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COVID-19 response in conflict zones hinges on respect for international humanitarian law

COVID-19 and conflict / Generating Respect for IHL / Law and Conflict 9 mins read

COVID-19 response in conflict zones hinges on respect for international humanitarian law

Mosul, Salma hospital. A nurse in front of the hospital that was destroyed. ICRC/André Liohn

In our collective response to COVID-19 in conflict zones, it is vital that key provisions of international humanitarian law are respected in order to respond adequately to the needs of communities, health professionals and authorities during these unprecedented times.


We are living through a shared, global crisis. COVID-19 does not heed borders or pay deference to people of power or wealth. However, while the virus does not discriminate in its reach, the effects of the pandemic are by no means equally distributed.

It is the men, women and children caught in the crossfire of armed conflict – displaced by violence, living in countries which have been structurally shattered by years of fighting, destruction, erosion of basic services – who are the most vulnerable to the current pandemic. Nearly 168 million people around the world now depend on humanitarian relief because of conflict, violence and disasters. As terrifying as the health, social, psychological and economic impacts have shown to be, the coronavirus is not one, but rather one more, calamity that befalls them.

Why are conflict zones viewed as powder kegs lying in wait for the spark of COVID-19? Of course, much of the problem lies with armed conflict itself; beyond immediate death and injury, impoverishment, displacement, and lack of access to essential services are the common consequences of armed conflict, and in particular of protracted armed conflicts. Even in situations where the rules are observed, the conduct of war can cause enormous damage and have important long-term humanitarian consequences, such as protracted displacement, the loss of access to basic services and the erosion of individual and community coping mechanisms.

However, while the root causes of the erosion of essential services, and especially healthcare, in a conflict situation are complex and manifold, the ICRC has repeatedly emphasized that respect for international humanitarian law (IHL) would go a long way towards reducing the suffering of populations and the humanitarian consequences of conflicts. Ensuring the protection of essential services, in the short- and the long-term, begins first and foremost with better respect for existing rules of international humanitarian law by parties to armed conflicts.

It is a root cause of the problem, and it cannot be overstated: the extreme vulnerability of people in conflict zones to COVID-19, the culmination of degraded or collapsed essential services such as water, sanitation, and health care, is in significant part the result of a disregard over many years of States’ and other belligerents’ obligations – as set out in international humanitarian law and international human rights law – towards populations under their control.

Now we are here, at a new crossroads, but one with familiar signposts. In the long term, a public health response to a pandemic and respect for fundamental legal protections go hand in hand. To illustrate this, the ICRC Legal Division has produced a basic reminder of the key provisions of international humanitarian law, relevant to the COVID-19 pandemic in conflict situations, that we must all keep close at hand when a pandemic hits countries at war.

Hospital Medical personnel, facilities and transport

Common Art 3 GC I-IV; Arts 19, 23, 24, 25, 26 and 35 GC I; Art 36 GC II; Arts 14(1), 15, 18, 2021 and 56 GC IV; Arts 12, 1516 and 21 AP I; Arts 10 and 11 AP II; Rules 25, 26, 28, 29 and 35 ICRC Customary IHL (CIHL) Study

Adequately staffed and well-equipped medical facilities are necessary for the provision of medical care on a large scale, as demonstrated by the outbreak of COVID-19 and the needs it has generated. Under international humanitarian law, medical personnel, units and transports exclusively assigned to medical purposes must be respected and protected in all circumstances. In occupied territories, the occupying power must also ensure and maintain medical and hospital establishments and services, public health and hygiene. In addition, international humanitarian law provides for the possibility of setting up hospital zones that may be dedicated to addressing the current crisis.


Arts 54(2) and 57(1) AP I; Arts 13(1) and 14 AP II; Rules 15 and 54 ICRC CIHL Study.

Water supply facilities are of critical importance during the current crisis. In armed conflict situations, many of these installations have been destroyed by fighting over the years. Any disruption to their functioning means thousands of civilians would no longer be able to implement the basic prevention measures, such as frequent hand-washing, which can lead to further spread of the virus. International humanitarian law expressly prohibits attacking, destroying, removing, or rendering useless objects indispensable to the survival of the civilian population, including drinking water installations and supplies. Moreover, in the conduct of military operations, constant care must be taken to spare civilian objects, including water supply network and installations.

Humanitarian relief

Common Arts 3 and 9/9/9/10 GC I-IV; Arts 70 and 71 AP I; Art 18(2) AP II; Rules 5556 ICRC CIHL Study

Humanitarian action in countries affected by armed conflicts is essential in saving lives during the ongoing crisis. Under international humanitarian law, each party to an armed conflict bears the primary responsibility to meet the basic needs of the population under its control. Impartial humanitarian organizations such as the ICRC have the right to offer their services. Once relief schemes have been agreed to by the parties concerned, the parties to the armed conflict and third States shall allow and facilitate the rapid and unimpeded passage of the humanitarian relief subject to their right of control (e.g. by adjusting any pandemic-related movement restrictions to allow victims to access humanitarian goods and services).

Persons specifically at risk

Common Art 3 GC I-IV; Arts 12 and 15 GC I; Art 16 GC IV; Art 10 AP I; Art 7 AP II; Rules 109, 110 and 138 ICRC CIHL Study.

Certain groups of people, including older persons, those who have weakened immune systems, or those with pre-existing health conditions, are at particular risk for severe illness if infected by COVID-19. Others, including persons with disabilities, may face a variety of barriers (e.g. communication, physical) in accessing necessary health-care services or particular difficulties in implementing the required hygienic measures to prevent infection (e.g. social distancing may not be possible for those relying on the support of others for everyday tasks). International humanitarian law requires parties to a conflict to respect and protect wounded and sick persons as well as to take all possible measures to search for, collect and evacuate them, without adverse distinction, whenever circumstances permit and without delay. They must receive, to the fullest extent practicable and with the least possible delay, the medical care and attention required by their condition, without distinction other than for medical purposes. Moreover, IHL provisions afford specific respect and protection to older persons and persons with disabilities who are affected by armed conflict.


Arts 22(1), 23(1), 29, 30 and 31 GC III; Arts 83(1), 85(1), 9192 GC IV; Arts 5(1)(b) and 5(2)(c) AP II; Rules 118 and 121 ICRC CIHL Study.

Detention facilities—which are often overcrowded, have poor hygiene or lack ventilation—pose a grave challenge when it comes to preventing and containing infectious diseases, including COVID-19. Under international humanitarian law, detainees’ health and hygiene must be safeguarded, and sick detainees must receive the medical care and attention required by their condition. In the current situation, new arrivals should be tested for the virus and hygiene measures should be increased (e.g. by installing hand-washing stations, providing soap and other washing equipment, and creating isolation wards), in order to prevent the spread of disease.

Internally displaced persons, migrants, asylum seekers and refugees

All general rules covering the civilian population; specific rules include Arts 35, 44, 45(4), 49, 70(2), 147 GC IV; Art 73 AP I; Art 17 AP II; Rules 105, 129 and 131 ICRC CIHL Study.

Internally displaced persons, migrants, asylum seekers and refugees are particularly exposed to outbreaks of COVID-19, given their frequently harsh living conditions and limited access to basic services including health care. Displaced civilians are entitled to shelter, hygiene, health, safety and nutrition. People facing outbreaks of COVID-19 in camps may aim to move to safety, leading local populations and/or authorities to react forcefully to contain them, including by turning the camps into isolated detention centres. International humanitarian law protects all civilians against the effects of armed hostilities and against arbitrary deprivation of liberty, and provides for their access to health care without discrimination.

Children and education

Arts 13, 24, 50(1), 94, 108 and 142 GC IV; Art 4(3)(a) AP II; Rule 135 ICRC CIHL Study.

Many schools have been temporarily closed to prevent further spreading of COVID-19. While an important preventive measure, this places education continuity under additional strain in contexts where education may already have been disrupted by armed conflict. The disruption of education has long-term effects, and it is important that efforts to ensure its continuity are not an afterthought in times of crisis. International humanitarian law contains rules that require parties to conflict to facilitate access to education, and State practice indicates the inclusion of access to education in the special respect and protection to which children are entitled under customary law. Measures to ensure that education is not interrupted and that children can learn from home are urgently needed.

Sanctions regimes and other restrictive measures

Common Arts 3 and 9/9/9/10 GC I-IV; Arts 70 and 71 AP I; Art 18(2) AP II; Rules 31, 32, 5556 and 109110 ICRC CIHL Study.

The current COVID-19 crisis requires the mobilization of significant humanitarian resources that are often lacking in countries affected by armed conflicts. Sanctions and other restrictive measures currently in place can impede impartial humanitarian action in these areas, to the detriment of the most vulnerable. Sanctions regimes and other restrictive measures that hinder impartial humanitarian organizations, such as the ICRC, from carrying out their exclusively humanitarian activities in a principled manner are incompatible with the letter and spirit of international humanitarian law. States and international organizations enforcing such measures should make sure that they are consistent with international humanitarian law and do not have an adverse impact on principled humanitarian responses to COVID-19. They should devise effective mitigating measures, such as humanitarian exemptions benefiting impartial humanitarian organizations.

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