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Humanitarian power has been hijacked and must regain its reputation for neutrality

BMJ 2013; 347 doi: (Published 02 September 2013) Cite this as: BMJ 2013;347:f5359
  1. Gabriele Rossi, paediatrician, public health doctor, and country medical coordinator, Médecins Sans Frontières, Brussels 1090, Belgium
  1. gab.rossi{at}

Attacks on its staff have led Médecins Sans Frontières (Doctors Without Borders) recently to stop offering humanitarian assistance in Somalia altogether. Gabriele Rossi says that humanitarianism must be uncoupled from political and military activity and rebuild its reputation of impartiality

The political manipulation of international public health, exemplified by the US Central Intelligence Agency’s fake vaccination campaign in Pakistan in 2010, orchestrated to “neutralise” Osama Bin Laden, was denounced in a courageous letter recently published in the New England Journal of Medicine.1

The authors warned that undermining of the neutrality of international public health efforts decreases security for humanitarian workers. Their concern is well founded. In 2011 a total of 308 aid workers were killed, wounded, or kidnapped—the greatest number on record. The aid worker security database showed that most attacks (72%) took place in a small number of extremely insecure countries (Afghanistan, Somalia, Pakistan, and Sudan).2 In most of these conflict areas, humanitarian action has become a proxy target for insurgency.

Neutrality has been sacrificed on the altar of international politics since the beginning of the so …

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