Interview with Michaël Neuman and Fabrice Weissman, research directors at Crash.

On Wednesday 28 September, MSF is invited to attend a UN Security Council briefing on resolution 2286, adopted in May 2016, which strongly condemns attacks against medical facilities and personnel in conflict situations. What is the background to this invitation?

Fabrice Weissman (FW) : MSF has already been invited to speak alongside the ICRC at the Security Council in May 2016. This meeting concluded with the vote on a resolution reaffirming Security Council members' wish to demand that all parties in an armed conflict guarantee the respect and protection of medical staff and humanitarian workers, and that they provide access for medical staff to people in need of help.

The invitation came in the wake of a series of bombings that struck Médecins Sans Frontières and other medical organisations: the bombing of the MSF hospital in Kunduz, Afghanistan, on 3 October 2015 by the American army, systematic bombing of Syrian hospitals, including a hospital supported by MSF in Maarat al-Nu'man in Idlib province on 15 February 2016 by the Syrian government and its allies, and the bombing in Yemen that hit four establishments supported by MSF.

Following on from adoption of resolution 2286, the UN Secretary General has asked his advisors to draft a paper detailing a series of measures to protect the medical mission in conflicts. The Secretary General's recommendations are to reinforce the international and national legislative arsenal protecting medical missions, reinforce mechanisms for investigating and sanctioning violations of the regulatory arsenal, and invite member states to bring their political influence to bear to ensure the law is respected. On 28 September, MSF is being asked to express an opinion on these different measures to the Security Council.

Do you feel that MSF should give a verdict on the recommended measures, as requested by the UN Secretary General?

FW: It is problematic on several levels. I don't think we need to attend the Security Council, as we did last May and are preparing to do again, to express our opinion on the bombing of our medical establishments. This situation gives the impression that MSF wants to sit down with those in power to share in the management of world affairs, in this case, jointly produce norms for international humanitarian law.

As I see it, it is not MSF's role to take part in defining the rules of war, defining how to \"kill correctly\" (a necro-ethics, to use Grégoire Chamayou's expression). I am uncomfortable with seeing MSF so eager to collaborate with armies in drawing up their rules of engagement, that it to say their procedures for opening fire, such as those that define the conditions under which a hospital loses its status as a protected establishment under international humanitarian law and so can be attacked.

What is more, we do not need new legal norms or mechanisms to condemn attacks against hospitals. The Security Council's invitation looks more like a diversionary tactic that makes it possible to avoid addressing the urgent need to condemn the states responsible for attacks currently underway, including members of the Security Council - and the diplomatic difficulties involved. We are fixated on ways to reform the rules of war with the idea that plugging gaps in the law will ultimately prevent attacks, which at the same time exempts states from condemning those currently responsible for them - I am thinking here in particular of the Syrian government and its Russian allies, the American government and its Afghan allies, and the international coalition headed by Saudi Arabia in Yemen.

I feel that naming and shaming, in other words, the swift denunciation of those responsible for the attacks affecting us, is the only deterrent we have at our disposal. But experience shows that most aid actors, including MSF, hesitate to criticise those responsible and are more inclined to campaign for the adoption of global measures, and to engage in low-key bilateral negotiations with armies, with highly questionable effectiveness in the absence of public pressure.

Michaël Neuman (MN) : The current episode of violence in the Aleppo area, in the form of exceptionally intense bombings, as well as the manoeuvring to limit the scope of humanitarian aid clearly illustrate the limitations of the exercise that consists of drawing up the rules of war in the diplomatic arena.

In my view, it is not unthinkable for MSF to consider deliberating on legal norms. The problem lies more in the dead-end that the exclusive nature of this approach is leading us into, if it is not combined with a public denunciation of those responsible for the attacks. If we contribute to these measures in some way, we also need to know how to seize opportunities to identify and denounce specific responsibilities.

On 19 September, a UN humanitarian aid convoy was bombed to the west of Aleppo, killing around twenty people.

FW: The attacks against hospitals in Syria have to be put into context: they are part of a policy of all-out war, a campaign of terror that targets medical establishments as well as public spaces and medical and non-medical humanitarian aid convoys, as shown by the bombing on 19 September.

The response of aid actors to this event illustrates the sector's reluctance to denounce those behind the bombings. The International Committee of the Red Cross, speaking through its Director-General Yves Daccord, has deplored the risks that go with the profession. As for the UN, it has described the attack as inexplicable. Stephen O'Brien, Under-Secretary-General for Humanitarian Affairs, Office for the Coordination of Humanitarian Affairs and Emergency Relief Coordinator, refused to even use the word of \"aerial attack\".

It is important to counter such reactions with a political interpretation of events, and to denounce the direct responsibility of the Syrian and Russian governments, engaged as they are in a campaign of terror directed against sectors of the population they judge to be hostile, a policy that includes denial of healthcare and assistance.

The bombing took place at the end of a seven-day ceasefire in Syria negotiated by the USA and Russia. The ceasefire agreement between Washington and Moscow included delivery of humanitarian aid to areas under siege.

MN: Emergency convoys, like those heading for Aleppo, can in no way mask the policy of all-out war that reigns in Syria - and the destruction of hospitals is just one aspect of this policy - and the inadequacy of assistance. During the ceasefire, the USA, Russia and the Syrian regime sought to train the spotlight on this emergency humanitarian aid. But convoys have a very limited impact and are insufficient to meet the needs of the Syrian people.

Delivering aid to Syrians is hugely dependent on the Syrian government's goodwill. On the one hand, most international aid actors that try to deploy humanitarian aid outside areas controlled by the government operate cross-line missions out of Damascus, including in partnership with the Syrian Arab Red Crescent whose deployments depend very much on the whim of the Syrian authorities.

On the other hand, although cross-border convoys have increased since the Security Council's 2014 adoption of resolution 2165 - which authorises aid delivery from neighbouring countries - they still have to get authorisation from Damascus to travel. The Syrian regime has a very wide-reaching grip on the aid system in the country, both for cross-line and cross-border operations.

Lastly, transporting aid to areas under siege where 590,000 Syrians currently live is still extremely difficult and raises the question of the role played by humanitarian organisations in the regime's siege strategies and evacuation operations. On 26 August 2016, the town of Daraya, close to Damascus, was evacuated after a siege of almost four years during which the Syrian regime authorised only one aid convoy to enter the town. The Damascus government's regulation of the flow of humanitarian aid is part of its siege strategy. Withholding aid in certain areas combined with the psychological war waged by the regime and indiscriminate bombing are characteristics of the conflict.

Between late August and early September, the Guardian published a series of investigations analysing UN contributions to the Syrian regime's war effort and the extremely tight restrictions imposed by the regime on deploying aid. Among other items, the newspaper described the contracts awarded to Bashar Al Assad's government and organisations linked to the president's family. In the wake of the articles, over 70 organisations suspended their collaboration with the UN in Syria, fearing manipulation of aid by the Syrian regime and requesting an immediate investigation into UN operations in the country.

MN: The cost to humanitarian actors, particularly the UN, of organising and delivering aid in Syria is very high. According to the Guardian, this cost is mainly linked to establishing partnerships with aid organisations very close to the Damascus government. These partnerships involve large sums of money changing hands, draining funds from humanitarian aid initially planned for the Syrian people.

On the other hand, aid convoys sent out from Damascus are massively taxed, particularly when they are headed for opposition areas. Not only are authorisations few and far between, but on top of it the Syrian authorities retain the right to take away everything they feel is problematic. This can range from obstetric kits to bandages, medicines, and kits for treating burns, among other items.

In terms of the UN goals, the aid actually provided to the Syrian people is very limited and totally inadequate to meet people's needs, particularly in opposition areas. This has been a constant feature of the war in Syria, right from the start. In early 2013, MSF drew attention to the imbalance between aid for Syrian people living inside the opposition areas and aid targeting people living in areas controlled by the Damascus government. At that point we called for deployment of cross-border aid in the hope that it would help to reduce this imbalance.

Do you think that the effectiveness and impartiality of aid are compromised in government areas?

MN: It is not a question of condemning outright all interventions in government areas. However, it is important to stress that organisations only have a very limited capacity to control the aid operations they are setting up. An intervention of this kind raises a number of questions relating to, among other factors, safety and perception, especially if we are working both with opposition groups and the Syrian government.

The way MSF works is rooted in an autonomous assessment of needs, its ability to talk to local people and to monitor and evaluate its programmes. Although projects organised in opposition areas already face major limitations - especially since they include extensive donation programmes that can inevitably only be partially monitored - these conditions are even less present in government areas: they have never yet allowed MSF to implement aid programmes in these areas.