A/68/297 I. Introduction 1. Conflicts pose immense challenges to the realization of the right to health. Some 1.5 billion people currently live in conflict-affected areas or fragile States, which face levels of child mortality and malnutrition twice as high as countries that are not affected by conflict, have poverty levels that are 21 per cent higher, and are furthest away from achieving the Millennium Development Goals. 1 Conflict affects health not only through direct violence, but also through the breakdown of social structures and health systems, and lack of availability of underlying determinants of health. This leads to a high incidence of preventable and treatable conditions including malaria, diarrhoea, pneumonia and malnutrition. 2 These health effects often persist well after the end of active hostilities, and negatively impact health indicators for years thereafter. 3 Addressing the right to health in conflict and postconflict situations is therefore imperative to realizing the right to health for all. 2. Contemporary conflicts take a variety of forms, including internal disturbances, protests, riots and civil strife and unrest, in addition to armed conflicts as addressed under international humanitarian law. They also include occupied territories and territories with constant military presence where populations may be affected by conflict for many years despite the lack of active hostilities. The report defines State obligations in relation to the right to health in all such conflict situations. Situations which do not meet the criteria for armed conflict or occupation are governed exclusively by human rights law, including the right to health. Armed conflict however is governed by international humanitarian law as well as human rights law. 3. Armed conflict is divided into international armed conflict — where there is “resort to armed force between States”, 4 and non-international armed conflict — where there is “protracted violence” involving at least one non-State organized armed group. 5 In both situations, international humanitarian law prescribes rules of conduct for States and non-State organized armed groups that are parties to the conflict. These govern circumstances such as the conduct of hostilities, treatment of prisoners, guarantees of fundamental rights such as access to justice and treatment of civilians and civilian property. 4. Human rights law continues to apply in situations governed by international humanitarian law. This has been affirmed by the International Court of Justice, 6 __________________ 1 2 3 4 5 6 13-42297 World Bank, World Development Report 2011: Conflict, Security and Development (Washington D.C., 2011), pp. 2, 5. International Rescue Committee (IRC), Mortality in the Democratic Republic of Congo: an ongoing crisis (New York, 2007), p. ii. Available from www.rescue.org/sites/default/files/ migrated/resources/2007/2006-7_congomortalitysurvey.pdf. Ibid., World Bank, World Development Report 2011, p. 2. International Tribunal for the Former Yugoslavia, Prosecutor v. Tadic, case No. IT-94-1-A, ICTY, Decision on the Defence Motion for Interlocutory Appeal on Jurisdiction, 2 October 1995, para. 70. International Committee of the Red Cross (ICRC), “How is the term ‘armed conflict’ defined in international humanitarian law?”, Opinion Paper (Geneva, 2008). Available from www.icrc.org/eng/assets/files/other/opinion-paper-armed-conflict.pdf. Legal Consequences of the Construction of a Wall in the Occupied Palestinian Territory, Advisory Opinion, I.C.J. Reports 2004, p. 136, para. 112; Case Concerning the Armed Activities on the Territory of the Congo (Democratic Republic of the Congo v. Uganda) I.C.J. Reports 2005, para. 216. 3/24