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  • A substantial part of the value of setting goals

    2019-05-27

    A substantial part of the value of setting goals, targets, and indicators lies in the imperative to collect information for measurement and accountability —“what gets measured gets done”. The decision to exclude an indicator because it EPZ015666 is less established is diametrically opposed to the potential gains of establishing new data collection systems. Indicators analogous to the MDGs\' indicator on access to affordable medicines have been proposed as SDG indicators. Global goals have substantial influence on the agendas of governments and NGOs. The deprioritisation of reporting on access to affordable medicines without consultation and without broader acknowledgment is unacceptable, and undermines global recognition of inequalities in access. Without true accountability and transparency, the development process is superficial and will fail to engage decision makers. To be taken seriously, the SDG targets and indicators on access to affordable medicines, vaccines, and medical technologies demand sufficient political will and investment for robust measurement.
    On Oct 3, 2015, a US airstrike hit Médecins Sans Frontières\' (MSF\'s) Kunduz Trauma Centre in Afghanistan; 42 lives, including 14 MSF hospital staff, were lost. The 92-bed hospital was the only facility with essential trauma care capabilities for hundreds of thousands of people living in northern Afghanistan; those who continue to live amid conflict will critically miss it. The attack was a violation of international humanitarian law and the Geneva Conventions, a war crime, and an incursion on the sanctity of humanitarian action globally. In Syria, since the start of the conflict in 2011, there have been 223 attacks on 175 health facilities; these attacks have killed 599 medical personnel. In 2015 alone, more than 90 airstrikes and shelling attacks hit facilities supported by MSF in Syria. Despite the global attention directed towards the need for all parties of conflict to respect the Geneva Conventions after the Kunduz attack, MSF and other hospitals continue to be bombed or shelled in both Syria and Yemen. Given these attacks, MSF has had to stop sharing the GPS coordinates of hospitals in Syria to protect the patients and humanitarians within them. In addition to the injuries, loss of lives, and destruction of facilities required to care for populations caught in war, these attacks have challenged the fundamental tenets of impartiality and neutrality of humanitarian actors in war zones. It is time for all parties involved in conflicts globally to renew their commitments to international humanitarian law and the protection of civilians and civilian objects (eg, schools, churches, mosques) and hospitals, medical units, and medical personnel operating in conflict. The First and Fourth Geneva Conventions provide for the protection of medical personnel and facilities to ensure that they are able to operate without military interference and care for patients based on need only. In 1970, the UN General Assembly adopted Resolution 2675, which states that a hospital zone or similar refuge should not be the object of military operations. Operations may be directed only against military objectives and combatants; Complex locus is prohibited to target civilian objects or civilians. Hospitals, medical units, and medical personnel are afforded “special protection” under international humanitarian law; they shall be protected, respected, and may not be the object of attack. This obligation applies at all times, even when the medical unit or hospital is not being used to accommodate wounded or sick patients, provided that the medical unit is used exclusively for medical purposes. Parties are obligated to do “everything feasible” to “cancel or suspend an attack” if the party learns that the target is either: (i) not a military objective; or (ii) the attack would violate the principle of proportionality. Extremist organisations often embed themselves with non-combatants or near protected structures, objects, or personnel. The fourth Geneva Convention states that the protection afforded to hospitals and medical personnel “shall not cease unless they are used to commit, outside their humanitarian duties, acts harmful to the enemy. Protection may, however, cease only after due warning has been given...” Therefore, indiscriminant or targeted attacks on hospitals, medical units, and medical personnel functioning in a humanitarian capacity are never admissible.