New England Journal of Medicine
March 21, 2013  Vol. 368 No. 13
http://www.nejm.org/toc/nejm/medical-journal

Perspective
Ensuring Public Health Neutrality
Les F. Roberts, Ph.D., M.P.H., and Michael J. VanRooyen, M.D., M.P.H.
N Engl J Med 2013; 368:1073-1075March 21, 2013DOI: 10.1056/NEJMp1300197
http://www.nejm.org/doi/full/10.1056/NEJMp1300197

In June 1968, a clearly marked Swedish Red Cross plane flying relief supplies into the breakaway state of Biafra was shot down by Nigerian fighters.1 Before the war was over, many relief planes would be shot down and far more would crash because the Nigerian government’s shoot-to-kill order forced them to fly at night. The brazen targeting of Red Cross relief flights on civilian humanitarian missions was hard to imagine. In the minds of some people, however, these attacks were justified by another clear violation of humanitarian neutrality: on at least one occasion, a plane painted with the Red Cross insignia was actually carrying weapons.2,3    That rare instance of military action masquerading as humanitarian relief completely undermined the neutrality of everyone who operated by the accepted rules of humanitarian assistance, cost the lives of both aid workers and aid recipients, and provided a blanket of impunity for the future criminal actions of the Nigerian government…