DPR Monthly Bulletin – Volume XXXVII, No. 4, CEIRPP, DPR Bulletin (April 2014) – DPR publication

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April 2014

Volume XXXVII, Bulletin No. 4

Bulletin

on action by the United Nations system and

intergovernmental organizations

relevant to the question of Palestine

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I. UNESCO ADOPTS DECISIONS RELATED TO QUESTION OF PALESTINE

During its meeting held in Paris from 2 and 15 April 2014, the Executive Board of the United Nations Educational, Scientific and Cultural Organization (UNESCO) made the following decisions related to the question of Palestine.

Implementation of 37 C/Resolution 44 and 192 EX/Decision5 (I)(D) relating to the Ascent to the Mughrabi Gate in the Old City of Jerusalem

The Executive Board,

1. Having considered the report of the Director-General (194 EX/5 Part I (C)),

2. Recalling the relevant provisions on the protection of cultural heritage, including the four Geneva Conventions (1949), the relevant provisions of the Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict of 1954 and its protocols, the Conventions for the Protection of the World Cultural and Natural Heritage 1972, the inscription of the Old City of Jerusalem and its Walls at the request of Jordan on the World Heritage List (1981) and the List of World Heritage in Danger (1982), and the recommendations, resolutions and decisions of UNESCO,

3. Also recalling previous UNESCO decisions relating to the Ascent to the Mughrabi Gate in the Old City of Jerusalem, including 180 EX/Decision 5 (II), 189 EX/Decision 5 (II), 191 EX/Decision 5(I), 192 EX/Decision 5 (I.D) and decision 37 COM 7A.26 of the World Heritage Committee (Phnom Penh, 2013),

4. Taking note of the 12th Reinforced Monitoring Report and of all previous reports, together with their addenda prepared by the World Heritage Centre,

5. Deplores the fact that neither the reactive monitoring mission to the Old City of Jerusalem and its Walls nor the meeting of experts on the Mughrabi Ascent have taken place despite the relevant Executive Board and World Heritage Committee (WHC) decisions: 189 EX/Decision 5(II), 189 EX/Decision 8, 191 EX/Decision 5 (I), 192 EX/Decision 5 (I.D), 191 EX/Decision 9 and WHC decision 34 COM 7A.20 (Brasilia consensus decision), and urges Israel to honour its commitments to implement the aforementioned decisions;

6. Recognizes the concerns raised, in this regard, about the decision by the Jerusalem District Planning and Construction Commission on the town planning scheme for the Mughrabi Ascent, and the subsequent decision by Israel’s National Council for Planning and Construction to adopt “an alternative plan for the Mughrabi Ascent”, approved on 31 October 2010 by the aforementioned Commission;

7. Requests that, despite the decisions mentioned in paragraph 6 of this decision, the process for the design of the Mughrabi Ascent be inclusive of and accepted by all parties, in accordance with the obligations and duties of such parties as stipulated in the content of the conventions mentioned in paragraph 2 of this decision and in previous World Heritage Committee decisions.

8. Affirms, in this regard, that the UNESCO process for the follow-up of the design of the Mughrabi Ascent, which is aimed at finding an accepted and monitored solution concerning the Mughrabi Ascent, be coordinated among all parties concerned, in accordance with the spirit and content of previous World Heritage Committee decisions, recognizes the concerns raised regarding Israel’s submission and the content of its plan for the Mughrabi Ascent referred to in paragraph 6 of this decision, and requests that the World Heritage Centre be proactive and follow closely, in the context of the Reinforced Monitoring Mechanism, the developments associated with this process and the evaluation of the Jordanian design received;

9. Reaffirms in this regard that no measures, unilateral or otherwise, shall be taken which affect the authenticity, integrity and cultural heritage of the site, in accordance with the Convention for the Protection of the World Cultural and Natural Heritage of 1972, and the relevant provisions on the protection of cultural heritage of the Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict of 1954 and the relevant decisions of UNESCO’s Executive Board and World Heritage Committee referred to above;

10. Reiterates its thanks to Jordan for its cooperation, urges Israel to cooperate with Jordanian Awqaf Department in accordance with the relevant provisions of UNESCO Conventions for the protection of cultural heritage referred to above, and calls on Israel to facilitate access of Jordanian Awqaf experts with their tools and material to the site;

11. Expresses its concern regarding the continuous, intrusive Israeli archaeological demolitions, excavations and works in and around the Ascent to the Mughrabi Gate despite World Heritage Committee decisions 36 COM 7A.23 and 37 COM 7A.26, and requests the Israeli authorities to end such excavations and works in conformity with this decision and the relevant UNESCO conventions for the protection of cultural heritage;

12. Deplores the recent construction by Israel of a platform in the Burāq (Western Wall) Plaza, in violation of its obligations under the conventions referred to above, and requests Israel to remove the structure built, immediately restore the site to its original character, and refrain from taking any further unilateral steps which jeopardize the site, and its integrity and authenticity;

13. Expresses its concern regarding the Israeli authorities’ admittance of provocative religious-extremist groups and uniformed forces into the al-Aqṣà Mosque compound (also known as the al-Ḥaram ash-Sharīf compound) through the Mughrabi Gate, and regrets the systematic violations of the sanctity of the compound and the continued interruption of the freedom of worship therein;

14. Affirms in this regard, the need to protect and safeguard the authenticity, integrity and cultural heritage of the al-Aqṣà Mosque compound;

15. Expresses its thanks to the Director-General for her attention to the sensitive situation in the Ascent to the Mughrabi Gate in the Old City of Jerusalem, and calls on the Director-General to facilitate the meeting of experts as well as confidence-building measures by dispatching the necessary expertise to assess possible damage incurred through the conduct of recent Israeli works on the site;

16. Invites the Director-General to submit to it at its 195th session a progress report thereon.

Follow-up to the UNESCO reactive monitoring mission to the Old City of Jerusalem and its Walls and the UNESCO experts meeting on the Mughrabi Ascent

The Executive Board,

1. Having examined document 194 EX/5 Part I (D),

2. Recalling 191 EX/Decision 5(I), 191 EX/Decision 9, 192 EX/Decision 5 (I) (D), 192 EX/Decision 11 and 192 EX/Decision 42, as well as World Heritage Committee decision 34 COM/7A.20,

3. Decides to implement paragraph 11 of decision 34 COM/7A.20 adopted by the World Heritage Committee in Brasilia at its 34th session as follows:

– (a) Phase I: the dispatch, on an agreed date prior, at least 10 days, to the 38th session of the World Heritage Committee, of the joint World Heritage Centre/ICCROM/ICOMOS reactive monitoring mission to the Old City of Jerusalem and its Walls to assess, as a first phase, the 18 sites included in the Action Plan as pilot sites;

– (b) Phase II: the dispatch, on an agreed date, of the joint World Heritage Centre/ICCROM/ICOMOS reactive monitoring mission to the Old City of Jerusalem and its Walls, to assess, as second phase, the major monumental complexes designated in the Action Plan (i.e. al-Ḥaram ash-Sharif, the Citadel, the Western Wall, the Holy Sepulchre and the City Walls);

4. Invites all parties concerned to participate in the experts meeting on the Mughrabi Ascent, to be held at UNESCO upon an agreed date prior, at least 10 days, to the 38th session of the World Heritage Committee;

5. Requests that the report and recommendations of the mission as well as the report of the technical meeting on the Mughrabi Ascent in Paris, be presented to the parties concerned before the 38th session of the World Heritage Committee;

6. Takes note of the technical adjournment of the five Middle East items on the agenda of its 194th session and their inclusion in the agenda of its 195th session;

7. Also invites all parties concerned to facilitate the implementation of the above-mentioned UNESCO joint mission;

8. Thanks the Director-General for her continuous efforts to implement the above-mentioned UNESCO joint mission and all related UNESCO decisions and resolutions;

9. Decides to include this item in the agenda of its 195th session, and invites the Director-General to submit to it a follow-up report thereon.

Jerusalem and the implementation of 37 C/Resolution 44 and 192 EX/Decision 11

The Executive Board,

1. Having examined document 194 EX/11,

2. Recalling resolutions and decisions of UNESCO on Jerusalem, as well as the provisions of the four Geneva Conventions (1949) and their Additional Protocols, the 1907 Hague Regulations on Land Warfare, the Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict (1954) and its related Protocols and the Convention for the Protection of the World Cultural and Natural Heritage (1972),

3. Affirming that nothing in the present decision, which is aimed at the safeguarding of the distinctive character of East Jerusalem, shall in any way affect the relevant United Nations resolutions and decisions, in particular the relevant Security Council resolutions on the legal status of Jerusalem,

4. Regrets the absence of progress in the implementation of previous UNESCO decisions concerning Jerusalem, particularly 185 EX/Decision 14, and reiterates its request to the Director-General to appoint, as soon as possible, a permanent and eminent expert(s) to be stationed in East Jerusalem to report on a regular basis about all the aspects covering all UNESCO fields of competence in the City of East Jerusalem;

5. Reaffirms the requirement to implement promptly and fully the above-mentioned decisions, and urges the Israeli authorities to facilitate their implementation, in conformity with the provisions of relevant UNESCO conventions, resolutions and decisions;

6. Deplores the failure of Israel to cease its persistent excavations and works in East Jerusalem, and reiterates its request to the Israeli authorities to prohibit all such works, in conformity with the provisions of relevant UNESCO conventions, resolutions and decisions;

7. Also deplores the continuous Israeli unilateral measures and practices, as well as the settlers’ incursions in East Jerusalem, which dangerously and irreversibly affect the city’s distinctive religious, cultural, historical and demographic character, and urges the Israeli authorities to take the necessary measures to end these abuses;

8. Thanks the Director-General for her efforts to implement previous UNESCO decisions on Jerusalem, and asks her to maintain and reinvigorate such efforts;

9. Decides to include this item in the agenda of the 195th session of the Executive Board and invites the Director-General to submit to it a progress report thereon.

Implementation of 192 EX/Dec.12 on “The two Palestinian sites of al-Ḥaram al-Ibrāhīmī/Tomb of the Patriarchs in al-Khalīl/Hebron and the Bilāl ibn Rabāḥ Mosque/Rachel’s Tomb in Bethlehem”

The Executive Board,

1. Having examined document 194 EX/12,

2. Recalling UNESCO decisions on the two Palestinian sites in al-Khalīl/Hebron and in Bethlehem, as well as the provisions of the four Geneva Conventions (1949) and their Additional Protocols (1977), the 1907 Hague Regulations on Land Warfare, the Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict (1954) and its related Protocols and the Convention for the Protection of the World Cultural and Natural Heritage (1972); also recalling the Convention on the Means of Prohibiting and Preventing the Illicit Import, Export and Transfer of Ownership of Cultural Property (1970),

3. Reaffirming that the two concerned sites located in al-Khalīl/Hebron and in Bethlehem are an integral part of Palestine,

4. Affirming that nothing in the present decision, which is aimed at the safeguarding of the Palestinian cultural heritage, shall in any way affect the relevant Security Council and United Nations resolutions and decisions on the legal status of Palestine,

5. Expresses its deep concern over the ongoing Israeli construction of private roads for settlers and a separation wall inside the Old City of Hebron, which dangerously and irreversibly affect the city’s distinctive religious, cultural, historical, and demographic character, and urges the Israeli authorities to end these violations, in compliance with provisions of relevant UNESCO conventions, resolutions and decisions;

6. Regrets the denial of freedom of movement and freedom of access to places of worship due to the above-mentioned Israeli violations and restrictions;

7. Also regrets the Israeli authorities’ refusal to comply with 185 EX/Decision15 concerning this item, and urges them to act in accordance with that decision;

8. Decides to include this item in the agenda of the 195th session of the Executive Board, and invites the Director-General to submit to it a follow-up report thereon.

Implementation of 37 C/Resolution 67 and 192 EX/Decision 33 concerning educational and cultural institutions in the occupied Arab territories

The Executive Board,

1. Recalling 37 C/Resolution 67 and 185 EX/Decision 36 as well as Article 26 of the Universal

Declaration of Human Rights with regard to the right to education, Articles 4 and 94 of the Fourth Geneva Convention with regard to the denial of the right of children to education, as well as the Hague Convention (1954) and its Protocols and the Convention for the Protection of the World Cultural and Natural Heritage (1972),

2. Having examined document 194 EX/27,

3. Committed to the safeguarding of monuments, works of art, manuscripts, books and other historical and cultural properties to be protected in the event of conflict,

4. Supports the efforts made by the Director-General with a view to the implementation of 36 C/Resolution 81 and 185 EX/Decision 36, and requests her to do everything possible to ensure that they are fully implemented;

5. Expresses its appreciation for the substantial contributions of all concerned Member States and intergovernmental organizations and non-governmental organizations to UNESCO’s action in Palestine, and appeals to them to continue assisting UNESCO in this endeavour;

6. Thanks the Director-General for the results that have been obtained in relation to the implementation of a number of current educational and cultural activities;

7. Invites the Director-General to strengthen UNESCO’s assistance to the Palestinian educational and cultural institutions in order to address new needs;

8. Expresses its continuing concern about the harmful impact of the Separation Wall and other practices on the activities of cultural and educational institutions, as well as obstacles resulting therefrom which prevent Palestinian schoolchildren and students from being an integral part of their social fabric and from exercising fully their right to education, and calls for the observance of the provisions of relevant UNESCO conventions, resolutions and decisions, particularly 185 EX/Decision 36,

9. Notes with deep concern the Israeli authorities’ censorship of the Palestinian curricula of schools and universities in East Jerusalem, and urges them to immediately halt such censorship;

10. Regrets the Israeli order to close for two weeks, in May 2013, the Hakawati Theatre in East Jerusalem, which was supposed to host, during that period, an international festival of puppets for children;

11. Encourages the Director-General to continue to reinforce her action in favour of the protection, reconstruction, rehabilitation and restoration of the Palestinian archaeological sites and cultural heritage, and invites her to address the needs for capacity-building in all UNESCO’s fields of competence by expanding the financial assistance programme for Palestinian students;

12. Requests the Director-General to organize, as soon as possible, the ninth meeting of the Joint UNESCO-Palestine Committee;

13. Also invites the Director-General:

(a) to continue the efforts she is making to preserve the human, social and cultural fabric of the occupied Syrian Golan, in accordance with the relevant provisions of this decision;

Report by the Director-General on the reconstruction and development of Gaza: implementation of 192 EX/Decision 34

The Executive Board,

1. Having considered document 194 EX/28,

2. Recalling the provisions of the four Geneva Conventions (1949) and their additional Protocols (1977), the Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict (1954) and its Protocols, and the Convention for the Protection of the World Cultural and Natural Heritage (1972), and the relevant recommendations, resolutions and decisions of UNESCO on the protection of cultural heritage and on the right to education,

3. Also recalling 185 EX/Decision 37,

4. Noting with deep concern the slow progress in the reconstruction of schools and other cultural heritage sites in the Gaza Strip that were damaged during the 2008-2009 war and the November 2012 war,

5. Deeply regrets the damaging impact of the November 2012 war on UNESCO fields of competence in Gaza, where 280 education facilities were damaged, affecting approximately 250,000 students, as reported in document 191 EX/35, as well as the severe damage inflicted to one cultural heritage site of the Palestinian Tentative List, the Port of Anthedon (the old port of Gaza);

6. Affirms, in this regard, that schools, universities and cultural heritage sites should not be involved and/or targeted in military conflicts;

7. Deplores the continuous Israeli blockade of the Gaza Strip, which harmfully affects the free and sustained movement of personnel and humanitarian relief items for the successful implementation of UNESCO reconstruction projects, as well as the injury of children, the attacks on schools, and the denial of access to education, as reflected in document 190 EX/39;

8. Thanks Member States and donors for their generous financial contributions to the UNESCO projects for Gaza, and invites Member States, international organizations and relevant international, national and private institutions to provide further assistance in this regard through extrabudgetary funding;

9. Thanks the Director-General for initiatives that have already been implemented in the field of education, and for the safety of media professionals, and calls upon her to continue her involvement actively in the reconstruction of its damaged educational and cultural heritage components;

10. Requests the Director-General to organize an information meeting to provide Member States with an update on the outcome of the projects conducted in the Gaza Strip-Palestine;

11. Decides to include this item in its agenda at its 195th session, and invites the Director-General to submit to it a progress report thereon.

II. WHO REPORTS ON HEALTH CONDITIONS IN OCCUPIED PALESTINIAN TERRITORY

On 17 April 2014, the Secretariat of the World Health Organization issued the following report entitled “Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan”, prepared for the 67th World Health Assembly (A67/41):

1. In 2013, the Sixty-sixth World Health Assembly adopted resolution WHA66.5, which requested the Director-General, inter alia, to report on progress in its implementation to the Sixty-seventh World Health Assembly.

2. The current population of the occupied Palestinian territory is 4 420 549 (2 719 112 in the West Bank and 1 701 437 in the Gaza Strip).¹ It is a predominantly youthful population: 40.1% of Palestinians are aged 0-14 years and 29.9% are aged 15-29 years. The proportion of the population living in urban areas increased from 62.5% in 1980² to 73.8% in mid-2012, while the proportion living in rural areas and refugee camps was 16.8% and 9.4% respectively.³

 In the fourth quarter of 2013 the unemployment rate was 18.2% in the West Bank and 38.5% in the Gaza Strip. For the Gaza Strip, this was the highest quarterly rate in the past three years.⁴ Palestinian exports have been in steady decline since 1994, dropping to 7% of gross domestic product in 2011, one of the lowest rates in the world. World Bank.⁵

3. Restrictions on the movement of people remain; these involve the blockade on the Gaza Strip, the presence of checkpoints and barriers within the West Bank, and the travel permit regime. Four of the 14 checkpoints around Jerusalem are accessible to non-Jerusalemite Palestinians with permits; the city has been separated from the rest of the West Bank by a barrier wall since 2006.⁶ In order to access health care, 14.3% of Jerusalem’s Palestinian population of 404 165 must cross the wall.⁷

4. The Palestinian Ministry of Health, UNRWA and nongovernmental organizations together provide extensive geographic coverage of public health and non-profit primary health care services, especially preventive health services and immunizations. However, the burden on households is high (39.8% of health expenditure comes from the general population) and two thirds of health expenditure concern curative care.⁸ The restrictions imposed on the movement of patients, health staff and goods have hindered the functioning and development of the health system. In recent years, the functioning of the Ministry of Health, the main health provider, has been seriously affected by the financial crisis of the Palestinian Authority. This has reduced the Ministry of Health’s ability to procure adequate stocks of essential drugs and medical disposables; the Ministry reported that for 2013, an average of 29% of essential drugs and 52% of disposables were out of stock in the Gaza Strip. Although referrals increased by 10% compared with 2012 — in part owing to shortages of medicines — the financial crisis has also lead to an increase in debts to specialized hospitals for the care of patients referred within and outside the occupied Palestinian territory.

5. The Ministry of Health operates four different levels of primary health care clinics according to population size and anticipated demand, but the distribution of both service components and human resources within the system remains inequitable. The current model is out-dated, providing services through a vertical, disease-focused approach, aimed predominantly at the main health challenges of the past, namely: communicable diseases and maternal and child mortality. The leading causes of death are cardiovascular disease, cancer, cerebrovascular disease and diabetes, reflecting the high prevalence of noncommunicable diseases and their risk factors. Data indicate that unhealthy behaviours start early in life.⁹

6. Infant and under-five mortality rates have declined over the last decade. In 2012, infant mortality was 19.2 per 1000 live births, compared with 23.9 per 1000 live births in 2002. The under-five mortality rate was 22.6 per 1000 in 2012, down from 28.5 per 1000 in 2002.¹⁰

7. The prevalence of disability in Palestine is 2.7% using a narrow definition, with about 113 000 persons reporting at least one disability; the rate is higher for males and higher in the West Bank. Some 53.1% of persons with disabilities are illiterate; more than one third of persons with disabilities over 15 years of age have never been enrolled in school; 22.2% dropped out of school because of access difficulties; and 87.3% are not employed.¹¹

KEY AREAS OF WHO SUPPORT TO THE PALESTINIAN MINISTRY OF HEALTH

8. WHO and the Palestinian Ministry of Health have engaged in a continuing dialogue on modernizing the primary health care system based on a family practice model. In September and October 2013 in collaboration with the Ministry of Health, WHO conducted a comprehensive situation analysis of the current primary care system as a foundation for the necessary transformation.

9. Noncommunicable diseases constitute a key public health concern in the occupied Palestinian territory. WHO supported the Ministry of Health in implementing the WHO package of essential noncommunicable disease interventions for primary health care. The interventions aim at improving access to good-quality, evidence-based noncommunicable disease care in a close-to-client environment. Between January 2013 and 2014, the package was successfully introduced in three pilot districts. The Ministry of Health and WHO are currently working on expanding the implementation of the package of interventions to all districts.

10. In 2013, WHO continued to work closely with the Ministry of Health focal point for tobacco control, focusing on raising public awareness of the dangers of tobacco use. With technical guidance from WHO, the Ministry of Health conducted a mass media campaign on the theme “It is my right to live in a smoke-free world”. WHO also supported the Ministry of Health and the Ministry of Education to reach over 12,000 secondary school students through an online competition aimed at improving their knowledge of tobacco-related health and social issues.

11. WHO, with the support of the Norwegian Government, maintained its support to the establishment of a Palestinian National Institute of Public Health. During 2013, the project team pursued the implementation of several recommendations of the qualitative assessment of the Cause of Death Registry; began a detailed description of the Cancer Registry; developed a draft report of the systematic review of water quality and health in the Gaza Strip; created the Hospital Management Dashboard and presented it to hospital directors in the West Bank and Gaza Strip for their use; finalized and printed the National Health Information System Strategy and the Health Information System assessment report; and began activities to establish a national Road Traffic Accidents Registry.

12. WHO is currently implementing a three-year mental health and psychosocial support project. The project represents the second phase of a European Union-funded initiative to strengthen mental health care in the occupied Palestinian territory. Over the past decade, WHO has supported the Palestinian Ministry of Health in reforming mental health services, with a move from institutionalized care in psychiatric hospitals towards community-based care and rehabilitation. In 2013, WHO supported the Ministry of Health in drafting a human resource plan for mental health professionals and an operational policy for community mental health centres. Mental health professionals were trained on cognitive behavioural therapy and child and adolescent mental health. Mental health has been fully integrated into primary health care in two districts in the Gaza Strip. As part of this effort, friends and family associations provided the general population and health professionals with a range of community-level education and advocacy activities on the rights of service users.

13. In support of activities against HIV/AIDS and with funding provided by the Global Fund to Fight AIDS, Tuberculosis and Malaria, WHO continues to act as technical adviser to the United Nations thematic group for tuberculosis and HIV/AIDS in the West Bank and Gaza Strip. With regard to HIV/AIDS, WHO conducted the first bio-behavioural survey among injecting drug users in the West Bank in 2013. The aim of the survey was to understand the epidemiological pattern of HIV/AIDS in this low-prevalence setting, following a similar survey conducted in 2010 in Jerusalem, which has a different social context. WHO further provided a range of capacity-building support for voluntary counselling and testing, antiretroviral therapy and adherence to treatment. The Ministry of Health has integrated HIV/AIDS treatment into primary health care services in the Ramallah and Gaza Strip governorates and has added dental services to its Ramallah special clinic. A technical mission by an external international expert monitored patients clinically to ensure that WHO standards of treatment and care continue to be used. An inventory study on tuberculosis was also conducted in the West Bank and Gaza Strip. The aim of the study was to determine the extent of: (a) tuberculosis case notification by the national tuberculosis programme; (b) tuberculosis case ascertainment in the country; and (c) tuberculosis under-detection through underreporting and under-diagnosis. In addition, a screening survey was undertaken of the Bedouin population in the West Bank.

14. With support from the European Union, WHO is working to improve the quality of hospital services at the six specialized medical referral facilities in east Jerusalem which comprise the East Jerusalem Hospitals Network. WHO is collaborating with the hospitals to build local capacity in the areas of quality management, risk management, facility safety and infection prevention. The objective is to ensure that standards at all the hospitals are ultimately ratified by the Joint Commission International, the international body for hospital quality accreditation. In 2013, the first two hospitals were accredited by the Commission. WHO supported the Network to develop a sustainable five-year strategy with a work plan. Network committees were established to facilitate coordination and collaboration, as well as joint activities. Since December 2013 the Network has been registered as an official body, which will enable it to appoint staff, conduct joint initiatives, and begin fundraising.

15. WHO is working with the Palestinian Ministry of Health to improve the Ministry’s service delivery system. A focal point for quality improvement and patient safety has been appointed at each of the district hospitals and in the primary health care department. A national team was trained in Jordan on the Patient Safety Friendly Hospital Initiative. This national team will work in collaboration with the national patient safety focal point to train government and nongovernment hospital staff on the Initiative, conduct initial assessments and ensure regular follow-up on implementation with participating facilities. To date, three hospitals (two governmental and one nongovernmental) have begun implementing the Patient Safety Friendly Hospital Initiative. In 2014, it is anticipated that all government hospitals in the West Bank, one government hospital in the Gaza Strip, and one non-government hospital in the West Bank will begin implementation.

16. WHO continues to support the Ministry of Health to develop its institutional capacity as well as the national health system. WHO supported the Ministry’s policy and planning department to lead the national health planning process and develop the 2014-2016 national health strategy. WHO is also working with this team to institutionalize a monitoring and evaluation mechanism to ensure accountability among all stakeholders in the health sector, particularly the Ministry of Health and the donor community. In order to improve human resource planning and policy development, WHO is supporting the Ministry of Health in the development of a Human Resources Observatory. In late 2013, a Palestinian delegation conducted a study tour to observe the implementation of the human resources observatory at the Ministry of Health in Khartoum. To support national health financing improvements, WHO collaborated with the Ministry of Health to complete the WHO’s health financing assessment tool.

17. With funding from the Government of Switzerland, WHO is working in the area of health advocacy in order to: improve data quality regarding human rights indicators and social determinants of health; monitor critical humanitarian issues affecting the public health sector; and provide advocacy with, and to, legal duty-bearers under international humanitarian and human rights law. Barriers to patient access from the West Bank and the Gaza Strip to the east Jerusalem hospitals, which serve as the main referral centres for tertiary care, are a major issue, as are barriers to the access of ambulances, hospital employees, and medical and health students from the West Bank. In 2013, 38 083 patients from the West Bank and the Gaza Strip were referred by the Palestinian Ministry of Health to hospitals in east Jerusalem, Egypt, Israel and Jordan. In the same year, 20.5% of requests for travel permits to access medical treatment made on behalf of West Bank patients, and 12.0% of requests on behalf of Gaza Strip patients, were denied or not answered.¹² For the Gaza Strip, this rate represents a 60% increase compared with 2012. WHO also undertook advocacy to the Ministry of Health and the humanitarian community concerning shortages of essential drugs, disposables and fuel in the Gaza Strip¹³ and to the Government of Israel for access to health services on the part of Palestinian prisoners.

18. Under the United Nations Partnership to Promote the Rights of Persons with Disabilities, WHO began to work jointly with five other United Nations agencies on mainstreaming disability rights in the agencies concerned and in their counterpart line ministries, including the Ministry of Health. The project was launched in January 2014, supported by the United Nations Humanitarian Coordinator for the occupied Palestinian territory.

19. WHO continues to lead the Health and Nutrition Sector, which it co-chairs with the Ministry of Health. The Sector provides a platform for joint coordination and partnership that aims at strengthening the collective capacity to respond efficiently to humanitarian health needs. The Ministry of Health and 30 humanitarian health organizations from United Nations agencies, nongovernmental organizations, and the private and public sectors are participating in the activities of the Sector. The partners provide essential primary health care and nutrition services to vulnerable communities with restricted access. WHO conducts monthly meetings with partners to discuss humanitarian health updates and to identify gaps and needs in support of better coordinated responses.

20. Together with the Ministry of Health and partners in the Health and Nutrition Sector, WHO developed the Humanitarian Needs Overview for 2014. The Overview provides an analysis of the humanitarian health situation and highlights priority needs, vulnerable communities and groups, and obstacles and difficulties in accessing essential health services in the following areas: the Gaza Strip, east Jerusalem peripheries, Area C in the West Bank, closed military areas, and the “seam zone”. Based on this, the Health and Nutrition Sector was able to develop its Strategic Response Plan for 2014, the main objectives of which are: to ensure the access by vulnerable communities to good-quality and affordable essential health services, and the referral of victims of violence to protection organizations and advocacy; and to ensure that vulnerable communities are better prepared to cope with the impact of current and potential man-made and natural disasters.

21. In 2013, as lead agency for the Health and Nutrition Sector and provider of last resort, WHO continued to support the reduction of shortages in life-saving drugs and medical disposables. Furthermore, WHO assisted in filling some of the gaps in the supply of pharmaceuticals and continued to help to coordinate the importing of medical supplies donated to the Gaza Strip. The Organization also provided urgently needed technical assistance, medical equipment and spare parts to maintain, repair and improve existing equipment, especially generators and medical equipment damaged as a result of the unstable power supply and the frequent blackouts caused by fuel shortages.

SITUATION IN THE OCCUPIED SYRIAN GOLAN

22. WHO has no access to the occupied Syrian Golan and thus cannot provide a report on the prevailing health conditions there. The Secretariat has requested the Governments of the Syrian Arab Republic and Israel to provide information in this regard.

ACTION BY THE HEALTH ASSEMBLY

23. The Health Assembly is invited to note the report.

III. UN SPECIAL COORDINATOR CONFIRMS CONTINUED SUPPORT FOR PALESTINIAN UNITY

On 24 April 2014, the Office of the United Nations Special Coordinator for the Middle East Peace Process, Robert Serry, issued the following statement regarding his meeting with Palestinian President Mahmoud Abbas in Ramallah:

During a meeting today with President Abbas, the Special Coordinator discussed recent developments, including the intra-Palestinian agreement on unity, and was assured that this agreement will be implemented under the leadership of the President and on the basis of the PLO commitments. President Abbas emphasized that these commitments include recognition of Israel, non-violence, and adherence to previous agreements. President Abbas also reiterated his continued commitment to peace negotiations and to non-violent popular protests.

The Special Coordinator confirmed the United Nations continued support for unity on this basis as the only way to reunite the West Bank and Gaza under one legitimate Palestinian Authority, welcoming this process which includes long-overdue Palestinian elections.

The Special Coordinator also underlined the importance for the parties, at this critical juncture, to refrain from measures that run counter to creating an environment for continued meaningful negotiations.

IV. PALESTINIAN RIGHTS COMMITTEE CONVENES ROUNDTABLE ON LEGAL ASPECTS OF QUESTION OF PALESTINE

On 24 and 25 April 2014, the Committee on the Exercise of the Inalienable Rights of the Palestinian People held a United Nations Roundtable on Legal Aspects of the Question of Palestine at the United Nations Office at Geneva. The following is the message of United Nations Secretary-General Ban Ki-moon to the event, delivered by the Acting Director-General of the United Nations Office at Geneva, Michael Møller (SG/SM/15791-GA/PAL/1292):

I am pleased to send greetings to all the participants in this Round Table on the Question of Palestine. I thank the Committee on the Exercise of the Inalienable Rights of the Palestinian People for organizing this discussion.

The round of peace negotiations being led by the United States offers an opening to advance the two-State solution to the Israeli-Palestinian conflict. Most importantly, the Israeli and Palestinian leadership committed themselves to nine months of focused talks on all core permanent status issues.

However, given the complexity of the issues, nine months have proved to be insufficient to complete the task. I urge the parties to continue the talks on a substantive basis beyond 29 April. The costs of walking away from the negotiating table would be exponentially higher than the pain of the compromises required to resolve the conflict. No lasting peace can be achieved away from the negotiating table, and the current situation is not sustainable for both parties, the region and the international community.

The establishment of an independent State of Palestine based on the borders of 1967, alongside a secure State of Israel, is long overdue. The suffering of millions of Palestinians under occupation has lasted far too long. I remain deeply troubled by Israel’s continuing settlement activity in the West Bank and East Jerusalem, which is illegal under international law. Settlement activity is deepening the Palestinian people’s mistrust in the seriousness of the Israeli side about achieving peace; it also risks rendering a two-State solution impossible. The peace efforts are also being hindered by violence and incitement from all sides. I am concerned over the rising tension with respect to the Temple Mount/Haram Al-Sharif in Jerusalem, and call on all parties to show utmost restraint as well as full respect for the sanctity of holy sites of all faiths.

The deteriorating condition of Gaza’s civilian population remains a source of alarm, as the seven-year-old closure continues to cause serious humanitarian consequences. More than 80 per cent of all families in Gaza are dependent on aid, yet Gaza remains subject to severe restrictions on imports, exports and the movement of people by land, air and sea.

I call for a complete opening of crossings into Gaza, including Rafah, to allow legitimate trade and movements of people. At the same time, Israel’s legitimate security concerns must be addressed by continuing to thwart militant attacks and preventing the smuggling of weapons.

I also reiterate my condemnation of indiscriminate rocket attacks from Gaza, which contravene international law. Israelis have a right to live free of cross-border violence.

I welcome the desire of the organizers of this conference to highlight some of the legal aspects of the Palestinian question. I have repeatedly expressed concern for the more than 4,000 Palestinian prisoners held by Israel, and have also called for ending the practice of prolonged administrative detention. I have also called on Israel to abide by its legal obligations as expressed in the advisory opinion of the International Court of Justice on the wall and the settlements.

I will continue to do my utmost to support the realization of a two-State solution. I am pleased to continue to be assisted in this endeavour by Mr. Robert Serry, the United Nations Special Coordinator for the Middle East Peace Process. We urge the international community to support both sides in continuing their negotiations with the aim of reaching a final peace settlement. I wish you success in your deliberations.

V. UN SPECIAL COORDINATOR BRIEFS SECURITY COUNCIL ON SITUATION
IN MIDDLE EAST, INCLUDING PALESTINIAN QUESTION

On 29 April 2014, United Nations Special Coordinator for the Middle East Peace Process Robert Serry briefed the Security Council on “The situation in the Middle East, including the Palestinian question”. The following are excerpts from the briefing (S/PV.7178):

…

We meet today, nine months to date since the launch of United States-brokered negotiations between Israelis and Palestinians with the previously agreed objective of achieving a comprehensive settlement on all core issues by this time. In those nine months, we have seen an unprecedented effort by Secretary of State Kerry, assisted by Mr. Martin Indyk as his envoy, to see the process through at long last. Quartet, regional and international stakeholders, recognizing it as perhaps one of the last chances to achieve a two-State solution, have also been actively engaged in support of the effort.

Yet efforts have faltered, given the inability of the parties to bridge the gaps on their substantive positions or even accept with reservations a United States framework that would attempt to do just that. As of today, we know talks have been suspended. It behooves the parties and all stakeholders to recognize that this is another moment of truth. Inaction could see the situation turn into a crisis. That is why joint reflection is in order on how the current impasse came about and ways to overcome it.

On 28 March, the Israeli Cabinet postponed its decision to follow through with the release of the fourth and last tranche of 30 pre-Oslo prisoners. On 1 April, interpreting that as a breach of the quiet understanding of a diplomatic truce in return for the release of 104 pre-Oslo prisoners, the Palestinians, by a unanimous vote of the Palestinian Liberation Organization (PLO), proceeded with submitting accession instruments to 15 international treaties and conventions. The announcements of 708 reissued tenders for settlement units in Gilo on the same day added to the Palestinian conviction that they had no other choice. Nevertheless, President Abbas reiterated his commitment to negotiations.

The Palestinian decision was met with surprise by the Israeli side, which has since indicated its understanding that they were nearing a deal to extend negotiations that comprised more than the aforementioned prisoners. In their interpretation, the original understanding was valid as long as there was progress within the talks.

Despite those events, the negotiators continued to meet in an effort to find a way out of the impasse. We understand that among the issues discussed as part of Palestinian demands have been the release of the fourth tranche of prisoners and a freeze of settlement construction, combined with an offer of continued talks if the issue of borders is front-loaded. The international community also remained active, urging both parties to remain constructively engaged in talks and not miss the opening presented by the United States. The Secretary- General was in contact with both leaders on 13 and 14 April, and High Representative Ashton issued a statement to that effect on 18 April. In an emergency meeting on 9 April, Arab Foreign Ministers remained appreciative of United States efforts and declared their support for President Abbas, including by renewed pledges of a safety net in the event of a loss of revenue as a result of Israeli potential reprisals. Such support is timely and welcome, while we urge Israel to adhere to the punctual and transparent transfer of revenues it collects on behalf of the Palestinian Authority, which is essential for the stability of the Authority.

In subsequent developments, Palestinians reached a unity agreement on 23 April, stipulating, inter alia, that a national consensus Government would be formed within five weeks and elections held no later than six months after the formation of that Government. Following the announcement of that accord, Israel cancelled a meeting scheduled between the Israeli and Palestinian negotiators and, after an emergency Cabinet meeting on 24 April, took the decision to suspend the talks. Quartet envoys remained in frequent contact throughout, holding several telephone calls to discuss the developments.

The political stalemate that I have been describing poses great risks to the prospect of a two-State solution, which I will elaborate on later. It will also not be without impact on the situation on the ground, which I will briefly address, as it is already volatile, with negative trends in the West Bank and a fragile calm in Gaza. The year 2013 saw the highest number of Palestinian fatalities in the West Bank since 2009. I was appalled by incidents of violence in the reporting period, against both Palestinians and Israelis, which we condemn. Two particularly disturbing instances were the killing of an Israeli man and the injury of two others, including a child, in an attack near Hebron on 14 April, during Passover, and the shooting by the Israel Defense Forces (IDF) of a 14-year-old Palestinian boy crossing the Barrier on 19 March, which resulted in his death.

The rise in violence in the West Bank was reflected by the following trends, inter alia: increased clashes between Israeli security forces and Palestinians, particularly in and around refugee camps; Palestinian stone- and Molotov cocktail-throwing, resulting in some injuries and material damage; and settler attacks against Palestinians and their property, in spite of some Israeli efforts to crack down on so-called price tag attacks, which have also targeted Israeli security forces. We should be under no illusion that the level of violence would be higher still were it not for the work of the Palestinian security forces to maintain law and order, and continued security coordination.

Settlement activity continued. In two worrisome developments on 13 April, the Government of Israel retroactively approved legalizing a West Bank outpost at Gush Etzion, appropriating private Palestinian land, and granted settler access to a disputed Hebron building that Palestinians have over the years argued in court was purchased illegally. The United Nations position on the illegality of settlements is well known. The reporting period saw 88 demolitions of Palestinian structures, including five residences and a mosque today, and the dismantling of five settlement outposts by the IDF.

The situation in East Jerusalem remains worrisome. Tensions and clashes in the Old City have continued, including during the holiday period. The Secretary-General has reiterated the importance of respect for the religious freedom of all, for worshippers of all faiths to have access to their holy sites and for all sides to refrain from provocations. He has restated the United Nations long-standing position that the status of the Old City and the religious sites within is an extremely sensitive final-status issue that can be resolved only through negotiations, and that the parties should refrain from attempts to establish facts on the ground and alter the character of the Old City.

All of that points to the fact that the situation on the ground is serious and likely to further deteriorate if not addressed. We must not forget Gaza, where practical steps are urgently needed to improve the humanitarian security situation. In Gaza, too, there are troubling signs, with more rockets fired at Israel, border incidents and Israeli operations, which have also caused death or injury to civilians in recent months. Ongoing political and security developments in Egypt have also led to the continued closure of tunnels, the tackling illegal smuggling and the frequent closure of Rafah.

The United Nations remains actively engaged, together with the Palestinian Authority and donors, in addressing some of the most pressing issues in Gaza, including by ensuring that a safety net is in place to allow the most critical water, sanitation and health-related facilities to continue operating. In that regard, I am pleased to report that the Government of Turkey recently pledged $1.5 million to the World Health Organization to address the shortages in a number of key drugs, which we hope will help decrease expensive referrals of patients outside Gaza. We are still waiting for Israel to deliver on its commitment to the full resumption of the previously agreed package of United Nations construction works, where some $26 million worth of projects are still stalled and another $120 million worth of new work is pending Israeli approval.

Political progress is crucial to address Gaza’s structural problems. In that context, I had an opportunity on 24 April to discuss with President Abbas the very important development towards Palestinian unity. I was assured by the President that the agreement would be implemented under his leadership and on the basis of the PLO commitments. President Abbas emphasized that those commitments would hold the future Government of national consensus to recognition of Israel, non-violence and adherence to previous agreements. President Abbas also reiterated his continued commitment to peace negotiations and to keeping protests non-violent, a message he also delivered to the PLO Central Council on 26 April.

On the basis of those commitments, the Secretary-General is of the view that this development can constitute an opening that offers at long last the prospect of reuniting the West Bank and Gaza under one legitimate Palestinian Authority, including by holding long overdue elections. For this to have a chance of success, it needs to be managed the right way. The Secretary-General calls on all parties to cooperate to that end. We now expect all factions to support that process as described by President Abbas, meaning that they must commit in deeds, not only words, to that path — first and foremost by adhering to non-violence in the West Bank and in Gaza.

We are also aware that Israel, facing a continued rocket threat from Gaza, has reacted with acute skepticism to this development, as manifested in its decision to suspend talks and threats of reprisals.

We urge all parties to refrain from measures that could turn a delicate situation into a full-blown crisis. We will be following developments closely in the period ahead, and continue to believe that if unity is implemented on the terms described by President Abbas, it is not contradictory with continued peaceful negotiations, as the President himself has reiterated. As such, it should be viewed as an opportunity, not a threat.

Difficult choices are now required of the parties. They should realize that not making a choice is the most detrimental choice of all, namely, to accept that we are going down the path of a one-State reality on the ground. This is a time for the parties to reflect on whether they wish to live up to their stated commitment to the two-State solution, or whether they will by default let it slip further away.

First and foremost, they must refrain from steps that will render futile any efforts to find a way back to negotiations and salvage the two-State solution. Both sides have to convince each other anew that they are partners for peace. If Israel is serious about a two-State solution, it must recognize the negative impact of continued illegal settlement activity. Palestinians in turn should be reflective of their actions in international forums. The international community and the region should also reassess its role, if we remain convinced — as I do — of the importance of the two-State solution, and ask what we can do to persuade the parties to make the right choice.

It is important to avoid escalation, diplomatically and on the ground. Yet it is equally important that we work in concert to define a long-overdue political horizon on the basis of principles already laid out, less the Oslo paradigm is put in real jeopardy. This can no longer be business as usual. Unrealistic and prescriptive timelines may be counter-productive, as can rushing the parties back to the table without having the necessary framework in place. I believe we must use the current moment of reflection for a discussion on a substantive basis for an early resumption of talks, while building on the United States effort of the past nine months and relying on continued United States engagement.

The Secretary-General firmly believes there is still a window for us, the international community and parties, to act if we wish to realize the vision of two States for two peoples, Israel and Palestine, living side by side in peace, security and mutual recognition of each other’s legitimate rights and those of their respective citizens, including self-determination. The United Nations remains as fundamentally committed as ever in helping parties bring this conflict to an end with an end to the occupation that began in 1967, an end to the conflict and an end of claims, in pursuit of lasting peace and security for both Israelis and Palestinians.

End Notes
¹Palestinian Central Bureau of Statistics (http://www.pcbs.gov.ps/site/881/default.aspx#Population, accessed 17 March 2014) and Palestinian Ministry of Health, Health report, Palestine mid year 2013 (http://www.moh.ps/attach/ 546.pdf, accessed 17 March 2014).
²World urbanization prospects, the 2011 revision (http://esa.un.org/unup/unup/index_panell.html, accessed 18 March 2014).
³Palestinian Central Bureau of Statistics (http://www.pcbs.gov.ps/Portals/_pcbs/PressRelease/int_Pop_2012e.pdf, accessed 18 March 2014).
⁴Palestinian Central Bureau of Statistics (http://www.pcbs.gov.ps/portals/_pcbs/PressRelease/Press_En_ LFSQ42013E.pdf, accessed 18 March 2014).
⁵World Bank. Fiscal challenges and long term economic costs. Economic Monitoring Report to the Ad Hoc Liaison Committee (http://siteresources.worldbank.org/INTWESTBANKGAZA/Resources/AHLCMarchfinal.pdf, accessed 18 March 2014).
⁶Factsheet issued by the United Nations Office for the Coordination of Humanitarian Affairs (http://www.ochaopt. org/documents/ocha_opt_Jerusalem_FactSheet_December_2012_english.pdf, updated in February 2014, accessed 18 March 2014).

⁷http://www.pcbs.gov.ps/Portals/PCBS/Downloads/book2020.pdf.
⁸Palestinian Central Bureau of Statistics (http://www.pcbs.gov.ps/Portals/_PCBS/Downloads/book2032.pdf, accessed 18 March 2014).
⁹Global school-based student health survey (http://www.who.int/chp/gshs/2010_GSHS_FS_Gaza_and_ West_Bank.pdf, accessed 18 March 2014).
¹⁰The United Nations Inter-agency Group for Child Mortality Estimation. CME Info database (http://www.childmortality.org/, accessed 18 March 2014).
¹¹Palestinian Central Bureau of Statistics (http://www.pcbs.gov.ps/portals/_pcbs/PressRelease/Press_ En_Disability2012E.pdf and http://www.pcbs.gov.ps/site/512/default.aspx?tablD=512&lang=en&ItemID= 969&mid=3171&wversion=Staging, accessed 18 March 2014).
¹²Right to health: barriers to health access in the occupied Palestinian territory, 2013. Geneva: World Health Organization; 2014 (in press). http://www.emro.who.int/countries/pse/.
¹³http://www.emro.who.int/pse/palestine-news/who-expresses-concern-over-the-gaza-humanitarian-health-crisis.html.