Following the recent detection of the polio virus in Gaza, Laura Wise, Sanja Badanjak and Ian Russell share PeaceRep research on vaccination ceasefires and their efficacy.
While vaccination ceasefires can contribute to eradicating infectious diseases, their use should be approached pragmatically, and there is limited evidence that vaccination ceasefires can directly jumpstart wider negotiations.
Read the report: Breathing Space: Vaccination Ceasefires in Armed Conflict
Pragmatically Approaching a Vaccination Ceasefire for Polio in Gaza
In late July 2024, the polio virus was detected in waste water samples in Gaza, leading Tedros Adhanom Ghebreyesus, Director General of the World Health Organisation, to call for a ceasefire to support urgent vaccination campaigns.
In his commentary, Dr Tedros is right to note that there is a precedent of ceasefires being brokered to deliver public health campaigns to eradicate infectious diseases such as polio and is right to call for a ceasefire in Gaza. However, we are concerned that such initiatives should be approached pragmatically, without any expectation that the progress in this area could contribute to progress in wider negotiations, particularly in Gaza where earlier ceasefire attempts have hit political roadblocks.
Our research during the Covid-19 pandemic at the University of Edinburgh found that between 1985 and 2018 there were 74 instances of ceasefires worldwide for the purposes of conducting a vaccination campaign or addressing a similar public health need. These ceasefires facilitated campaigns against diseases including polio, measles, cholera, and rubella, with the majority occurring in Afghanistan, El Salvador, and Sri Lanka.
Crucially, we found limited historical evidence for vaccination ceasefires translating into progress in peace processes, and it appears unlikely that vaccination ceasefires can directly jumpstart wider negotiations. At best, such arrangements may contribute to temporary trust-building among warring parties and between armed groups and humanitarian actors; at worst, if poorly executed, they could exacerbate conflict situations and damage public perceptions of vaccines.
Our study also showed that trust is fundamental to implementing ceasefires for public health in the first place. In Gaza, gross International Humanitarian Law (IHL) violations have destroyed the trust necessary to conduct public health activities, making even a limited public health ceasefire difficult to envisage.
Vaccination ceasefires should not be ruled out. However, any attempts to forge a truce to deal with polio will need to understand why previous efforts in other contexts failed, to detach health activities from peacebuilding ambitions, and to adapt lessons from historical contexts to a conflict that has challenged the foundations of IHL.
About the Authors:
Laura Wise is a Research Fellow with PeaceRep at the University of Edinburgh School of Law.
Dr Sanja Badanjak is a Chancellor’s Fellow in Global Challenges at the University of Edinburgh School of Law.
Dr Ian Russell is a Lecturer in African Studies and International Development at the University of Edinburgh School of Social and Political Science.