Six essential lessons for a pandemic response in humanitarian settings

Statement to UN Security Council Open Debate: Pandemics and Security

02 July 2020
Six essential lessons for a pandemic response in humanitarian settings
Peter Maurer, ICRC President

Conflict zones are the sharp end of pandemics. Communities are already living on a knife edge where additional shocks can be catastrophic.

The ICRC is seeing first-hand how COVID-19 and its economic aftershocks are deepening fragility – spiking humanitarian needs, accentuating the impact of violence and conflict, opening the doors to alarming levels of stigmatization, increasing global poverty, heightening instability and tensions and reversing hard-won development gains.

These are deeply complex and fragile places in which to launch a pandemic response. It is clear that pandemics cannot be addressed solely as health issues.

Instead the precondition is a political environment which supports health systems, social supports and humanitarian action; simultaneous emergency and development approaches; as well as a fundamental change of behavior of belligerents in conflicts.

Unquestionably pandemics are changing humanitarian work. We already know that needs are vast and growing: according to our legal analysis there are now around 100 armed conflicts around the world involving 60 States and more than 100 non-state armed groups as parties to those conflicts. This represents a steady rise in the total number of classified conflicts over recent decades.

The ICRC is drawing lessons from the impacts of COVID-19 across these conflicts as well as the experiences of other infectious diseases like Ebola, cholera, and tuberculosis. Today I bring to your attention six essential lessons for a pandemic response in humanitarian settings.

One, International Humanitarian Law must be better respected to protect civilians and their infrastructure from multiple future shocks, including pandemics.

Violations of IHL – cities bombed to rubble, mass displacement – are the enemy of a pandemic response.

Countries where health services have been destroyed by war stand little chance to treat or contain COVID-19. Emergency room mortality rates are spiking dramatically. Attacks – including cyber-attacks – on health care workers and facilities are continuing unabated.

Health workers and humanitarians are our first and last lines of defence and they must be protected. Words and promises, resolutions like 2286, which are agreed by this Council, are fruitless if they do not result in meaningful changes on the ground.

Positive influence by those who have leverage over parties to conflict must be a priority. The ICRC is doing our share with millions of health workers around the world with advice on implementing protective measures, fighting stigma and maintaining neutral and impartial services in the midst of war and violence.

Two, assistance and protection must be available to all those in need without the threat of politicization or manipulation.

Under international law, impartial humanitarian aid cannot come with strings attached or be withheld from so-called 'enemy' groups. People's needs are the only reasonable basis on which to respond.

Misinformation and exclusionary responses can fuel unrest and instability. Today, the distribution of scarce medicine and protective materials are triggering violent flare-ups; tomorrow, the inequitable distribution of any COVID-19 vaccine could destabilize communities.

The Red Cross Red Crescent Movement has joined the UN Secretary General in calling for a people's vaccine which ensures no one is left out. Once vaccines will be available, their equitable distribution will be critical. We are working to plan with States and with millions of Red Cross and Red Crescent and other humanitarian workers to help to mitigate against potentially very dangerous situations.

Three, the response must go far beyond health needs and mitigate the wider secondary impacts of pandemics.

Pandemic responses cannot be reduced to the delivery of masks or confined to emergency rooms.

Communities need measures to guard against the multiple dimensions of fragility - health and sanitation systems, social safety nets and livelihoods.

There are no silver bullets, but where people are hit by the double burden of conflict and disease, context-specific, evidence-driven approaches will balance the imperatives of controlling infections and mitigate the secondary impacts.

I warn against compartmentalizing the response into humanitarian or development – we must enable emergency and long-term responses, preventative and curative responses in sync. It is possible.
ICRC has seen a growing recognition that inhumane conditions, for example in detention or in displacement camps, can become deadly during a pandemic – not only for those interned but for host communities.
In detention facilities in more than 50 countries, the ICRC is working with the authorities to strengthen health care and hygiene measures. We have seen such measures effectively prevent the spread of cholera and Ebola into places of detention in Guinea, Liberia and the Democratic Republic of the Congo.

By responding to health needs, it is possible to improve inhumane conditions for the longer term and diffuse rising tensions in communities. ICRC has delivered more than 200 confidential reports to authorities concerned over the past few months on the conditions in detention facilities, making recommendations on systems wide improvements covering health, sanitation and hygiene services, overcrowding, family contact, ill treatment and judicial processes. We commend the many authorities, who have responded positively to our recommendations and who have prevented a degradation of their security environment.

Four, responses must be built to reach the most vulnerable and marginalized community members. No-one is safe from a pandemic until everyone is safe.

Pandemics will affect some people more than others. We must ensure responses reach those less visible and silenced. For example, displaced people, those working in the informal sector, those in areas controlled by non-State armed groups, people detained, people with disabilities, the elderly, racial groups, women and girls as well as sexual and gender minorities.

We must look at the landscape of needs, rather than creating trade-offs between the COVID-19 response and other responses. The war wounded, those with chronic diseases must still be treated, mental health and sexual violence responses must be scaled up to dramatically increasing demand. Livelihood assistance and other social supports must be boosted as critical prevention measures. Failure to do so will nurture the cycle of exclusion, violence and conflict.

Five, we must proactively guard against any rollback of civilian protections.

Governments must not exploit the pandemic and set draconian precedents, which undermine International Humanitarian Law and International Human Rights Law. Any exceptional measures to fight and contain the pandemic must be time-bound, non-discriminatory and proportional to public health needs.

We urge wider implementation of the good practice of granting exceptions to humanitarians whenever possible. Humanitarian organizations are ready for their part to take additional precautionary measures in their work.

Given the mistrust and heightened tensions in areas of violence and conflict, States need to be especially vigilant to ensure that laws restricting the use of force are thoroughly applied. This should be followed through to ensure rules of conduct and training are in place, as well as robust oversight of security forces. Checks and balances must be in place so emergency measures, such as lock downs or widescale data collection, are not used as abusive tools to control a population, nor undermine public trust in health measures. Temporary restrictions on humanitarian access must not become fixed.

Six, responses will only be effective if there is community trust and engagement.

The global COVID-19 response is a game changer for state-citizen trust. Healthcare at gunpoint is futile. Even in conflict-affected environments, local authorities can build trust by listening to communities, and acting with transparency.

Responders also need to be trusted, and stigma combatted. ICRC, together with the Red Cross and Red Crescent Movement, and its existing community networks is often one of the few responders in contested areas.

We see there is no substitute for neutral and impartial humanitarian action which secures the trust of populations, and the trust of authorities across frontlines and the so-called "last mile" of service delivery.

Trust can be achieved by listening to the plight of communities, by walking the talk, by engaging and cooperating with local leaders and faith-based organizations and religious leaders. On the frontlines of fighting the pandemic the convergence of health and security is not a matter of political debate but of simple and experienced truth.

Colleagues, even in this uncertain time, we have the knowledge and the lessons on how to tackle COVID-19. Much can be done – in this Council and beyond:

The passing of UNSC resolution 2532 represents a chance to reset – to translate the consensus reflected in the text into greater cooperation and action to protect civilians.

The choices are there - choose to respect the ceasefire; choose to intensify diplomacy to make it happen. Choose to enable humanitarian access including facilitating movement. Choose to follow the laws you created in international humanitarian law. Choose to give space to first responders and local communities.

Millions around the world are depending on you to make the choices that protect them from the health crises of the future.