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Based on MCAI’s 27-year experience of working on the ground in armed conflicts (Bosnia, Kosovo, Pakistan, Afghanistan, and Sri Lanka) and observing its terrible effects on women, babies, and children, we are calling for a revolution to the supposed “protective” systems currently available within the UN Security Council and/ or UN General Assembly. We propose that the UN Security Council and / or UN General Assembly immediately engage, with UN support, neutral countries that would not likely be perceived as a threat to Russia, to provide on the ground and in the air protective military action for Ukraine.

Action  1.

The most effective and immediate solution to prevent further war crimes and massacres occurring in Ukraine is for the UN Security Council to reform the role of permanent members and to remove The Russian Federation from sitting in on future debates on the management of the current conflict in Ukraine, thereby preventing its veto on military peace keeping actions.

However, even without a Russian presence, it is still possible that other permanent members of the Security Council might not support UN peace keeping and UN military protection in Ukraine and therefore the whole structure of the Security Council needs reform. This reform could and should have happened in the past, based on Russian’s aggression in other countries and its vetos on other situations involving armed conflict.

Action 2.

Another possible and potentially immediately effective solution to protecting civilians and humanitarian aid within Ukraine could be a new Emergency Special Session (ESS) and Resolution 377A(V) to be urgently debated, and, hopefully, approved, on the establishment and deployment of a UN General Assembly supported military protection force. A carefully constructed no-fly zone over civilian infrastructure and humanitarian corridors could also be created as part of this military protection, designed on no-fly systems previously and successfully established during other past armed conflicts.


Protection forces could be provided by as many as possible of the countries out of the neutral countries who supported the UN General Assembly Resolution A.RES.ES-11.2 (110 countries). Inevitably at this stage, forces from the 30 of the 140 countries who supported this last resolution are NATO allies, even if they provided only non-military protection, this would likely not be accepted by Russia and could inflame the situation. However, NATO countries could provide protective military vehicles to safely transport civilians and international aid workers providing humanitarian aid, as well as non-military aid itself, protected by the military forces deployed to Ukraine by the UN General Assembly.

Any country willing to provide protective military forces must be fully supported by the United Nations and be assisted by the UN with their postings to Ukraine. UN troops must wear and carry the UN insignia.

Effective military protective actions would allow UN agencies such as UNICEF, WHO, UNHCR, UNFPA and the World Food Programme, The Red Cross, and International Charities to be accompanied by neutral protective troops and carry with them any humanitarian essentials that are needed by the population present in Ukraine (including injured Russian as well as Ukrainian forces).

Action 3.

A revolution to re-structure the UN security systems must be urgently undertaken to protect civilians and provide safe humanitarian assistance in all countries where there are wars. In the meantime a “Uniting for Peace” resolution within the UN General Assembly could be activated to request on the ground and in the air military support and protection for Ukraine.

A proposed new approach to UN Peacekeeping and protection, catalysed by the invasion of Ukraine by Russia, a permanent member of the UN Security Council


When the United Nations was established, following the UN Charter in 1945, the world was recovering from the trauma of World War Two. Giving absolute power to the five countries was a good gesture because they were the winners and presumed protectors of the world. Out of the 51 sovereign nations at the time, 13 Western European countries were devastated and were recipients of the US Marshall Plan, but economic hardship had engulfed the entire world. Gradually that good gesture resulted in the five countries exercising absolute power but initially they were never expected to exercise that much power. That gesture resulted in the creation of the most exclusive club in the world - a club that does not allow new members. The application to join was closed when the UN charter was signed.

Here below is the full text of the preamble to the UN-Charter:



to save succeeding generations from the scourge of war, which twice in our lifetime has brought untold sorrow to mankind, and to reaffirm faith in fundamental human rights, in the dignity and worth of the human person, in the equal rights of men and women and of nations large and small, and to establish conditions under which justice and respect for the obligations arising from treaties and other sources of international law can be maintained, and to promote social progress and better standards of life in larger freedom,


to practice tolerance and live together in peace with one another as good neighbours, and

to unite our strength to maintain international peace and security, and to ensure, by the acceptance of principles and the institution of methods, that armed force shall not be used, save in the common interest, and to employ international machinery for the promotion of the economic and social advancement of all peoples,


Accordingly, our respective Governments, through representatives assembled in the city of San Francisco, who have exhibited their full powers found to be in good and due form, have agreed to the present Charter of the United Nations and do hereby establish an international organization to be known as the United Nations.

Since the UN Charter was signed, the P-5 (Permanent 5) member countries have never experienced war within their territories and have not declared wars against each other either. Therefore, the UN charter works for them but not for the less empowered nations. Many wars have been declared since 1945. The first few sentences of the preamble of the UN Charter above should have worked for all nations but has failed in many and now its failure in Ukraine threatens the security of the whole world.

The Uppsala Conflict Data Program defines war as "a state-based conflict or dyad which reaches at least 1000 battle-related deaths in a specific calendar year". The following 21 countries were identified by the World Population Review between 2020 and 2021 as having conflicts defined as wars: Afghanistan, Algeria, Burkina Faso, Cameroon, Chad, Colombia, DR Congo, Ethiopia, Iraq, Libya, Mali, Mexico, Mozambique, Myanmar, Niger, Nigeria, South Sudan, Syria, Tanzania, Tunisia, Yemen. Now in 2022, Ukraine must be added.


Solutions to enable the United Nations to intervene effectively and provide peace, protection, and security for all 22 countries at war in the world are urgently required.

The Responsibility to Protect (R2P) populations from genocide, war crimes, crimes against humanity and ethnic cleansing has emerged as an important global principle since the adoption of the United Nations “World Summit Outcome Document” in 2005.

The R2P concept emerged in response to the failure of the international community to adequately respond to mass atrocities committed in Rwanda and the former Yugoslavia during the 1990s. The International Committee on Intervention and State Sovereignty developed the concept of R2P during 2001. R2P was unanimously adopted in 2005 at the UN World Summit, the largest gathering of Heads of State and Government in history. It is articulated in paragraphs 138 and 139 of the World Summit Outcome Document:

R2P stipulates three pillars of responsibility:


Every state has the Responsibility to Protect its populations from four mass atrocity crimes: genocide, war crimes, crimes against humanity and ethnic cleansing.


The wider international community has the responsibility to encourage and assist individual states in meeting that responsibility.


If a state is manifestly failing to protect its populations, the international community must be prepared to take appropriate collective action, in a timely and decisive manner and in accordance with the UN Charter.


Please see this recent (5th April 2022) UN document which outlines what the UN currently can and cannot do.

The Security Council can under Chapter VII of the UN Charter take strong measures to maintain or restore international peace and security including, when peaceful means are exhausted, through the use of military force by Member States, coalitions of Member States, or UN-authorized peace operations. All members of the UN, have agreed under Article 25 of the UN Charter, to accept and carry out decisions adopted by the Security Council. Actions taken by the Council are binding on all UN member countries. However, outside procedural matters, substantive decisions such as establishing a peace keeping operations require “YES “votes from all five permanent members: China, France, Russia, UK, USA. One permanent member can veto to end the discussion, which is why a peacekeeping operation to protect Ukraine did not happen on the 25th February 2022 because it was vetoed by Russia. In addition, even though China abstained, this was not a “YES” vote.

United Nations General Assembly resolution 377 A (V), also called the "Uniting for Peace" resolution, was adopted on 3 November 1950 and remains active now in 2022. It states that in any situation where the UN Security Council, because of a lack of unanimity among its permanent members fails to act as required to maintain international security and peace, the United Nations, as a whole, can act by holding an Emergency Special Session (ESS) of the UN General Assembly. It can consider the problem immediately and may issue appropriate recommendations to all UN member states for collective measures, including the use of armed force when necessary, in order to maintain or restore international security and peace.


Resolution 377A (V) was designed to provide the UN with an alternative avenue for action when the Security Council is prevented by actions of its 5 permanent members from carrying out its peace-keeping functions as mandated by the UN Charter. The General Assembly. established the first ever UN Emergency Force (UNEF I) in 1956.

The worsening situation in Ukraine shows there is little time left for action if masses more civilians are to be prevented from death, abuse or torture. The approach below and in the initial Action Points highlights possible ways forward, drawing attention to the conflicts, not only in Ukraine, but elsewhere in the world.

All wars are unique in their origins and content but the war in Ukraine is in several major ways different to the others, not in terms of the terrible tragedies that all wars include, but in terms of the risks it creates for the whole world.  Almost unthinkably, the Ukrainian war results from the invasion of a sovereign neighbour state by one of the 5 permanent members of the UN Security Council. This invasion alone constitutes a war crime and does not need to wait for action in the International Criminal Court before the world must act. It has enabled The Russian Federation to threaten the use of its military power (including through dominance in its ownership of nuclear weapons ) to threaten the whole world with a nuclear confrontation.


The direct action of a permanent member of the UN Security council to start a war is contrary to the UN Charter. There is an urgent need to re-construct the UN security system before it is too late, not only for Ukraine and countries such as Afghanistan, Syria and The Yemen, but for the prevention of a third world war.

Specific issues regarding the urgent need for United Nations to implement security solutions to the war in Ukraine

Examination of data from UNICEF’s State of the World’s Children in 2019 reveals a population in Ukraine of 44 million people with 421,000 births per year. Around 5% of these births will need emergency Caesarean section to address complications of the pregnancy and delivery without which they will die (around 21,000 in a year). Approximately 10% of all newborn infants require special medical care if they are to survive (42,000 in the next year). It is just not possible to care for such vulnerable women and babies in basements without electricity, light, warmth, and food. There are also many children with conditions such as cancer and genetic conditions that need constant high level medical care.


Although additional military equipment has been provided to Ukrainian forces to try and stop the Russian invasion and other war crimes, there is such a major mismatch between the number of Ukrainian troops compared with those available to Russia and Belarus that without additional incoming international forces both on the ground and in the air (as a no-fly zone) MCAI cannot otherwise understand how the Ukrainian forces alone can protect civilians whilst doing its best to combat Russian incursions.


THE TABLE below presents World Bank data on military troops available to Ukraine compared with Russia +/- Belarus.

                        COUNTRY                                          NUMBER OF TROOPS


                        UKRAINE                                               311,000

                        RUSSIAN FEDERATION                     1,454,000

                        BELARUS                                              155,000

                        TOTAL NON-NATO COUNTRIES         23,465,000

On 25th February 2022, a UN Security Council meeting (Number 8979) failed to adopt a draft resolution aimed at ending the Ukraine Crisis. The Russian Federation’s aggression was described as in violation of Article 2, paragraph 4 of the Charter of the United Nations — an obligation to refrain from the threat or use of force against the territorial integrity or political independence of any state. The Russian Federation applied its veto to this draft resolution.

The UN Security Council (through Resolution 2623) then called on 27th February for an Emergency Special Session of the UN General Assembly. 15 voting members were present and debated a draft resolution under the “Uniting for Peace” resolution the invasion of Ukraine by Russia calling for an end to the crisis. Eleven members approved (Albania, Brazil, France, Gabon, Ghana, Ireland, Kenya, Mexico, Norway, United Kingdom, United States of America). Only one country opposed (Russia), and three members abstained (China, India and the United Arab Emirates). As this was a procedural resolution, no permanent member could exercise their veto power and the Emergency Special Meeting of the UN General Assembly eventually went ahead on March 22-23rd 2022.

The Draft Resolution (number A.RES.ES-11.2) of the subsequent Emergency Special Session (ESS) at the UN General Assembly debated between the 23rd

and 24th March 2022 are attached in these links..


The Resolution was comprehensive in its aims to try and end the conflict and protect civilians from danger and death. It was supported by 140 countries. However, it did not call for countries supporting the Resolution to find ways of providing protected humanitarian aid and assistance, to relieve the sieges of towns and villages, and prevent attacks on health workers, health facilities, and humanitarian corridors. Crucially it did not discuss the possible use of military action by UN member states to ensure that Russia complied with the written demands that were raised in this Resolution.


If there had been a call for military actions, and unlike Security Council resolutions, UN General Assembly resolutions would have been non-binding, meaning that country states would not be obligated to implement them.

Input from the UN Secretary General on 28th March 2022

Additional input from a UN Security Council debate on Ukraine on 5th April 2022

Extracts from the statement of President Zelensky during the UNSC debate on 5th April 2022.


“How is this different from what the ISIS terrorists were doing in the occupied territory?  Except that it is done by a permanent member of the United Nations Security Council”.


“So where is the security that the Security Council must guarantee? There is no security. Although there is a Security Council, as if nothing happened. So where is the peace that the United Nations was created to guarantee? It is obvious that the key institution of the world, which must ensure the coercion of any aggressors to peace, simply cannot work effectively”.


“We are dealing with a state that turns the right of veto in the UN Security Council into a right to kill. Which undermines the whole architecture of global security.  Which allows evil to go unpunished and spread the world. Destroying everything that can work for peace and security. If this continues, the finale will be that each state will rely only on the power of arms to ensure its security, not on international law, not on international institutions.  Then, the UN can simply be dissolved”.


“Are you ready for the dissolving of the UN? Do you think that the time of international law has passed? If your answer is no, you need to act now, act immediately. The power of the UN Charter must be restored immediately. The UN system must be reformed immediately so that the right of veto is not a right to kill. So that there is a fair representation of all regions of the world in the Security Council.


The aggressor must be forced to peace immediately. Determination is needed. The chain of mass killings from Syria to Somalia, from Afghanistan to Yemen and Libya should have been stopped a long time ago to be honest.  If tyranny had ever received such a response to the war it had unleashed that it would have ceased to exist and a fair peace would have been guaranteed after it, the world would have changed for sure. And then, perhaps, we would not have a war, a war in my country. Against our nation, the Ukrainian nation. Against people”.


“But the main thing is that today is the time to transform the system, the core of which is the United Nations. To do this, we propose to convene a global conference. And we ask to do it already in peaceful Kyiv - in order to decide.  How we will reform the world security system. How we will really guarantee the inviolability of universally recognized borders and the integrity of states. How we will ensure the rule of international law”.


“It is now clear that the goals set in San Francisco in 1945 during the creation of a global international security organization have not been achieved. And it is impossible to achieve them without reforms.  Therefore, we must do everything in our power to pass on to the next generations an effective UN with the ability to respond preventively to security challenges and thus guarantee peace.  Prevent aggression and force aggressors to peace. Have the determination and ability to punish if the principles of peace are violated. There can be no more exceptions, privileges. Everyone must be equal. All participants in international relations. Regardless of economic strength, geographical area and individual ambitions.  The power of peace must become dominant. The power of justice and the power of security. As humanity has always dreamed of.  Ukraine is ready to provide a platform for one of the main offices of the updated security system”.


“Just as the Geneva office specializes in human rights, just as the Nairobi office specializes in the field of environmental protection, the Kyiv U-24 Office can specialize in preventive measures to maintain peace”.


“If every time there was a need everyone in the world was confident that help would come, the world would be definitely safer.  Therefore, Ukraine has the necessary moral right to propose a reform of the world security system”.


“And now we need decisions from the Security Council. For peace in Ukraine. If you do not know how to adopt this decision, you can do two things.  Remove Russia as an aggressor and a source of war from blocking decisions about its own aggression, its own war. And then do everything that can establish peace.  Or show how you can reformat and really work for peace.  Or if your current format is unalterable and there is simply no way out, then the only option would be to dissolve yourself altogether.  I am convinced that you can do without the third option.  Ukraine needs peace. We need peace. Europe needs peace. The world needs peace”.

Extracts from Ambassadors and The Emergency Relief Coordinator at the debate

The USA Ambassador Linda Thomas-Greenfield stated that “The United States is seeking suspension of the Russian Federation from the Human Rights Council, as Moscow uses its membership as a platform for its propaganda”.
The Albanian Ambassador also said they would support removing Russia from the UN Human Rights Council.

The Indian Ambassador called for guarantees for safe passage of humanitarian and medical supplies and said the Russia-Ukraine conflict had caused an increase in food and energy costs, particularly being felt by developing countries.

Addressing the Council from Geneva, Emergency Relief Coordinator Martin Griffiths, said  “Perilous conditions are hampering our efforts to access civilians - or for them to access us”.


UN General Assembly votes to suspend Russia from the Human Rights Council
7th April 2022

In favor: 93,  Abstained: 58,  Against: 24.

Speaking after the adoption of the resolution, Deputy Permanent Representative Kuzmin, suddenly stated that Russia had already decided that day, to leave the Council before the end of its term.

Summary April 20th 2022

It is evident from responses to earlier condemnations and sanctions that The Russian Federation  led by President Putin will not stop just because it/he is requested to or ordered to do so by the UN as currently constructed.


It must be clear to all that only incoming of military protective troops on the ground and a no-fly zone over at-risk civilian infrastructures or humanitarian corridors, will achieve the goals of the UN General Assembly Resolution on 23rd March and the intervention of the UN Secretary General (see above).

Analysis by the UN of previous vetos on UNSC Resolutions made between 11th May 1993 and 25th February 2022 revealed that the Russian Federation has vetoed 29 resolutions, many of which concern armed conflict, for example, blocking a ban of the use of chemical weapons in Syria, and the withdrawal of Russian troops from Ukraine (

Russia is renowned for its attacks on civilians. For example, in addition to the current situation in Ukraine, The UK-based Syrian Observatory for Human Rights (SOHR) stated that between the initiation of the Russian intervention in the Syrian conflict in September 2015 and end of February 2016, Russian air strikes killed at least 1,700 civilians, including more than 200 children. Weapons used included unguided bombs, cluster bombs, incendiaries similar to white phosphorus and thermobaric weapons. By the end of September 2017, the SOHR stated that Russian airstrikes had killed around 5,703 civilians, about a quarter of them children. (

NATO failed to admit Ukraine as an ally in 2014, failed to send in protective troops when it saw the build-up of massive Russian forces on Ukrainian borders, and now is limited to partial sanctions and the provision of weapons to help Ukraine protect itself. Unfortunately, the use of NATO troops on the ground or in the air to support a new UN Resolution at this stage would be high risk and may lead to dangerous, potentially nuclear, responses from Russia and potentially a third World War.

Out of the 140 countries that supported UN General Assembly Resolution A.RES.ES-11.2; there were 30 from NATO leaving potentially 110 who can, if willing, provide protection for civilians and protection of humanitarian aid. Some of these 110 countries could be seen as providing a low risk of a threat to Russian forces (countries of diplomatic and economic importance to the Russian Federation which Russian forces won’t be willing to attack) and might represent the most suitable to provide protection. However, some of the 30 NATO countries themselves who supported the UN General Assembly ESS resolution could help those non-NATO countries who agree to provide protective troops by supporting them with funds, with the necessary vehicles containing humanitarian aid, and with non-military healthcare workers.


A revolution to re-structure the UN security systems must be urgently undertaken and in the meantime the “Uniting for Peace” resolution within the UN General Assembly must be activated to request on the ground and in the air military support and protection for Ukraine.

May 20th 2022  Additional importance of the provision of a peacekeeping /humanitarian protection system for Ukraine

On 19th May 2022, Secretary General of the UN Antonio Guterres in a tweet stated: The war in Ukraine, on top of all other global crises, threatens tens of millions of people with food insecurity, malnutrition, mass hunger and famine One way of possibly relieving some of these predicted disasters would be for an international peacekeeping /protection system to overcome the blockade induced by Russia on the ability of Ukraine to export grain from its sea ports on the Black Sea. 

For further information please contact:

Professor David Southall OBE, MD, FRCPCH,  Dr Rhona MacDonald MBChB MPH MRCGP DCH DRCOG, Dr Sarah Band MBChB MRCPCH DTM&H Honorary Medical Director, Honorary Executive Director, and Honorary Deputy Medical Director, Maternal and Childhealth Advocacy International MCAI, 1 Columba Court, Laide IV22 2NL,   
Twitter: @DavidSo925  WhatsApp +44 7944 632011 and

Dr Anastasiya Dumcheva, MD, MPH, LL.M, international expert and consultant on health policies,
Twitter: @AnastDumcheva, WhatsApp +380975731795



David P Southall, Rhona MacDonald, Olena Kostiuk, Volodymyr Shcherbakov, Aniko Deierl .  The UN must provide secure medical and humanitarian assistance in Ukraine.

The Lancet Published March 17, 2022.

Background to proposed actions initially and urgently needed to address reform of the United Nations security systems and immediately to address the Ukrainian invasion and provide protection for its population.

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