As wars hollow out hospitals, vaccination systems, water access, and humanitarian space, attacks on health workers expose how conflict is turning care itself into a battlefield
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This essay is part of the series: World Health Day 2026: Standing with Science in an Age of Shared Risk
As conflicts across the world are on the rise, their devastating effects on people have been reduced to mere numbers on our screens. Médecins Sans Frontières (MSF) or Doctors Without Borders bears witness to many of the tragic and complex realities on the ground. As World Health Day 2026 approaches, the monumental health crises that wars present, and how health workers are increasingly getting caught in the crosshairs, need to be a acknowledged. The most visible damage is the decimation of infrastructure that ruptures the passage of essentials, from water to vaccinations to the affected population, further exposing them to disease and infections. Today, in addition to the difficulties of reaching the most affected populations, healthcare workers and systems are themselves becoming targets of violence. The violence ranges from physical bombardment to digital misinformation. The growing hostility against medical and humanitarian workers is putting organisations like MSF in an impossible position: either risk staff staying and caring for those most in need, or withdraw in the middle of a humanitarian crisis.
MSF’s Medical Care in the Crosshairs report, released in January 2026, reveals record-level attacks against healthcare workers in recent years. Drawing from existing international databases and MSF’s own experience, the report reveals a growing pattern of non-compliance by states of the obligations under International Humanitarian Law (IHL) to protect medical facilities and personnel. In 2025, the World Health Organization (WHO)’s Surveillance System for Attacks on Health Care (SSA) reported a total of 1,348 attacks on medical facilities, resulting in the deaths of 1,981 people. This marked a significant increase in fatalities among medical personnel and patients in conflict zones, which doubled from 944 in 2024. Sudan was the most affected country, with 1,620 people killed, followed by Myanmar with 148, Palestine with 125, Syria with 41, and Ukraine with 19 people killed.
The growing hostility against medical and humanitarian workers is putting organisations like MSF in an impossible position: either risk staff staying and caring for those most in need, or withdraw in the middle of a humanitarian crisis.
Wars themselves are a catastrophic health emergency, even without the targeted attacks on health institutions. In addition to injuries caused by gunshots, explosions, abuse, torture, and getting trapped under debris, numerous studies show that regions facing continued violence record a resurgence of preventable infectious diseases, often due to breakdown in vaccination systems, lack of clean water and hygienic surroundings, malnutrition, shortage of medicines, displacement, stress, amongst others.
In August 2024, Gaza recorded its first polio case in 25 years in an unvaccinated 10-month-old child. In July 2024, the United Nations Children's Fund (UNICEF) and WHO raised an alarm about the high risk of the spread of polio in Gaza, after viral traces were detected in six wastewater samples. It is also important to note that today, none of the hospitals in Gaza are fully functional, with less than 14 out of the 36 partially functioning. Similarly, cholera outbreaks have become worryingly frequent in Sudan, which is facing the world’s largest displacement and hunger crisis due to continued war. Since the Federal Ministry of Health declared the outbreak in 2024, thousands of new cases have been recorded, with 113,000 infections and 3,000 deaths. Today, cholera has spread to all 18 states of Sudan, often due to the consumption of dirty water in refugee camps under dire conditions.
The story is similar in other war-torn regions, be it Yemen, Ukraine, or Syria. Diseases that can be easily prevented resurge in tandem with violence, wreaking havoc on people’s health and lives, even as their homes and hospitals are razed to the ground by more visible artillery. People in conflict regions, particularly women, children, gender minorities, people with disabilities, and the elderly, are already facing unprecedented challenges. These dire circumstances are further compounded when there is deliberate targeting of health facilities, one of the last few safe havens for the distressed population to seek treatment and care. Attacks on health facilities and the destruction of health systems have a devastating, life-threatening consequence on civilians long after the attack itself. Aside from people losing access to care, there is also fear that deters people from seeking care at hospitals and health facilities.
In 2025, the World Health Organization (WHO)’s Surveillance System for Attacks on Health Care (SSA) reported a total of 1,348 attacks on medical facilities, resulting in the deaths of 1,981 people.
In 2024, the latest available data from the Safeguarding Health in Conflict Coalition documented 3,623 incidents targeting healthcare, 15 percent increase in 2023 and 62 percent more than in 2022. In 2024, approximately 81 percent of incidents of violence against healthcare were attributed to state groups. Locally hired staff are particularly affected. According to the Aid Worker Security Database, between 2021 and 2025, 1,241 locally hired staff members were killed, 1,006 were injured, and 604 were kidnapped worldwide. They represent 98 percent of the total of aid workers killed, 96 percent of those injured, and 94 percent of those kidnapped. MSF has lost 15 of its own staff members to the violence in Gaza that erupted in October 2023.
This year’s World Health Day theme is “Together for Health. Stand with Science”. Under IHL, state and non-state armed groups are obligated to ensure unimpeded passage for humanitarian aid, protect civilians and humanitarian workers and protect healthcare. However, we are witnessing health and relief being increasingly weaponised by parties involved in different conflicts. The narrative, too, has shifted from framing such incidents as “mistaken attacks” to justifying them because medical facilities and humanitarian personnel have “lost protection” under IHL. A narrative more conducive to military necessity than the obligation to protect civilians and health workers. Consequently, the burden of responsibility has changed: instead of automatically being seen as civilians and therefore protected, communities and healthcare facilities now must prove that they are not military targets.
People losing access to care, there is also fear that deters people from seeking care at hospitals and health facilities.
Treating the wounded and sick, and the corresponding protection of medical personnel and facilities, has been at the core of IHL since its inception in 1864. This was further enshrined in the Four Geneva Conventions of 1949 and the Two Additional Protocols of 1977. The protection of medical services in war zones is also part of International Humanitarian Customary Rules and is reflected in the domestic law and military code of all countries around the world. IHL also protects medical personnel to ensure that they are able to resist military interference and act with independence and autonomy according to medical ethics only. The obligation under IHL also extends to medical facilities and transports that should be respected, protected and cannot be attacked.
Normalising violence against healthcare facilities and workers will have long-ranging consequences on the abilities of organisations and individuals to provide lifesaving care to some of the most distressed populations during violence. It will impact how aggressors–state or non-state–treat medical and humanitarian workers. This World Health Day, it is important we look at the fine print of the wars erupting around us: Why are health workers and hospitals being targeted with impunity? Who does it benefit? And how do we stop this?
Why are health workers and hospitals being targeted with impunity? Who does it benefit? And how do we stop this?
Even as this grave issue is being discussed, health and humanitarian workers the world over are facing the realities of it. It is forcing them to choose between their safety and the well-being of the patients. The attacks are forcing them to witness the incineration of lifesaving medicines and equipment, in a situation where there are already too few. It is forcing them to constantly rethink decisions when they are given very little time to make them. It is making them mourn their lost colleagues and fear for the ones who continue to work in dangerous conditions. This World Health Day, a ban on attacks on health and humanitarian workers and institutions should be instituted. As we witness daily escalations of violence, we have the obligation to continually hold states and warring parties accountable to proper mechanisms of military engagement that integrate the protection of medical missions into military doctrine and decision-making. In the words of the UN Secretary-General, ‘Even wars have rules’.
Parthesarathy Rajendran is an Executive Director, Doctors Without Borders/Médecins Sans Frontières (MSF) South Asia.
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Parthesarathy Rajendran is a humanitarian professional and global health expert with nearly two decades of experience across crisis and development contexts. He holds degrees in ...
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