Protection of Medical Personnel and Facilities in Armed Conflicts
Amani Africa
Date | 05 November, 2021
Tomorrow (5 November), the African Union (AU) Peace and Security Council (PSC) is expected to convene its 1044th session to discuss the protection of medical personnel and medical facilities in the context of armed conflicts.
Following the opening remarks of the PSC Chairperson of the month and Permanent Representative of Egypt to the AU, Mohamed Omar Gad, the AU Commissioner for Political Affairs, Peace and Security (PAPS), Bankole Adeoye, is expected to make a statement. Council is also expected to receive statements from Hanna Tetteh, Special Representative of the United Nations (UN) Secretary General and Head of the UN Office to the AU (UNOAU); Bruce Mokaya, Head of International Committee of the Red Cross (ICRC) Delegation to the AU; and a Representative of Doctors without Borders.
While this is the first session of the PSC dedicated to the specific theme, Council has at its various previous thematic and country specific sessions condemned attacks on medical personnel and facilities, such as its 862nd and 965th sessions. The protection of medical personnel, units and transport is a core principle stipulated under the Geneva Conventions of 1949 and also forms part of customary International Humanitarian Law (IHL). As such, in both cases of interstate and internal conflicts, attack against medical personnel and facilities engaged in discharging professional activities is prohibited under international law. Moreover, having regard to the growing cases of attacks against healthcare providers and facilities in conflicts, the UN Security Council (UNSC) adopted in 2016, Resolution 2286 which calls on States to “develop effective measures to prevent and address acts of violence, attacks and threats against medical personnel, their means of transport and equipment, as well as hospitals and other medical facilities in armed conflict”. Despite the existence of these and other normative standards necessary for the protection of healthcare in conflict situations, recent trends signify the growing rate of attacks perpetrated against medical personnel and facilities.
As reports indicate, in the period from 2016 to recently, there have been well over 4500 incidents of attacks against healthcare providers and facilities in armed conflicts across the world, which include killings, kidnappings, and sexual assault perpetrated against medical personnel as well as looting, damage and destruction to medical facilities. In Africa, countries such as Central Africa Republic (CAR), Democratic Republic of Congo (DRC), Libya and Nigeria have experienced the highest rate of attacks. In the DRC for instance, 434 incidents of violence against and obstruction of healthcare were recorded only during the year 2019. Added to the outbreak of Ebola throughout various regions of the country, the impact had been nothing short of catastrophic. In Libya, 77 cases of attacks against and obstruction to healthcare were recorded during 2020. In addition to resulting in injury and death of health workers, these incidents have been cause for multiple hospitals in the country to cease operation, therefore creating serious healthcare vacuum and constraints in the time of Covid-19 pandemic.
While these exemplify incidents that were recorded, it is not hard to imagine that these numbers would increase significantly if unrecorded cases of violence against healthcare in those and other conflict affected countries in the continent were to be considered. Such trend has grave implications not only on medical personnel and facilities, but also on civilian populations in conflict affected areas and their access to humanitarian assistance. This is further aggravated in times of pandemics as has been witnessed in the period from February to December 2020, when the Covid-19 pandemic was at peak. According to data recorded by the ICRC, there were 848 Covid-19 associated violent incidents perpetrated against health workers in that period. It is also important to note that in addition to its immediate impacts, attack on medical facilities also endangers years of developmental efforts and progresses obtained in the medical field.
One of the major reasons behind the persistent attacks against medical personnel and facilities in conflict settings is the lack of awareness and guidance among belligerents regarding the relevant international rules protecting healthcare in armed conflicts. In addition to the lack of awareness of these rules, armed forces are usually not sufficiently trained to understand the overall applicability of IHL, which is fundamental in regulating military operations. Particularly, the basic IHL principles applicable to the conduct of hostilities – distinction, proportionality and precaution – are essential to minimise civilian casualty in conflicts, including healthcare. It is therefore important for States to ensure that the core principles of IHL are made part and parcel of their military doctrines and manuals and that their troops are well trained on abiding these rules throughout any engagement in hostilities. This would contribute towards ensuring that medical personnel and facilities as well as other protected persons and objects under IHL are not deliberately targeted and that their risk of being subject to indiscriminate and disproportionate attacks is minimised. Mandatory and periodic trainings which target senior leadership as well as junior members of States’ armed forces are also important in translating these basic rules and principles into action. On top of training armed forces to identify and avert attacks against healthcare, it is as important for military manuals to provide guidance on how armed forces can assist and provide protection to medical personnel and facilities.
In addition to integrating IHL rules into military manuals, it is also important for States to develop domestic legal frameworks protecting medical personnel and facilities in times of conflicts. This includes particularly rules which emphasise the prestige and significance of emblems such as the Red Cross and Red Crescent movement’s. Such rules would be instrumental in propagating the protected status of medical units, transport and personnel bearing such emblem, thereby protecting them from attacks throughout their operations in conflict settings. Laws which criminalise and prescribe penalties for attacks against and obstruction to healthcare are also necessary not only to deter, but also to fight related impunity and to set precedent of consequences for such acts.
Misconceptions around the provision of neutral and impartial medical treatment in conflict settings also often put medical personnel at risk of attacks. The principles of neutrality and impartiality under IHL oblige health workers to provide medical care to all sick or wounded persons without regard to their status – civilian or combatant/fighter – or their affiliation or lack thereof with either one or more of the conflicting parties. Despite the rule however, medical personnel have in various cases been targeted and attacked by conflicting parties, for providing medical assistance to members of adversary forces or individuals perceived to be affiliated with the “enemy”. This indicates the need for raised awareness regarding not only the obligation of medical personnel to provide care without distinction based on affiliations, but also regarding Geneva Convention I and Common Article 3 of the Geneva Conventions which provide for the protection and humane treatment of persons not taking active part in conflicts, including those rendered “hors de combat” due to wounds or sickness.
Both States and non-State armed forces have been implicated in multiple armed conflicts for attacks on medical personnel and facilities. It is therefore important to emphasise and support initiatives of impartial and neutral organisations to create awareness of domestic and international norms protecting healthcare in the context of conflicts to ensure that belligerent parties comply with such norms.
The outcome of tomorrow’s session will be a communiqué. The PSC may express concern over the growing rate of attacks against medical personnel and facilities in situations of armed conflicts in Africa. Council may urge member States to ensure increased efforts towards raising awareness on international standards protecting medical personnel and facilities in the context of conflicts. It may also call on member States to strengthen domestic laws and military doctrines to sufficiently integrate IHL rules on the protection of healthcare in armed conflicts and to fight impunity and ensure that violations are properly addressed. It may also encourage member States to report on implementation of Resolution 2286(2016) of the UNSC. Moreover, Council may urge both State and non-State conflicting parties to put their best efforts towards minimising civilian casualty from their engagement in hostilities, including to health workers and medical facilities, and to ensure that medical personnel are granted safe environment to provide medical care and assistance to all in need, in a neutral and impartial manner.
Monthly Digest on the AUPSC - November 2021
Amani Africa
Date | November 2021
In November, Egypt chaired the African Union (AU) Peace and Security Council (PSC). Eight sessions were convened during the month. PSC’s initial programme of work for the month envisaged six sessions. The revised programme of work which guided Council’s activities throughout the month introduced few changes including the addition of substantive sessions.
Monthly Digest on the AUPSC - November 2021
Amani Africa
Date | November 2021
In November, Egypt chaired the African Union (AU) Peace and Security Council (PSC). Eight sessions were convened during the month. PSC’s initial programme of work for the month envisaged six sessions. The revised programme of work which guided Council’s activities throughout the month introduced few changes including the addition of substantive sessions.
Monthly Digest on the AUPSC - November 2021
Amani Africa
Date | November 2021
In November, Egypt chaired the African Union (AU) Peace and Security Council (PSC). Eight sessions were convened during the month. PSC’s initial programme of work for the month envisaged six sessions. The revised programme of work which guided Council’s activities throughout the month introduced few changes including the addition of substantive sessions.
Provisional Programme of Work of the PSC for the Month of November 2021
Amani Africa
Date | November 2021
In November, Egypt will be the Chairperson of the African Union (AU) Peace and Security Council (PSC). The PSC’s provisional programme of work for the month envisages four sessions dedicated to thematic issues, one country specific session and a joint consultative meeting with the United Nations (UN) Peacebuilding Commission (UNPBC). As a conclusion to Council’s activities of the month, a press conference by the PSC Chairperson is scheduled to take place on 30 November.
The first activity the PSC will be undertaking during the month is the meeting between the PSC Chair and the African three elected members of UN Security Council (UNSC) and Saint Vincent and the Grenadines (A3+1), scheduled to take place on 1 November. It is to be recalled that at its 983rd session on the unified role of the A3, Council made some concrete decisions aimed at improving the role played by the A3 in advancing common African positions on African peace and security issues which are on the agenda of the UNSC. One of the key decisions emerging from that session was to have monthly consultations between the PSC Troika and the A3, in order to ensure provision of timely updates and guidance to the A3 on African peace and security issues ahead of UNSC meetings. At the 13th PSC Retreat which took place in May 2021 in Mombasa, it was further reiterated that the incoming Chair of the PSC shall convene monthly meetings with the Coordinator of the A3 and that these meetings shall be reinforced with quarterly meetings at the level of the PSC Troika and the A3 as whole. The upcoming meeting therefore takes place within the framework of these decisions and could also contribute to preparations being made for the upcoming joint consultative meeting of the PSC and UNSC.
The PSC Committee of Experts (CoE) will be convening on November 2 to prepare for the planned filed mission to Somalia as well as for engagement with UNSC experts at the upcoming annual joint consultative meeting between the PSC and UNSC.
On 5 November, Council will convene its first substantive session, which will focus on the protection of medical personnel and facilities in armed conflicts. The session is likely initiated in response to the growing trend of attacks against medical personnel and facilities observed in conflict affected areas globally, most of these being concentrated in west and central Africa. Reports signify that in the period from 2016 to 2021, over 1000 reported cases of attacks against health workers and medical facilities have been recorded in west and central Africa. Particularly, in Central African Republic (CAR), Democratic Republic of Congo (DRC) and Nigeria, a concerning surge in such attacks has resulted in suspension of medical activities, constraining peoples’ access to healthcare, an issue compounded further by outbreak of the Covid-19 pandemic.
The PSC is scheduled to undertake a field mission to Somalia from 9 to 10 November.
On 12 November the PSC is set to consider three agenda items. In the morning session the PSC will receive a briefing on AU Post-Conflict Reconstruction and Development (PCRD). This will be the second session on the theme to take place within this year, in line with PSC’s 2021 indicative annual programme of activities, which envisages convening twice to review PCRD efforts in the continent. It is to be recalled that the first meeting on the theme took place at Council’s 1017th meeting convened in August, with a focus on AU support to member States in political transition and in post-conflict situations. At the upcoming session, Council may follow up on some of its key decisions made at the 1017th session, mainly on the reactivation of the PSC Sub-Committee on PCRD and its request for the Chairperson of the AU Commission to submit a comprehensive report on implementation of PCRD activities in Africa.
In the afternoon of 12 November, Council will convene its joint consultative meeting with the UNPBC. It is to be recalled that the two bodies had their last annual consultative meeting in October 2020, where country specific, regional and thematic peace and security issues of common concern were discussed. The upcoming meeting provides the stage for further reflection on these issues and to exchange ideas on how the AUPSC and UNPBC can further consolidate collaborations on peacebuilding in Africa, particularly taking account of the need to give effect to the contents of the Common African Position on the 2020 Review of the UN Peacebuilding Architecture adopted at Council’s 948th session.
The consideration and adoption of the draft programme of work for the month of December is also expected to take place on 12 November, through email exchanges.
The next PSC session is scheduled for 15 November, although the date is yet to be confirmed. The session is planned to take place at the ministerial level and will be committed to the theme of countering radicalism and extremist ideologies in Africa. In October 2021, Council already convened a ministerial level session to consider the report of the Chairperson of the AU Commission on continental efforts in the prevention and combating of terrorism in Africa. This trend demonstrates that the PSC is giving much needed attention to the interconnected concern of radicalisation, extremism and terrorism, which are intensifying, in some parts of the continent.
On 17 November, Council will be convening to receive a briefing on the situation in Libya. In May 2021, Council convened a ministerial session on Libya (997th meeting) where the AU Commission was requested to provide regular progress reports on the implementation of AU decisions aimed at supporting the Libyan transitional process. The upcoming briefing could therefore highlight, among others, the status of preparations for the planned general elections, particularly regarding finalization of all necessary constitutional frameworks, and more generally, the challenges and progresses in the implementation of the October 2020 Ceasefire Agreement.
The final substantive session of the month will be convened on 26 November, addressing climate change and peace and security in Africa. The session is a timely one provided that the current year has seen increasing impacts of and corresponding concerns over climate change. It is also to be recalled that one of the agenda items of Council’s 984th session convened at the summit level was dedicated to climate change and its effects on peace and security in Africa. At that session, decisions were adopted including establishing an AU special fund on climate change. In addition, the AU Commission was requested to submit a report elaborating the nexus between climate change and peace and security in Africa and also to provide updates regarding the appointment of AU Special Envoy for climate change and security. The upcoming session presents the opportunity to also follow up on these decisions.
As envisaged in the footnotes of Council’s indicative programme of work for the month, meetings may be scheduled as needed, to assess situations in Chad, Guinea, Mali, Somalia and Sudan, countries currently facing pressing peace and security challenges. The footnotes also indicate that the 12th Annual Retreat of AU High Representatives is expected to take place from 1 to 3 November and engagement of PSC CoE with UNSC Experts as well as preparations for the PSC-UNSC annual joint consultative meeting is to continue in New York, from 22 to 24 November.
Disaster Management in Africa: Challenges and Perspectives for Human Security
Amani Africa
Date | 29 October, 2021
Tomorrow (29 October), the African Union (AU) Peace and Security Council (PSC) is expected to convene its 1043rd session on ‘Disaster Management in Africa: challenges and perspectives for human security’ at the level of Heads of State and Government. This session takes place under the chairship of Mozambique, which also hosted a virtual meeting of the Committee of Ministers Responsible for Disaster Risk management from the Southern African Development Community (SADC) on 26th May 2021 with the aim to review progress on regional Disaster Risk Management programmes and ensure effective coordination at the regional level.
The session is expected to have two segments, an open and a closed session. In the open session invited guests will deliver their statements. Following the opening Statement by Felipe Jacinto Nyusi, President of the Republic of Mozambique and Chairperson of the PSC for the month of October, the Chairperson of the AU Commission, Moussa Faki Mahamat, is expected to make remarks. Further remarks are expected from the President of Equatorial Guinea, Teodoro Obiang Nguema Mbasogo, in his capacity as the AU Champion for Refugees, Returnees and Internally Displaced Persons, as well as President of Gabon, Ali Bongo Ondimba, in his capacity as the Leader of the Committee of African Heads of State and Government on Climate Change (CAHOSOC). AU Commissioner for Health, Humanitarian Affairs and Social Development, Amira EL Fadil, and AU Commissioner for Agriculture, Rural Development, Blue Economy and Sustainable Environment, Josefa Leonel Correia Sacko, are scheduled to deliver presentations.
This session comes on the heels of the International Day for Disaster Risk Reduction, which is observed on 13 October to raise awareness about disaster risk reduction. This year’s commemoration took place under the theme of ‘international cooperation for developing countries to reduce their disaster risk and disaster losses’, the sixth target of the Sendai Framework for Disaster Risk Reduction 2015-2030. The session also takes place ahead of the 26th UN Climate Change Conference of the Parties (COP26) in Glasgow, which is scheduled for 31 October-12 November 2021. As Africa bears the brunt of climate change but has contributed least to climate emissions, the summit may also present an opportunity to remind commitments around climate finance and adaptation.
This high level engagement on disaster management becomes all too important as Africa continues to face evermore frequent disasters and increasing vulnerability with a devastating repercussion on the lives and livelihoods of its people. According to World Risk Report 2021, Africa has the second highest disaster risk next to Oceania while it is the continent with the highest overall societal vulnerability—12 of the 15 most vulnerable countries in the world are located in Africa. The risk has been evident from multiple disasters that hit the continent in recent years including the volcano eruption on Mount Nyiragongo in the city of Goma in DRC, locust swarms and flooding in Horn of Africa, cyclones and storms that led to heavy rains and flooding in Southern Africa countries such as the Comoros, Malawi, Mozambique and Zimbabwe. 90 percent of the major disasters in Africa have been climate related.
Over the years, the AU has put in place policy and institutional frameworks to effectively respond to the increasing disasters confronting the continent. The African Regional Strategy for Disaster Risk Reduction (ARSDRR), which was adopted by the Assembly (Assembly/AU/Dec.38) during its third ordinary session held in July 2004, guides the continent’s disaster risk reduction efforts. The AUC has further developed the Programme of action (PoA) for the implementation of the Sendai Framework for Disaster Risk Reduction 2015-2030. To address the humanitarian consequences of disasters, the Union also adopted, among others, the Kampala Convention for the Protection and Assistance of Internally Displaced Persons in Africa and the Common African Position (CAP) on Humanitarian Effectiveness that shaped Africa’s new humanitarian architecture.
On the institutional aspect, the African Risk Capacity (ARC)—a specialized agency of the AU established in 2012—comes at the center of Africa’s ‘disaster risk architecture’. The ARC aims to help African governments improve their capacities to better plan, prepare, and respond to extreme weather events and natural disasters by combining the concepts of early warning, disaster risk management, and risk finance. The Special Emergency Assistance Fund (SEAF) is also established to support African countries affected by drought and/or famine although it needs to be replenished. The African Humanitarian Agency (AUHA) is also expected to facilitate coordination in humanitarian response. The African Standby Force (ASF) is another mechanism that has the mandate to respond to natural disasters.
While there are notable progress in terms of laying down the necessary structures to address disaster risks in the continent, many challenges remain. One of the significant challenges in this respect is, as captured by Lesley Ndlovu (CEO African Risk Capacity Limited) in her recent remarks on the international day for disaster risk reduction, that ‘disaster response is extremely slow and inefficient and, by the time governments and NGOs have raised enough money to respond meaningfully, the problem has become much worse, and more funding is needed’. In most cases, not only the response is ‘slow and inefficient’ but also it is largely reactive focusing on relief and immediate rehabilitation while ignoring preventive disaster reduction measures.
Hence inadequate early warning system and the gap in translating early warning to early action remain critical hurdles. As captured in the notes prepared for this session, ‘in most countries, early warning systems are sectoral in nature and hardly coordinated’. A positive development in this respect is a recent conference convened this month by the AU Commission to validate a Multi-Hazard Early Warning/Early Action (MHEWS/EA) Framework. The development of the Framework is a step forward in building the resilience of African countries as it ensures a functional early warning system. It is also to be recalled that the Council, at its 864th session held in August 2019, suggested the ‘establishment of command centers which operate on a 24 hour basis to closely monitor and timeously issue early warning alerts on impending natural disasters’, something that the Council find it worth following up in terms of strengthening the early warning system.
Inadequate funding has heavily affected disaster management. Not only there is a huge gap between the needs of people at risk to disasters and the available funding but also most of African countries and the continental mechanisms lack sustainable and predictable funding as they rely largely on external sources. Though there is an Assembly Decision to increase AU Humanitarian Fund from 2% to 4% of member states’ assessed contributions, meant to ensure predictable and sustainable resources for the AU to enable fulfil its humanitarian responsibilities, its practicality and buy-in from member states remain questionable. As indicated in the notes prepared for tomorrow’s PSC session, there is a growing trend of establishing uncoordinated disaster specific funds, and hence there is a need to embrace ‘multi-hazard funding mechanisms’.
The expected outcome is a communiqué. Among others, while commending the existing AU structures that are established to address disaster risks, the PSC may emphasize on the need to operationalize and strengthen the capacity of these structures, and in this respect, there much to be desired from member states in supporting the mechanisms. In addition, the Council may also stress the importance of enhancing coordination among the plethora of AU mechanisms for disaster management to ensure complementarity as well as avoid duplication of efforts. The PSC may underscore the importance of shifting the focus from treating the effects of disasters (reactive measures) towards a proactive approach that is more economical and efficient. On the funding challenge, the Council may stress not only on the need to rely on Africa’s own resources in the spirit of pan-Africanism but also highlight the imperative of diversifying sources of finance, as well ensuring predictable and sustainable funding for the AU to effectively discharge the expected role in addressing disaster risks. In this regard, the Council is likely to explore options to raise funds from non-traditional donors from non-traditional donors including African civil society, private sector and the diaspora, in addition to traditional sources of funding. The Council may further reiterate its support for the upcoming African Humanitarian Summit and Pledging Conference in Malabo, which is expected to serve as impetus to operationalize the African Humanitarian Agency and mobilize required financial resources to address the ever growing humanitarian needs of the continent. In relation to building effective early warning system and bridging the gaps between early warning and early action, the Council may also urge for the finalization of the Multi-Hazard Early Warning/Early Action (MHEWS/EA) Framework and the development of Continental MHEWS/EA Situation Room, which are pivotal in providing operational guidance on Multi-Agency and Multi-Sectoral coordination and communications at member states, regional and continental level. Finally, the Council may reiterate its 864th session which underscored the need for the ‘Regional Standby Forces to reinforce their engagement in responding to natural disasters’.
