpetrators to conform to international humanitarian law.

We understand that in some circumstances security considerations may preclude sharing details of some of these attacks, but that can be decided on a case-by-case basis. Regional and country WHO offices, for example in Palestine and Afghanistan, have often provided such details, and we believe a press conference about the attacks would both increase knowledge about them and develop further pressure to stop them.

2. Expand the WHO’s leadership on protection of health care. We believe you can use your platform, representing the entire global health community, to speak more frequently about violence against and obstruction of health care and further expand the WHO’s engagement in other ways to raise the visibility of the violence and increase pressure on perpetrators to stop. We would be pleased to discuss ideas for greater engagement.

3. Address the current limitations of the Surveillance System for Attacks on Health Care. As reporting on the Ukraine crisis has shown, the Surveillance System for Attacks on Health Care has become an important global resource, but it is extremely limited both in the extent of and nature of its reporting of attacks. As noted above, it lacks information about the object of the attack, a description of the incident and where it took place. The lack of essential information to understand what happened in each incident renders the system less useful, not only for pressuring combatants to conform to international humanitarian law but also to develop prevention strategies. Further, in many conflicts, the surveillance system does not report many incidents that are reported elsewhere and could easily be confirmed. The absence of more comprehensive reporting can lead Member States, the media, and the public to believe that attacks are not taking place. Therefore, we ask that you urgently address the system’s limitations. The WHO could also strengthen coordination with UNICEF and other agencies monitoring grave violations against children regarding attacks on health care.

Thank you very much. We look forward to working together to address the terrible violence inflicted on health facilities, personnel, and transports, and the people they serve in Ukraine and other places in conflict.


For Professional Associations

Elizabeth Adams, President, European Federation of Nurses

Dr. Georges Benjamin, American Public Health Association

Dr. Pamela Cipriano, President, International Council of Nurses

Dr. Victor J. Dzau, President, Institute of Medicine (in his personal capacity)

Dr. Zoe Greaves, Chair, British Medical Association Ethics Committee

Dr. Christiaan Keijzer, Standing Committee of European Doctors

Dr. Otmar Kloiber, Secretary-General, World Medical Association

Dr. Keith Martin, Executive Director, Consortium of Universities for Global Health

For NGOs

Dr. Sarah Band, Honorary Deputy Medical Director, Maternal and Childhealth Advocacy International

Polly Dunford, President and CEO, IntraHealth International 

Dr. Ran Goldstein, Executive Director, Physicians for Human Rights Israel

Dan Irvine, Senior Director for Health and Nutrition, World Vision International

Iain McSeveny, Interim CEO, Medical Aid for Palestinians

International Rescue Committee

Jennifer Sime, Interim Executive Director, Physicians for Human Rights

Dr. Adriaan Van Es, Director, International Federation of Health and Human Rights Organizations

Dr. Ronald Waldman, President and Chair of the Board, Doctors of the World-USA

Christina Wille, Director, Insecurity Insight and Aid in Danger Project

For Academic Centers

Dr. Joseph Amon, Dornsife School of Public Health, Drexel University

Dr. Chris Beyrer, Director, Center for Public Health and Human Rights, Johns Hopkins

Bloomberg School of Public Health

Dr. K. Alexa Koenig, Executive Director, Human Rights Center, University of California

Berkeley School of Law

Leonard Rubenstein, Director, Program on Human Rights, Health and Conflict, Center for Public

Health and Human Rights, Johns Hopkins Bloomberg School of Public Health 

Dr. Paul Spiegel, Director, Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health

Dr. Michael VanRooyen, Director, Harvard Humanitarian Initiative

cc: Dr. Ibrahima Soce Fall

Dr. Michael Ryan

Dr. Altaf Musani

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