Ukraine Health Emergency Takes Center Stage at World Health Assembly – Once Again
Two residents stand in the ruins of homes in Borodianka in the Kyiv region.

Three days into the World Health Assembly (WHA), the health emergency caused by Russia’s fifteen-month invasion of Ukraine looks set to become a dominant issue at the World Health Organization’s (WHO) top decision-making body for a second consecutive year.

Over 140 Russian missiles and drones have rained down on Ukraine’s energy, civilian and medical infrastructure since the start of this month. The consequences of the onslaught continue to affect millions of civilians, jeopardizing their access to physical and mental health care and forcing nearly 10 million to flee their homes since the start of the war. 

Supply chains for essential medicines have been disrupted, hospitals destroyed, and the medical facilities that remain operational are forced to fight to keep the lights on amid regular power outages due to attacks on Ukraine’s power grid. One in five ambulances in Ukraine’s medical fleet has been damaged or destroyed. 

More than 1,256 health facilities have been damaged and 177 more reduced to rubble, Ukraine told WHA delegates on Tuesday. The World Health Organization has independently confirmed 974 attacks on medical facilities and the deaths of over 100 healthcare workers since the start of the war.

Will there be enough time to discuss other humanitarian emergencies?

The overwhelming focus on the health crisis in Ukraine by delegates in Geneva is well-founded. But amid a flurry of ongoing humanitarian crises and the re-emergence of familiar battles litigated at the WHA last year, the question of whether enough time will be left to discuss the plight of millions of civilians outside of Ukraine has grown in importance.

The World Health Organization currently counts 13 ongoing crises as “grade 3” emergencies, the UN health body’s highest internal threat level. These include the extended droughts in the Horn of Africa, the humanitarian situation in Afghanistan, and ongoing conflicts in Yemen, Syria and Ethiopia.

A deadly civil war featuring regular attacks on hospitals and civilians also recently erupted in Sudan, threatening the stability of the wider region as hundreds of thousands flee the country. 

Civilian casualties in armed conflicts increased by 53% year-on-year since 2022, according to a report presented by the Swiss Presidency of the UN Security Council on Tuesday, raising concerns that an over-focus on Ukraine could leave civilians in less represented conflicts by the wayside. Over 90% of deaths from explosive weapons detonated in populated areas documented in the report were civilians. 

The draft resolution submitted by Ukraine and its allies on Monday is near-identical – even sharing the same title – to the one passed by the WHA in 2022 which described the Ukrainian health crisis as “stemming from Russian aggression.”

Russia responded by submitting its own resolution – described by Ukraine as a “recycled” version of Russia’s 2022 proposal shot down by the WHA – calling on countries to “refrain from the politicization of global health cooperation” and to “respect their obligations under international and humanitarian rights law.”

Syria, the counter-resolution’s co-sponsor, called on WHA delegates to “avoid escalating crises” and support the Russian draft to “help further stability in Ukraine and neighbour countries.” 

North Korea, Nicaragua and Belarus are currently the only other WHO member states to voice their support for the Russian resolution.

Vote to show WHA will not stand for attacks on health infrastructure, Ukraine says

Operating theatre in a Ukrainian hospital destroyed by a Russian airstrike.

On Tuesday, the Ukrainian delegation called on the WHO’s 194 member states to support its resolution condemning Russian “aggression”. It also asked states to vote down the Russian counter-resolution, which it said is based on a “distorted, alternative reality.” 

“The Russian text is nothing short of a desperate attempt to put the aggressor on par with the victim and avoid responsibility for their attacks on the health care system in Ukraine,” its delegate said. “[Voting down the resolution] will send a clear signal that provoking a health emergency of outstanding proportions and destroying medical structures on a massive scale is not tolerated by this assembly.”

Russian diplomats, meanwhile, protested statements by Ukranian allies such as Poland and the United States condemning Russian actions in Ukraine, which its delegates argue “don’t have any relationship to the mandate of the WHO.”

Russia’s interventions have so far been shot down by WHA President Dr Christopher Fearne and other committee chairs due to the scale of the health crisis caused by the war. The Ukrainian health crisis is “clearly a health matter relevant to this assembly,” Fearne said in response to a Russian protest on Monday.

“Russia has no respect for human life,” an Estonian delegate said. “Suspend the Russian Federation from the decision-making [of WHO] until it has restored full respect to international law and human rights.”

Russia circulates document accusing Ukraine of attacking its own health care system 

Confirmed attacks on health care in Ukraine, according to the WHO.

An average of two attacks on health care a day were reported in the first year of the Russian invasion. These include strikes on hospitals, shootings of ambulances, torturing of medics and looting of medical facilities. 

This has not stopped Russia from attempting to mount a diplomatic counter-offensive. In a bid to garner support for its draft resolution, Russian diplomats circulated pamphlets in WHA accusing Ukraine of attacking its own hospitals and health care facilities. 

The delegate for the United Kingdom, referring to the move in a heated debate Tuesday afternoon, compared the Russian efforts to the “theater of the absurd.” 

“We are aware that like last year, Russia has passed around pamphlets to our fellow delegates which allege that Ukraine has been attacking its own health system,” UK diplomats told the assembly. “We are confident … delegates here today won’t be fooled by such disinformation.” 

Russia has not openly voiced such accusations in its own statements at the WHA. Its draft resolution, however, expresses “serious concern” that the WHO Surveillance System for Attacks on Health Care (SSA) – the UN health body’s database documenting attacks on medical facilities and staff – does not accurately reflect “all the incidents with attacks on health care facilities.”

It also calls on the WHO to improve its collection of “data on attacks on health care facilities, health workers, health transports and patients” – an odd request from a country accused of perpetrating nearly 1,000 attacks on Ukrainian health care. 

Human Rights Watch and other groups documented repeated “unlawful” Russian and Syrian attacks on “schools, hospitals, and other civilian objects” throughout the Syrian civil war.

Attacks on Ukranian health facilities are not the first

Attacks on hospitals, health workers and civilians by Russian forces in their intervention in Syria’s civil war have been well-documented by rights groups. Bashar al-Assad, the Syrian President and key co-sponsor of the Russian resolution, repeatedly used chemical weapons to attack civilians in his bid to retain power. 

The Russian resolution also calls for countries to “refrain from deliberately placing military objects and equipment” in the vicinity of civilians and civilian infrastructure or in “densely populated areas.” 

The language of the Russian text appears to mirror the findings of a report by Amnesty International published in August, which accused Ukrainian forces of repeatedly putting “civilians in harm’s way” by stationing soldiers nearby and staging military operations from populated areas.

Russian officials portrayed the report as a vindication of its actions in Ukraine. The Russian ambassador to the United Nations, Vasily Nebenzya, claimed the report proved Russia does not use “the tactics Ukrainian armed forces are using” such as “using civilian objects as military cover.”

An independent review of the report later found Amnesty’s claims that Ukraine had violated international law were “not sufficiently substantiated”. 

The review also called some of the language used by Amnesty “legally questionable,” particularly with respect to the report’s implication that Ukrainian forces were “primarily or equally to blame for the death of civilians” resulting from Russian attacks.

The International Criminal Court in the Hague issued a warrant for the arrest of Russian President Vladimir Putin for the war crime of abducting and deporting thousands of Ukrainian children to Russia in March.

Image Credits: Matteo Minasi/ UNOCHA, Christian Treibert.

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