Saudi Coalition Blockade and Its Effect on the Importation of Medicines Into Yemen
Historical Background on Conflict
1. On 26 March 2015, a Coalition led by Saudi Arabia consisting of the United Arab Emirates, Qatar, Kuwait, Bahrain, Egypt, Jordan, andMorocco (together “the Coalition”) launched a war on the people of Yemen without a UN mandate. From the outset, this Coalition was supported politically, diplomatically, and militarily by the United States of America, the United Kingdom, France, and Turkey. Upon launching the war, the Saudi Coalition conducted airstrikes that killed and injured hundreds of civilians and leveled civilian infrastructure. After three weeks of airstrikes, the UN Security Council adopted Resolution 2216 on 14 April 2015, placing an arms embargo on 5 named individuals in Yemen.[ii]
2. After about two months of war without achieving its stated official objectives and after failing to convince Egypt[iii], Pakistan[iv] and Turkey[v] to provide ground troops, the Coalition sought out other ways to bolster its troops on the ground in preparation for a ground invasion. To achieve that end, the Coalition hired foreign troops and mercenaries. After months of stalemate, the number of countries participating in the Coalition increased to include Sudan[vi] and Senegal[vii], both sending large numbers of troops to Yemen. In addition to hiring Sudanese and Senegalese troops, the Coalition relied and continues to rely on the use of mercenaries to continue hostilities.
3. The Saudi Coalition imposed a comprehensive land, air and sea blockade on Yemen, under the cover of U.N. Security Council Resolution 2216, which involve an arms embargo, asset freeze and travel ban on five named individuals. The Saudi Coalition stopped ships at will, and over the course of the first 600 days of war delayed their entry for days, weeks or months at a time under the pretext of ongoing weapons searches, granting them entry at times only after a coerced bribe. Ships were also whimsically denied entry entirely.
4. In May 2016, former Secretary General Ban Ki-moon announced the U.N. Verification and Inspection Mechanism (UNVIM). The UNVIM is designed to facilitate the unimpeded flow of commercial goods and services to 3 Yemeni ports - Saleef, Mokha, Hodeidah and associated oil terminals - while ensuring compliance with the arms embargo imposed by the U.N. Security Council. In effect, the UNVIM addresses the Coalition’s blockade by establishing a U.N. mechanism for searching and inspecting incoming ships for weapons, making the process more efficient and thereby helping to alleviate the mass suffering caused by the blockade.
5. In his update to the U.N. Security Council on 31 October 2016, the Undersecretary General and Emergency Relief Coordinator Stephen O’brien stated that offloading cargo can take up to 30 days because of 1) inefficient port management, 2) financial disputes among shippers and above all 3) slow offloading due to limited capacity at Hodeida port which was severely damaged by airstrikes in August 2015. As a consequence, fuel imports have averaged a fifth of the pre-airstrikes levels since February 2016.[viii] In his most recent update to the U.N. Security Council on 26 January 2017, O’brien stated that “delays in receiving clearances are also due to restrictions imposed by the Saudi-led Coalition such as the hampering of vessels’ access to Yemeni Red Sea ports and the absence of clear lists of prohibited items.”[ix] Providing an example of the Coalition’s interference with incoming cargo ships, O’brien stated that “a vessel carrying four WFP-procured mobile cranes has arrived in the Red Sea, but has been ordered by Saudi authorities to leave Yemeni waters and is now anchored 15 miles off Yemen’s coast. The vessel is awaiting the Coalition’s approval to berth at the port. These cranes will boost the port’s capacity in handling humanitarian cargo. Two of the cranes will be used exclusively by the U.N. (WFP) and help expedite the timely delivery of vital humanitarian aid supplies.”[x] Unfortunately, even with U.N. involvement and mechanisms in place, the Coalition continues to have the final word on cargo attempting to enter Hodeida port, which is the lifeline of the population handling more than 80 percent of imports into Yemen before the war began.
Statement of Facts and Allegations
6. According to the 2017 Humanitarian Needs Overview, “the financial crisis faced by the Ministry of Public Health and Population (MOPHP) is likely to leave broad swathes of Yemen without health services, especially in remote areas not served by private-sector providers.” [xi] This financial crisis has been largely brought on by the Coalition’s comprehensive blockade on all commercial imports, reducing customs taxation and fees that provide revenue to the government which is then used towards covering public sector needs. This issue prompted the MOPHP in August 2016 to make an announcement that Ministry funding can no longer cover operational costs.
7. According to the Supreme Board for Drugs and Medical Appliances, 85% of the market for medicines is satisfied through importation by merchants. The following are issues listing the obstacles faced by merchants regarding the importation of medicines into Yemen:
a. The Coalition’s land, air, and sea blockade bans commercial flights to and from Sanaa International Airport and blocks ships from entering Hodeida Port. Ships are often diverted to Jeddah International Port or a port in Djibooti delaying entry by up to three months. In addition, members of the Coalition such as the United Arab Emirates, do not allow any medicine to be shipped from its ports to Hodeida Port. Furthermore, the flight ban to and from Sanaa International Airport for the past 6 months restricts the ability to import medicine via commercial flights, which is often times the only way to import medicines requiring refrigeration and timely transport.
b. Even when ships are allowed entry, they cannot dock and unload at Hodeida Port in a timely, efficient manner as a result of Coalition airstrikes that destroyed all cranes at Hodeida Port causing problems in offloading cargo and long delays that can take up to three months.
c. Merchants importing through Aden Port and transporting to northern governorates are facing higher transportation costs that have risen sharply due to the dangers and instability posed by the war.
d. In addition to increased transportation costs, the dangers and instability posed by the war have also increased insurance costs which make the importation of medicines less financially feasible for merchants as it increases the price to end consumers who cannot afford the price hikes with their ever diminishing disposable incomes.
e. The refusal of many shipping companies to ship to Yemen due to the security situation and pressure posed by the Coalition is also cited as an obstacle.
f. The concern of merchants that the delays due to Coalition inspections will cause their products to expire at ports in Djibooti and elsewhere makes them less keen to take on the risk.
g. The difficulty in transferring hard currency to banks outside of Yemen makes it difficult for Yemeni merchants to conduct transactions with foreign suppliers of medicinal products.
8. According to the Supreme Board for Drugs and Medical Appliances, 15% of the market for medicines is satisfied through local production. The following points are issues listing the obstacles faced by manufacturers regarding the local production of medicines in Yemen:
a. The inability of manufacturers to import the necessary components of the manufacturing process such as raw materials and packaging materials hinders local production.
b. Airstrikes causing damage to factories and in other cases complete destruction leading to an increase in absentees among employees fearing death and injury hinder local manufacture of medicines.
9. The following is a chart[xii] showing a 47% decrease in 2015 and a 20% decrease in 2016 as compared to pre-war medicine imports in 2014:
10. According to UNICEF’s Representative in Yemen, Julien Harneis, nearly 10,000 children under the age of five died from preventable diseases due to the collapse of the country’s health system[xiii], stating that those children would not have died if it were not for the war. He also stated that ten million children, or eighty percent (80%) of all of Yemen’s children, are in need of urgent humanitarian aid. About 460,000 children are suffering from severe acute malnutrition. Again this would not be the case but for this war.
11. Most recently on 18 December 2016, UN Humanitarian Coordinator for Yemen, Jamie McGoldrick, addressed the Yemeni press stating that “at least one child dies every 10 minutes from preventable diseases in Yemen.”[xiv] In other terms, 144 children die every day in Yemen from preventable diseases.
12. Allowing for commercial and humanitarian aid imports to resume and facilitating the unfettered distribution of necessary food, medical and fuel supplies to all locations in Yemen are essential to stemming further rapid increases in humanitarian needs of the Yemeni people. Since the outset of the war, the Coalition’s blockade on imports – as well as damage to port infrastructure due to airstrikes –added to the humanitarian burden by preventing commercial goods from entering. For example, when their own medical supplies ran out, like bandages and ointments to treat burned victims, hospitals were not able to procure them from the market as before they were once plentiful but now unavailable due to the blockade.
13. Taken together, the Coalition airstrikes on medical facilities and personnel in addition to the Coalition blockade on food, medicine and fuel are measures deliberately inflicted on the Yemeni people that create conditions of life calculated to bring about their physical destruction or subjugation let alone being a serious interference with their access to healthcare services.
14. An independent international investigation is in order in Yemen to assess and quantify the damages caused to the healthcare sector and the ensuing pain and suffering caused to millions of civilians, so that the people of Yemen are compensated fully and the perpetrators are held to account. Without a repercussion or consequence in place for violators, the right to health and the principle of medical impartiality will continue to be violated with impunity in an ever increasing manner.
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Citations
[i] All statements of allegations are based on field work and discussions with local and international NGOs, the various UN organs, the Yemeni Ministry of Public Health and Population, the Yemeni Supreme Board for Drugs and Medical Appliances, the Yemen Red Sea Ports Corporation and the Executive Director of ARWA. Media reports are only cited to show that the statements made herein have been reported by media outlets from various countries across the world.
[ii] Security Council Demands End to Yemen Violence, Adopting Resolution 2216 (2015), with Russian Federation Abstaining, 14 April 2015, http://www.un.org/press/en/2015/sc11859.doc.htm
[iii] Mohammed Aboud, Egypt allegedly sends ground forces into Yemen quagmire, The Middle East Eye, 9 August 2015. http://www.middleeasteye.net/news/egyptians-allegedly-sends-ground-forces-yemen-quagmire-132459953#sthash.qu9yz0EN.dpuf
[iv] Mohammad Mukashaf, Pakistan declines Saudi call for armed support in Yemen fight, Reuters, 10 April 2015. http://www.reuters.com/article/us-yemen-security-idUSKBN0N10LO20150410
[v] Blog, Turkish and Saudi leaders discuss Yemen conflict, The Middle East Eye, 27 March 2015. http://www.middleeasteye.net/news/live-blog-saudi-and-arab-allies-bomb-houthi-positions-yemen-1521000548
[vi] Sudan to send 10,000 troops to join Arab forces in Yemen: report, The Sudan Tribune, 19 October 2015. http://www.sudantribune.com/spip.php?article56779
[vii] Ishaan Tharoor, Why Senegal is sending troops to help Saudi Arabia in Yemen, The Washington Post, 5 May 2015. https://www.washingtonpost.com/news/worldviews/wp/2015/05/05/why-senegal-is-sending-troops-to-help-saudi-arabia-in-yemen/
[viii] Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Stephen O'Brien Statement to the Security Council on Yemen, 31 October 2016, http://reliefweb.int/report/yemen/under-secretary-general-humanitarian-affairs-and-emergency-relief-coordinator-10 [accessed 26 December 2016]
[ix] Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, Stephen O’Brien Statement to the Security Council on Yemen, New York, 26 January 2017, http://reliefweb.int/report/yemen/under-secretary-general-humanitarian-affairs-and-emergency-relief-coordinator-11 [accessed 30 January 2017]
[x] Ibid
[xi] 2017 Humanitarian Needs Overview, http://reliefweb.int/report/yemen/yemen-2017-humanitarian-needs-overview, [accessed 30 January 2017]
[xii] A table showing the development of medicine imports for the years 2014-2016. Yemeni Supreme Board for Drugs and Medical Appliances
[xiii] The Impact of Violence and Conflict on Yemen and its Children. 29 March 2016, https://www.unicef.org/media/files/Yemen_FINAL.PDF
[xiv] https://twitter.com/OCHAYemen/status/810476064099233793?lang=en