by Dominic Norcliffe-Brown, British Medical Association (BMA) policy lead: medical ethics & human rights; and Andrew Green, Chair, BMA Medical Ethics Committee
BMJ 2025;390:r1242; 25 July. https://doi.org/10.1136/bmj.r1242
Attacks on healthcare and violations of medical neutrality—the fundamental principle that medical care must operate free of political or military interference—have become alarmingly unexceptional in modern conflicts. Patients have been dragged from hospital beds by security forces. Medical supplies have been looted and blockaded. Hospitals are bombed while others are repurposed for military uses. Doctors are arbitrarily detained, tortured, or even killed. All of these actions represent clear violations of international humanitarian law.
Simultaneously, wars are becoming more common, with the number of conflicts increasing dramatically since 2010. The Geneva Academy of International Humanitarian Law records over 110 conflicts in the world today. From 2021 to the end of 2024, conflict-affected areas increased by two-thirds, encompassing a land mass nearly double the size of India. UNICEF has stated that nearly one in five children now live in conflict zones, a record high.
These two trends—the decrease in respect for medical neutrality and increase in conflict zones—are combining with lethal impact. The recently published Safeguarding Health in Conflict Coalition report for 2024 indicated it was the worst year on record for attacks on healthcare, stating that they had never before “recorded such a high number of reported incidents of violence against or obstruction of healthcare in conflict”. The report recorded 3,623 incidents in 2024, a 15% increase compared with 2023, and a 62% rise compared with 2022. This included the killing of more than 900 health workers, a 21% increase compared with 2023.
PHOTOS:
–Al Ahli Arab – a small medical facility before the war – was the only fully functional hospital in Gaza City, following the destruction of Al-Shifa medical complex and other hospitals in the northern part of the Gaza Strip. https://www.bbc.co.uk/news/articles/cjr7l123zy5o
–Footage shows damage at Gaza City hospital site