WHO Right to Health Report 2022: Duty bearers must grant unhindered access to health facilities

Article, 05.06.2023

Switzerland contributes to the World Health Organization`s (WHO) advocacy efforts and renews its commitment to a human rights based approach to health.

An elderly couple sits on a bench.
Patients waiting at Erez checkpoint to exit Gaza for specialized treatment in East Jerusalem. © WHO

The WHO 2022 Right to Health report documents that considerable barriers to the right to health for Palestinians continue to exist. Palestinian access to health is impacted by the structural weaknesses of the national health care system, the fragmentation of the territory and the ongoing occupation, which puts physical obstacles to the freedom of movement and limits the access to specialized treatment.

Public provision of health services in the oPt is challenged by limited government expenditure on health (only 158 US$ per capita). This is attributable to limited overall economic growth in the oPt (GDP per capita 3664 $) and high unemployment. Furthermore there is a lack of specialized human resources and health facilities in the oPt. Over a third of the Ministry of Health (MoH) spending is on medical referrals (e.g. referrals to non-MoH providers such as hospitals in East Jerusalem, in Jordan or in Israel) which is a source of budget inefficiency. The Palestinian Authority faced a severe fiscal crisis throughout the reporting period, with implications also for the expenditures on health.

In the West Bank, access to health facilities is restricted by Israeli checkpoints, the separation wall and an expanding settlement infrastructure, while movement of Palestinians into east Jerusalem and Israel is controlled by the Israeli permit regime. The approval rate for patient and companion permits have been consistently higher for the West Bank than for the Gaza strip, with 84% of patient applications approved between 2019-2021. However 24’000 patient applications have not been approved during the period. The report calls on duty bearers in Israel and the oPt to respect the right to health and to do their utmost to facilitate access to quality health services and hence to save lives.

The closure of Gaza since 2007 has severely affected the movement of people and the access to specialized treatment for Gazans. Palestinians in the Gaza Strip must apply for Israeli permits to cross the checkpoints. Since 2017, Israel more than doubled the required time for submission of non-urgent patient applications from 10 to 23 working days prior to hospital appointment. Despite the severity of their conditions from 2019-2021 only 65% of patients permits were approved in time to reach the patients hospital appointment. There has been growing concern over the criminalization and scrutinization of health care, with 385 interrogations of patients and companions needing access out of Gaza.

In response to the barriers to right to health of Palestinians, WHO has, since 2009, built a successful programme for right to health in the occupied Palestinian territory, in partnership with and support from SDC. The Programme focuses on the following main activities:

  1. Monitoring, documentation, and production of evidence for enhanced analysis on barriers to right to health affecting Palestinians in the occupied Palestinian territory.
  2. Capacity building for rights holders to claim health rights; for duty bearers to design policies and programmes to uphold respect, protection and fulfilment of the right to health; and for partners to uphold human rights-based approaches to health care delivery and to advocate for right to health.
  3. Advocacy to shift policies and practices of key duty bearers, including Israel as occupying power, the Palestinian Authority, de facto authorities in the Gaza Strip, and third States, through reporting and dissemination of key messages and recommendations for strengthening respect, protection, and fulfilment of right to health in the occupied Palestinian territory.

The domain of Local Governance and Essential services is one of three thematic pillars of SDC engagement in the oPt. SDC aims to build the resilience of local communities through a better access to basic services at local level. In line with its Cooperation Strategy 2021-2024, SDC advocates for inclusivity in service delivery and leaving no behind.