BACKGROUND GUIDE
WORLD HEALTH ORGANISATION
AGENDA
Peace for Health and Health for Peace: Medical, Social and
Economic response through health in conflict regions.
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EXECUTIVE BOARD
Dear Delegates,
With a sense of elation and excitement, we would like to welcome you
all to the CHIRECMUN 2023 and moreover to the norm of oncampus/physical mode of conferences. The last couple of years have
been the worst this generation has experienced, and we emerged
through the adversity much stronger and resilient. Nevertheless, our
journey continues towards identifying and fighting against some of the
deep-seated and ingrained health, political, social, and economical
issues the world faces.
Over the past few decades and especially the past couple of years, we
have witnessed the integral part the World Health Organization (WHO)
plays in safeguarding and leading the fight to ensure healthcare
advancement, access, and awareness throughout the globe. Goes
without saying the WHO has implanted constitutionally and
fundamentally it’s importance as one of the committees to look out for.
You delegates will be seeded with the responsibility of being part and
leading one of the most engaging and riveting discussions of the
conference.
On account of continuing our journey, the agenda for WHO this time
around sheds light on one of the most deep-rooted issues this world is
constitutionally divided on. “Peace for Health and Health for Peace:
Medical, Social and Economic response through health in conflict
regions.” being the agenda of the discussion, is a carefully articulated
move towards introducing one of the most heated and opinionated
discussions to take place in the WHO.
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To simplify the meat of the conversation, the agenda aims to highlight,
reinvigorate, and reimagine the role of the WHO in dealing with
emergences and related health support in conflict regions. With the everrising disruptions in the geopolitical landscape, WHO’s preparedness and
emergency response becomes imperative to be reviewed, with scope of
work and action plans ideated for current conflicts and worst case
scenario, all future ones too.
With the abiding ambiguous mandate of the committee, the 6-point
agenda of the WHO, and emphasis on the functional mandate, we expect
the discussion to cover the difference in national policies politically, the
nitty-gritty of the health aspects and the social awareness and
methodology to adopt towards a certain plan of action. Ideating towards
a Global emergency response action plan or updation of the
International Health Regulations (IHR) could also be an interesting
approach to take. Nevertheless, it’s the delegate’s part and parcel
towards defining the roadmap they wish to take, and we will be the
effective mediators towards driving this discussion towards fruitful
solutions.
We are always available for you to approach before, during and after the
conference. We wish to provide a captivating and memorable experience
with comfort for all delegates irrespective of an individual’s MUN
experience. We expect a reciprocated certain level of contextualized
debate and commitment to research from the delegates to ensure
smooth sailing and an enthralling experience. Adding to the same, we
expect the agenda to be respected and for delegates to not just cram-up
knowledge for awards but a genuine interest in understanding
contextually the gravity of the situation, to socially be active citizens
advocating the right picture long after the conference and if interested
to one day be in a position to enact a real change in policy.
With this, we would officially like to welcome all of you to the World Health
Organization at CHIRECMUN 2022. May the force be with you!
Mohammed Samraan Ghouse
Chairperson
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Mihir Eshan
Vice-Chairperson
Niva Barde
Director
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OVERVIEW
Historical Analysis
Armed conflicts degrade established healthcare systems, which
typically manifests a resurgence of preventable infectious diseases. In
Tajikistan, malaria was effectively eradicated in the early 1960’s.
However in 1994, during the 1992-97 civil war, an epidemic of malaria
broke out. The cases escalated to 200,000 - 500,000. (approx)
Wars specifically influence prevention programs, including critical
vaccination programs. The ten-year war in Sierra Leone (1991–2001)
devastated infrastructure and healthcare, leading to the collapse of
the immunisation program. Before the war, 75% of children were fully
vaccinated, reducing infant mortality. After the conflict, only half of
children under three were correctly vaccinated, impacting child
health, with around 280 out of 1000 children dying before their fifth
birthday in 2005.
In the late 1990s, a yellow fever epidemic struck African nations amid
conflicts, migrations, and vaccine program disruptions. Polio cases
globally dropped significantly after the 1988 program but rose due to
program interruptions and conflict-driven misinformation. Somalia's
prolonged conflict hindered polio efforts, and Sudan and Syria faced
outbreaks amid conflicts, highlighting deteriorating health systems.
Armed conflicts in 2000 caused 26.1 million disability-adjusted lifeyears (DALYs), 19% of the global burden of disease, now estimated at
41.3 million disability-adjusted-life- years. Civil wars in Liberia and
Sierra Leone displaced nearly a million people to Guinea, exacerbating
health crises with endemic diseases and limited healthcare access.
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Current Situation
Situation in Gaza
In the occupied Palestinian territory, women, children, and newborns in
Gaza are disproportionately affected by hostilities, with 67% of
casualties. The escalating conflict disrupts health services, leaving
pregnant women without essential obstetric care. Closed hospitals
force some to give birth in unsafe conditions, increasing maternal and
newborn health risks. Malnutrition, limited access to food and water,
and damaged healthcare facilities compound the humanitarian crisis,
demanding urgent international intervention to provide essential aid
and ensure a humanitarian pause in the conflict.
Situation in Ukraine
The Ukrainian Healthcare Center has meticulously documented the
extensive attacks on Ukraine's healthcare infrastructure and personnel
by Russian forces. In the initial two weeks of the invasion, a staggering
four to five hospitals and clinics faced attacks daily. As of December 31,
2022, a total of 707 documented assaults transpired, encompassing
damage to 218 hospitals and clinics, constituting nearly 9% of the
country's healthcare facilities. Additionally, 181 attacks targeted other
health facilities, such as pharmacies, blood centers, dental clinics, and
research institutions. Ambulances were subjected to 65 attacks, while
medical personnel endured 86 attacks, resulting in 62 deaths and 52
injuries, likely an underestimate of the true toll.
Situation in Afghanistan
Afghanistan suffers with a prolonged humanitarian crisis, worsened by
decades of instability, drought, and disasters. The revised 2023
Afghanistan Humanitarian Response Plan indicates a critical situation,
with 28.8 million people needing urgent aid. While commendable
progress has been made in healthcare response, insufficient funding
poses a threat, potentially depriving 8 million individuals of vital health
assistance and impeding access to trauma care and mental health
support for hundreds of thousands.
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Situation in Syria
Conflict not only hinders healthcare access but directly targets facilities,
with airstrikes, looting, and violence. In Syria, the protracted civil war has
led to a critical shortage of medicines, and healthcare workers and
civilians face danger, leaving services severely deprived and life
expectancy reduced by 20 years.
Past UN/International Bodies Involvement
In 1995, WHO established the Commission on Social Determinants of
Health in recognition of the need to act to reverse the increasing
differentials in health status, both within and between countries, which
have been observed since the early 1990s. The Commission recognizes the
distinction between inequalities or disparities in health, and inequities.
Inequities are defined as unfair or unjust differences in health status that
are avoidable, and hence, can be remedied. In a conflict setting, health
inequalities are clearly inequities. A corollary of this distinction between
inequalities and inequities in health is the recognition of WHO that health
is a fundamental human right.
The 1949 Geneva Conventions, focusing on "war" situations, emphasize
protection for combatants and civilians. Recent protocols aim to
safeguard victims of modern military conflicts, prohibiting illegal attacks
on civilians if deemed "intentional," "indiscriminate," or "disproportionate."
The Fourth Geneva Convention strictly forbids attacks on civilian
hospitals. The UN's "responsibility to protect" against genocide, war
crimes, and crimes against humanity, accepted in 2005, reinforces human
rights grounded in ethics.
The UN Adopted resolution 2286 (2016), which condemned attacks and
threats against the wounded and sick, medical personnel and
humanitarian personnel exclusively engaged in medical duties, their
means of transport and equipment, as well as hospitals and other medical
facilities.It deplored the long-term consequences of such attacks for the
civilian populations and health-care systems of the countries concerned.
It demanded also that all parties to armed conflict facilitate safe and
unimpeded passage for medical and humanitarian personnel.
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KEY AREAS
Emergency Response
A primary health care approach is an essential foundation for health
emergency and risk management, and for building community and
country resilience within health systems. In emergencies, infrastructure,
supplies and the health workforce can be impaired or non-existent,
creating challenging environments in which to deliver good-quality care.
In emergencies, health systems face disruptions in geographic
accessibility, workforce availability, and funding, affecting care quality.
Health workers, vulnerable due to increased workload and risks, lack
training in emergency response. Systemic issues like unpaid wages and
staff shortages persist, worsened by recruitment by international
agencies. In fragile, conflict, or violence settings, disrupted health
systems and vulnerable populations in protracted emergencies lead to
increased morbidity. Two billion people in such contexts, with 134 million
needing humanitarian aid, require accessible primary care to address
health inequities and lay the groundwork for universal health coverage.
Strengthening Emergency Management
· Integrate primary health care into national emergency management
policies, recognizing its vital role at all levels from national to community,
with leaders actively involved in planning and coordination.
· Implement a people-centric approach, engaging communities in
health service design, empowering individuals, and investing in
community-level interventions, while concurrently strengthening the
health workforce through training, adequate staffing, and supportive
policies for effective emergency prevention, preparedness, and
response.
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· Enhance health care financing for emergency resilience, emphasizing
flexible funding and barrier-free access. Invest in robust infrastructure,
supply-chain management, and strategic information systems to
strengthen primary health care, ensuring effective prevention,
preparedness, and response in emergencies.
WHO’s work in health emergencies
WHO’s Health Emergencies Programme works with all countries and
partners to ensure the world is better prepared for all-hazards health
emergencies that threaten global health security. It helps to prevent and
manage epidemic and pandemic-prone diseases; to strengthen and
expand systems to rapidly detect, investigate and assess potential
threats to public health; and to respond immediately and systematically
to manage acute emergencies. In some conflict affected and
humanitarian settings, WHO staff and operational partners even act as
health-care provider of last resort.
WHO developed strategic response and operational plans with national
health authorities and partners for all graded and protracted
emergencies. The Organization provided support for the efforts of
national governments to increase the quality and coverage of health
services; strengthen primary, secondary and hospital care by deploying
mobile teams and reinforcing health facilities; improve surveillance and
early warning systems; conduct vaccination campaigns; distribute
medicines and supplies; and train health workers in situ and through
online courses.
In January 2022, WHO launched the Framework on Strengthening Health
Emergency Preparedness in Cities and Urban Settings. This was followed
by the publication in February 2022 of the accompanying operational
guidance on urban preparedness for national and local authorities. At the
Seventy-fifth World Health Assembly in May 2022, Member States
adopted resolution WHA75.7 (2022) on strengthening health emergency
preparedness and response in cities and urban settings.
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Obstruction of Healthcare Services
WHO defines an attack on health care as any act of verbal or physical
violence or obstruction or threat of violence that interferes with the
availability, access and delivery of curative and/or preventive health
services during emergencies. Types of attacks vary across contexts and
can range from violence with heavy weapons to psychosocial threats and
intimidation.
Health care is under attack. In 2022 alone, over 1000 confirmed attacks on
health care took place in emergency-affected countries and fragile
settings. These attacks deprive people of urgently needed care, endanger
health care providers, and undermine health systems.
Conflict zones often witness cruel circumstances such as those of
obstructed and damaged healthcare systems. The WHO aims to minimize
these damages and focus on rebuilding strength.
Health refugee & Migrants
The experience of migration is a key determinant of health and well-being.
Refugees and migrants remain among the most vulnerable members of
society faced often with xenophobia; discrimination; poor living, housing,
and working conditions; and inadequate access to health services,
despite frequently occurring physical and mental health problems.
Global migration is a long-standing phenomenon. It may increase because
of conflict, persecution, environmental degradation and climate change,
and a profound lack of human security and opportunity. Many people
move in the hope of improved employment and life opportunities.
The correlation between health and migration is dynamic by nature and
complex. Health is strongly related to the social determinants of health,
including employment, income, education and housing. When not
properly supported by appropriate intersectoral policies, migration can
expose the most vulnerable socioeconomic groups to significant risks.
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Disease Control
Humanitarian emergencies increase the risk of transmission of infectious
diseases and other health conditions such as severe malnutrition. An
effective disease surveillance system is essential to detecting disease
outbreaks quickly before they spread, cost lives and become difficult to
control. Effective surveillance can improve disease outbreak detection in
emergency settings, such as in countries in conflict or following a natural
disaster.
In conflict-affected areas, health-care facilities provide life-saving
services with very limited resources. Combined with poor infection
prevention and control (IPC) measures, inadequate water supply and
sanitation, and weak hygiene infrastructure, this can often result in
disease amplification among staff and patients, and in some situations in
the community itself.
Reporting, Analysis, and Administration
Public health surveillance is the continuous, systematic collection, analysis
and interpretation of health-related data.
Disease surveillance data:
· serves as an early warning system for impending outbreaks that could
become public health emergencies.
· enables monitoring and evaluation of the impact of an intervention,
helps track progress towards specified goals; and
· monitors and clarifies the epidemiology of health problems, guiding
priority-setting and planning and evaluation public health policy and
strategies.
Conflict areas often tend to underreport the magnitude of health
emergencies due to poor administration and governance. This is where the
WHO’s role comes in.
The issue in conflict is not its existence, rather its management. When it is
managed poorly, the outcome will be uncomplimentary with
counterproductive results and if managed properly, it encourages
competition, recognizes legitimate differences and becomes a powerful
source of motivation.
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Funding
Given the regional nature of many conflicts and shocks, health financing
analysis and support may be needed at regional level - for example in the
EMRO region, where all countries are either directly or indirectly affected
by conflict - as well as at national and sub-national levels. The focus should
be on tailored strategies, which build on international learning but are
closely contextualized and able to adapt. The only certainty is change, and
building capacity to manage change is critical.
Many of the health financing challenges are linked to this configuration,
with external actors adding to the fragmentation of policies and practices
in many cases - hence the importance of coordination, even if direct
relationships with governments are constrained.
The WHO seeks to mitigate funding constraints through international
assistance and cooperation.
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REFERENCES
Historical Analysis
https://www.mdpi.com/2071-1050/13/19/10783
Social determinants of health in countries in conflict
Current Situation
Situation in Gaza
https://www.who.int/news/item/03-11-2023-women-and-newbornsbearing-the-brunt-of-the-conflict-in-gaza-un-agencies-warn
Situation in Ukraine
https://www.thelancet.com/journals/lancet/article/PIIS01406736(23)003872/fulltext#:~:text=By%20Dec%2031%2C%202022%2C%2070
7,and%2086%20attacks%20on%20medical
Situation in Afghanistan
https://www.who.int/news/item/18-08-2023-afghanistan-s-healthsystem-suffers-critical-underfunding--calls-fordonorsupport#:~:text=However%2C%20despite%20these%20efforts%20a
nd,including%20blood%20transfusions%20and%20referrals.
Situation in Syria
https://www.healthpolicypartnership.com/under-threat-healthcare-inconflictzones/#:~:text=Health%20services%20in%20conflict%20zones,violence%2
0that%20destroys%20health%20infrastructure.
Past UN/International Involvement
https://press.un.org/en/2016/sc12347.doc.htm
https://applications.emro.who.int/dsaf/dsa955.pdf
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Emergency Response
https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_11-en.pdf &
https://www.who.int/docs/default-source/primary-health-careconference/emergencies.pdf
Obstruction of Healthcare Services
https://www.who.int/activities/stopping-attacks-on-health-care
Health Refugee & Migrants
https://www.who.int/news-room/questions-and-answers/item/refugeeand-migrant-health
Disease Control
https://www.who.int/europe/news/item/16-09-2019-world-patientsafety-day-making-infection-prevention-and-control-everyone-sbusiness-in-conflict-affected-areas
Reporting, Analysis, and Administration
https://pubmed.ncbi.nlm.nih.gov/30739920/
Funding
https://iris.who.int/bitstream/handle/10665/331658/9789240003491eng.pdf?sequence=1
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QARMA
·What categorizes as a health emergency in an international sense?
·What the key pain-points with respect to emergency response in current
conflicts?
·What efforts have been taken with respect to availability and access of
healthcare & medication?
·How to ensure safe delivery and administration of healthcare supplies in
conflict regions?
·Which national policies conflict with the basic right to access of
healthcare in conflict regions and are they to be withheld?
·Is there a need for an updated version of International Health Regulations
(IHR)?
·Is there an inherent need of a Global/Conflict Health Emergency
Response Plan?
·Who are to take policy & logistical decisions in the event of an
emergency?
·How can the social aspects of conflict affected individuals; refugees &
migrants be addressed?
·Is awareness and education a driving force behind safer and more
efficient first aid Medicare?
·How does the organization plan on raising continued funding and rallied
global support towards addressing the emergency situation?
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BEING READY
·The first step for making a good intervention and impression during the
debate is to research the topic itself, in a more general way. Make sure to
not only attend to not only statistics, but also research information that
identify the roots of the problems and effective policies that have been
promoted both nationally and by International bodies such as the WHO,
UN, OHCHR.
After getting a general idea on the topic itself, you should research your
state’s policy about it. It is crucial to know what your country’s aspirations
are, and what kind of measures can be put into practice. Besides that,
political alliances are one of the master keys to make sure that your
state’s goals will be successful. How is your state in terms of diplomacy? Is
it more bellicose, strategist and likes to be a leader? Or is it more peaceful
and gentler, more like a follower, in an already formed block? These are
some points that you should keep in mind to get information about the
subject.
After that you need to have a look in statistics, legal framework and,
maybe, try to find interesting facts and anecdotes that capture the
Committee´s attention! That will help you to reach partners and political
coalitions for your ideas.
The Office of the United Nations High Commissioner for Human Rights
(OHCHR) and the World Health Organization (WHO) website can also be
useful tools for your research since you can look for information on Draft
Resolutions about this topic or related issues, and some official speeches
from your state, explaining its position about this problem. Beyond that,
and if you have curiosity, you can also see other state’s speeches to have
an idea of which are the ones that are on your side and the ones that you
have to convince with your views.
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You should also keep in mind that not all sources are reliable. Then again,
you must keep in mind that regarding social and political affairs, and
particularly, if you search for media coverage, being impartial is almost
impossible so it is likely to find more obstinate convictions about this topic.
However, media articles are always very useful for your research, and you
shouldn’t forget to take a look at them too.
You, as a Delegate, are an official representative of your State in the World
Health Organization (WHO). Therefore, you must share its views as faithful,
as precise, and as dignified as possible.
Unity makes strength so don’t forget that consensus must be a goal, and
this can only be achieved through dialogue and tolerance. Finally, if every
delegate is open to new suggestions, the Debate will be much more
successful – and even if we don’t find a solution to the problem, we are
making efforts to accomplish one in the near future.
GOD SPEED!
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