Healthcare Worker Vaccine Hesitancy: What Drives COVID-19 Vaccine Acceptance?

Healthcare workers were among the first groups prioritized for COVID-19 vaccination during the pandemic. As trusted sources of health information and frontline responders, their attitudes toward vaccination play a critical role in public confidence and immunization uptake.

While vaccines remain one of the most effective public health interventions, research has shown that healthcare workers are not immune to vaccine hesitancy. Understanding what drives vaccine acceptance—and what creates barriers—is essential for strengthening future vaccination campaigns and building trust in public health systems.

A recent review conducted by researchers from the World Federation of Public Health Associations (WFPHA) and its International Immunization Policy Taskforce examined the factors influencing COVID-19 vaccine acceptance among healthcare workers across multiple countries and regions.

Why Vaccine Acceptance Among Healthcare Workers Matters

Healthcare workers face a higher risk of exposure to infectious diseases and play a central role in advising patients about vaccination. Their confidence in vaccines can influence both workplace vaccination rates and public perceptions of immunization.

The review analyzed 56 studies from around the world to better understand the demographic, behavioral, and social factors associated with COVID-19 vaccine acceptance.

The findings revealed significant variation between countries and regions, highlighting the complexity of vaccine decision-making among health professionals.

COVID-19 Vaccine Acceptance Rates Varied Widely

One of the most striking findings was the variation in vaccine acceptance among healthcare workers.

The highest reported uptake was found in Italy, where acceptance reached 98.9%, while one study from Cyprus reported acceptance rates as low as 30%.

These differences suggest that vaccine confidence is influenced not only by individual factors but also by local contexts, health systems, communication strategies, and levels of trust in institutions.

Key Factors Associated with Higher Vaccine Acceptance

The review identified several characteristics that were consistently associated with greater willingness to receive a COVID-19 vaccine.

Older Age

Healthcare workers aged 30 years and older were generally more likely to accept vaccination than their younger colleagues. Greater clinical experience and increased awareness of personal risk may contribute to this trend.

Male Gender

Many studies have found that male healthcare workers report higher vaccine acceptance than female healthcare workers, although findings have not been consistent across all countries.

Physician Occupation

Physicians consistently demonstrated higher vaccine acceptance rates than other healthcare professionals. In contrast, vaccine hesitancy was often more common among nursing professionals.

Higher Levels of Education

Healthcare workers with university, master’s, or doctoral-level education were generally more likely to accept vaccination, suggesting that health literacy and understanding of vaccine science may influence decision-making.

Presence of Comorbidities

Individuals with chronic health conditions were more likely to be vaccinated, likely due to greater awareness of the risks associated with COVID-19 infection.

Influenza Vaccination History Was the Strongest Predictor

Across the studies reviewed, previous influenza vaccination emerged as one of the strongest predictors of COVID-19 vaccine acceptance.

More than 65% of the included studies found that healthcare workers who regularly received seasonal influenza vaccines were significantly more likely to accept COVID-19 vaccination.

This finding suggests that vaccine acceptance may reflect broader health-seeking behaviors and existing confidence in immunization programs.

What Drives Vaccine Confidence?

The review identified several factors that increased the likelihood of vaccine acceptance.

Knowledge and Health Literacy

Healthcare workers with greater knowledge of COVID-19 vaccines, including their effectiveness and safety, were more likely to be vaccinated.

Trust in Health Authorities

Confidence in governments, public health agencies, scientists, and healthcare institutions played an important role in vaccine acceptance.

Perceived Risk and Vulnerability

Healthcare workers who believed they were at greater risk of infection or severe disease were more likely to accept vaccination.

Protecting Others

Many healthcare workers cited protecting patients, family members, and colleagues as a key motivation for receiving a vaccine.

Common Barriers to COVID-19 Vaccine Acceptance

Despite the overall success of vaccination campaigns, several barriers contributed to hesitancy among healthcare workers.

Concerns About Side Effects

Fear of short-term and long-term adverse effects was the most frequently reported barrier across the studies.

Questions About Vaccine Effectiveness

Concerns regarding efficacy, particularly during the early stages of vaccine rollout, reduced confidence among some healthcare workers.

Lack of Information

Limited access to clear, transparent, and evidence-based information was another common factor associated with hesitancy.

Distrust in Institutions

Distrust of governments, pharmaceutical companies, or public health authorities negatively affected vaccine confidence in several settings.

An Important Research Gap: Public Health Professionals

While the review identified extensive research on healthcare workers, it revealed a notable gap in the literature.

No studies specifically focused on the vaccination sentiments of public health professionals.

Given their role in shaping public health policy, promoting immunization, and communicating evidence to communities, understanding their perspectives remains an important area for future research.

What Can Improve Vaccine Acceptance?

The review concluded that vaccination campaigns alone are unlikely to achieve optimal uptake.

Effective strategies should include:

• Educational initiatives that improve vaccine knowledge
• Transparent communication about safety and effectiveness
• Targeted interventions for groups with lower acceptance rates
• Efforts to build trust in health institutions
• Approaches that address misinformation and disinformation

A combination of evidence-based communication, tailored outreach, and community engagement is more likely to strengthen vaccine confidence than relying solely on vaccine availability.

Looking Ahead

The findings reinforce that healthcare worker vaccine hesitancy is influenced by a complex mix of personal, professional, and societal factors.

Older age, physician status, higher education, existing health conditions, and previous influenza vaccination were consistently associated with greater COVID-19 vaccine acceptance. At the same time, concerns about safety, effectiveness, information quality, and trust continue to shape vaccine decision-making.

As public health systems prepare for future outbreaks and vaccination campaigns, understanding these determinants will remain essential for building confidence, improving uptake, and protecting both healthcare workers and the communities they serve.

Read the original review here: Determinants of Acceptance of COVID-19 Vaccination in Healthcare and Public Health Professionals

Improving Childhood Vaccination Coverage Rates in Europe

Childhood vaccination plays a critical role in reducing mortality and morbidity worldwide, lowering disease incidence, and strengthening public health protection. In short, vaccination remains one of the most effective tools for preventing infectious diseases.

Over the past several decades, childhood vaccination coverage has improved across Europe, with several countries achieving the World Health Organization’s (WHO) 95% coverage target. While this progress is significant, vaccination coverage rates declined in many European Union (EU) countries between 2010 and 2021. As a result, Europe has experienced outbreaks of vaccine-preventable diseases (VPDs), including major measles outbreaks.

These trends highlight the urgent need to strengthen resilient immunization systems across the EU. Addressing barriers to vaccine uptake is essential to protecting populations from preventable illnesses, reducing deaths linked to VPDs, and improving preparedness for future public health crises.

Researchers from the World Federation of Public Health Associations (WFPHA) and its International Immunization Policy Taskforce examined changes in childhood vaccination coverage across the EU between 2010 and 2021. Their analysis focused on WHO vaccination indicators, including:

• Diphtheria, Tetanus, and Pertussis (DTP) 1st dose
• DTP 3rd dose
• Haemophilus influenzae type b (Hib3)
• Hepatitis B 3rd dose (HepB3)
• Measles 1st dose
• Measles 2nd dose
• Polio 3rd dose

The study identified major trends, barriers, and policy recommendations for improving childhood vaccination coverage rates in Europe.

Childhood Vaccination Coverage Rates in the EU (2010–2021)

The analysis revealed several important patterns across EU member states:

• Vaccination coverage rates fluctuated significantly across countries and vaccine types.
• Most vaccines had lower coverage rates in 2019 than in 2010.
• Lower-performing countries, including Austria and Romania, experienced more severe and frequent fluctuations.
• Higher-performing countries generally maintained stable vaccination coverage rates.

These findings suggest that vaccination systems across Europe remain vulnerable to disruptions and uneven public health capacity.

Why Fluctuations in Vaccination Coverage Matter

Variations in childhood vaccination coverage are a major public health concern. Fluctuating vaccine uptake rates reveal weaknesses within national immunization systems and increase the risk of outbreaks of vaccine-preventable diseases.

Lower vaccination coverage also weakens herd immunity, leaving vulnerable populations, including immunocompromised individuals and children unable to receive vaccines, at greater risk.

To improve long-term public health resilience, EU countries need stronger vaccination infrastructure, more reliable delivery systems, and crisis preparedness strategies.

Key Factors Causing Declining Childhood Vaccination Rates in Europe

The WFPHA article identified several major barriers contributing to declining childhood vaccination coverage rates in Europe.

Structural Barriers to Vaccine Access

Practical challenges continue to limit vaccine uptake for many families. Common structural barriers include:

• Difficulty taking time off work for vaccination appointments
• Limited access to healthcare facilities
• Delays in vaccine procurement and supply chains
• Inconvenient clinic hours

Evidence suggests that improving accessibility plays a major role in increasing vaccination rates.

Vaccine Hesitancy and Misinformation

Vaccine hesitancy remains one of the leading contributors to declining vaccination coverage across Europe. The spread of misinformation (particularly online) has negatively affected public confidence in vaccine safety and effectiveness.

Research highlighted declining vaccine confidence in several EU countries, including:

• Austria
• Bulgaria
• Romania
• Germany
• France
• The Netherlands
• Sweden

Public awareness campaigns, trusted healthcare communication, and evidence-based educational initiatives have proven effective in rebuilding confidence in vaccines.

Impact of COVID-19 on Routine Immunization

The COVID-19 pandemic significantly disrupted routine childhood vaccination services across Europe.

Key pandemic-related challenges included:

• Healthcare resource diversion
• Lockdowns and restricted movement
• Reduced healthcare visits
• Supply chain interruptions
• Delayed data collection and reporting

Many countries experienced additional declines in vaccination coverage between 2020 and 2021, increasing the risk of outbreaks of measles, polio, and other vaccine-preventable diseases.

The Ukraine Crisis and Regional Vaccination Gaps

The ongoing Ukraine crisis further intensified vaccination challenges across Europe. Countries already experiencing immunity gaps, including Poland and Romania, faced additional pressure due to population displacement and disruptions to vaccination services.

The study emphasized the importance of coordinated crisis preparedness plans to prevent widening immunization gaps during humanitarian emergencies.

Strategies for Increasing Childhood Vaccination Coverage Rates

The article identified several evidence-based strategies that can improve childhood vaccination uptake across Europe.

Improve Access to Vaccination Services

Improving convenience and accessibility can significantly increase vaccine uptake. Recommended strategies include:

• Expanding the number of providers authorized to administer vaccines
• Offering vaccinations outside traditional healthcare settings
• Providing extended clinic hours
• Delivering outreach services and catch-up campaigns

Countries with accessible, community-based vaccination systems tend to achieve more stable vaccination coverage rates.

Strengthen Vaccine Communication and Education

Effective communication between healthcare professionals and families is essential for improving vaccine confidence.

Successful approaches include:

• Public awareness campaigns
• Reliable vaccine information materials
• School and community education programs
• Direct communication between patients and healthcare workers

Healthcare professionals remain one of the most trusted sources of vaccine information.

Expand the Use of Digital Technologies

Digital tools can help improve immunization tracking and reduce missed vaccinations.

Key recommendations include:

• Electronic immunization records
• Real-time surveillance systems
• Automated vaccine reminders
• Improved vaccination data collection

Countries using digital reminder systems have reported improved vaccination coverage and more accurate immunization records.

Policy Recommendations for Strengthening Childhood Vaccination Programs

Based on the WFPHA International Immunization Policy Taskforce recommendations, policymakers across the EU should focus on the following priorities.

Facilitate Easier Access to Vaccination

• Expand vaccine administration locations
• Increase provider flexibility
• Offer vaccinations outside standard working hours
• Reduce logistical barriers for families

Invest in Immunization Infrastructure

• Strengthen healthcare workforce capacity
• Improve vaccine supply systems
• Enhance outbreak preparedness plans

Improve Data Collection and Surveillance

• Develop real-time monitoring systems
• Expand electronic immunization records
• Use automated reminder technologies

Increase Public Awareness and Education

• Launch targeted vaccine education campaigns
• Combat misinformation with evidence-based communication
• Support healthcare worker engagement initiatives

The Importance of Resilient Immunization Systems in Europe

The findings demonstrate that childhood vaccination systems across Europe remain vulnerable to public health crises, misinformation, and structural barriers.

Evidence consistently shows that improving vaccine accessibility, strengthening communication, and investing in digital health infrastructure can increase vaccination coverage rates and reduce the risk of disease outbreaks.

As Europe continues to navigate the long-term effects of COVID-19 and the Ukraine crisis, resilient immunization systems will remain essential to protecting children and communities from vaccine-preventable diseases.

Maintaining strong childhood vaccination programs requires continuous investment, coordinated policy action, and sustained public trust in vaccination systems.

Global One Health Index Report, One Health for All

Geneva Principles for One Health Implementation

Adopted on the occasion of the World Health Assembly Side Event “One Health for All to Improve Global Public Health” on May 19, 2026, Geneva, Switzerland.

Preamble

We, the participants of the 79th World Health Assembly side event convened by the World Federation of Public Health Associations (WFPHA) and the Chinese Preventive Medicine Association (CPMA), reaffirm that human, animal, and environmental health are inextricably linked, forming a single, indivisible system.

Recognizing the persistent gaps between One Health policies and their effective implementation, and acknowledging the urgent need for coordinated action against emerging infectious diseases, antimicrobial resistance, climate-sensitive health threats, zoonotic pandemics, biodiversity loss, and food insecurity, as well as recognizing the essential role of civil society, faith communities, and Indigenous peoples as partners in One Health delivery, we hereby adopt and commit to the following Geneva Principles for One Health Implementation.

Principle 1: Shared Responsibility and Inclusive Governance

One Health implementation requires mandatory, institutionalized collaboration across health, agriculture, environment, water, food systems, and infant sectors at local, national, and global levels. Decision-making must include representatives of human, animal, and ecosystem health, civil society organizations, Indigenous peoples, and faith communities throughout design, implementation, and evaluation.

Principle 2: Bridging Policy-Practice Gaps

All One Health commitments shall be accompanied by gender-responsive, actionable roadmaps, clear budgetary allocations, and time-bound milestones. Policies must be co-designed with field implementers, community health workers, civil society organizations, Indigenous knowledge holders, and veterinary and wildlife services.

Principle 3: Monitoring, Evaluation, and Accountability

Each signatory institution commits to establishing measurable One Health performance indicators, including joint outbreak-response metrics, zoonotic disease transmission rates, antimicrobial-use surveillance, and ecosystem health outcomes. Regular independent peer review and public reporting on implementation progress shall be conducted, with findings made publicly accessible through open platforms.

Principle 4: Science-Based and Locally Informed Decision-Making

While global indices can serve as valuable tools, implementation decisions must be guided by local epidemiological, ecological, and social data, as well as traditional and Indigenous knowledge systems. We encourage the systematic adoption of integrated One Health assessment frameworks, including city-level One Health assessments, to identify capacity gaps and track improvements.

Principle 5: Capacity Building and Equitable Access

Sustainable One Health requires investment in cross-sectoral workforce training, laboratory networks, and digital surveillance systems, with priority given to low- and middle-income countries, small island developing states, and vulnerable communities. Knowledge exchange, open science, technology transfer, and expanded joint financing mechanisms should be prioritized.

Principle 6: Emergency Preparedness and Adaptive Management

One Health implementation must function as a dynamic, real-time system for early warning and rapid response. Mechanisms for adaptive management, including regular simulation exercises, community-based surveillance networks, and after-action reviews, shall be integrated into national and global health security and planetary resilience architectures.

Advancing One Health Through Global Cooperation

The COVID-19 pandemic highlighted the deep connections between health, animals, ecosystems, food systems, and the environment. A One Health approach is critical not only to prevent outbreaks of zoonotic diseases but also to address antimicrobial resistance, food safety, biodiversity loss, and climate-related health threats.

One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment is closely linked and interdependent. Through collaboration across sectors, disciplines, and communities, the approach supports prevention, preparedness, detection, and response to current and emerging global health challenges.

International cooperation has become central to advancing One Health implementation. The collaborative work of the World Health Organization, the Food and Agriculture Organization of the United Nations, the World Organization for Animal Health, and the United Nations Environment Program has strengthened global recognition of the need for coordinated action at the human-animal-environment interface. Their continued efforts support countries in improving prevention, prediction, detection, and response to global health threats while contributing to sustainable development.

The Geneva Principles for One Health Implementation reinforce the importance of measurable action, inclusive governance, and accountability. By bridging knowledge and implementation, these principles aim to support stronger national and global systems that protect public health, strengthen resilience, and promote equitable and sustainable futures for all.

Bridging knowledge and action through measurement done by the Global One Health Index Research Team

A Vision for Our Federation: Two Years, Four Priorities, One Purpose

It is a thought I carry with me as I begin this presidency. We live in a turbulent world. Conflicts, climate crises, emerging pandemics, and deepening inequalities do not wait politely for our strategic plans to catch up. Events will challenge our priorities. They will test our resolve and demand our flexibility.

But what events cannot change — what I am determined they will not change — is the DNA of this Federation. The reason each of us gives so much of our time, energy, and passion to this agenda is a shared and unshakeable belief: that global public health matters, that the health of our societies and our planet is a collective responsibility, and that our greatest obligation is to those who are most vulnerable. That conviction is our compass, however turbulent the waters.

With that compass firmly in hand, I want to set out four work streams that will shape my two-year mandate.

First: strengthening our member organizations. WFPHA is only as strong as the national public health associations that make up its family. I am committed to ensuring the center serves the membership by sharing regular updates, a bi-monthly newsletter that keeps every association informed of major events and opportunities, and by introducing travel grants to enable young public health professionals to attend key international gatherings. The next generation of leaders must have a seat at the table.

Second: supporting our World Congresses on Public Health. These congresses are among the most important convening spaces in global public health. I want to ensure they are exceptionally well planned, properly resourced, and financially sustainable — events that our members are proud to attend and that leave a lasting legacy in their host cities.

Third: the creation of a WFPHA academic journal. Knowledge must be a public good. I envision an open-access journal available free of charge to all our members, and one in which up to 20 percent of published articles incur no publication costs for authors from the Global South. If we are serious about equity, we must begin with how we share knowledge.

Fourth: building a true Global Public Health Alliance. We are not alone. The Global Network of Academic Schools of Public Health and the International Network of Institutes of Public Health share our values and our ambitions. Working more closely together — creating something genuinely greater than the sum of our parts — is both a strategic opportunity and a moral imperative.

None of this will be achieved alone. It will take all of us, working in the same direction, with generosity and determination. I am fortunate to have the support of our outstanding CEO, Professor Bettina Borisch, and COO, Dr. Marta Lomazzi. With a team of this caliber — and a membership of this commitment — I am confident we can deliver.

The journey begins now. I am honored to take it with you.

Public Health Citizenship in a Wounded World

The World Federation of Public Health Associations (WFPHA) convenes Global Public Health Week (GPHW) to mark the entry into force of the WHO Constitution, one of the UN Treaty Collection treaties, on April 7th, 1948. This year, GPHW could hardly have come at a more urgent moment, as war, displacement, climate breakdown, and political intimidation, once again demonstrate how fragile the systems on which global public health is built.

Beyond “Polycrisis”: Interlocking Global Threats to Public Health

Although referred to in the WFPHA–GNAPH GPHW seminar on “Geopolitics and Public Health” as polycrises, more accurately, these are not a series of crises (which are, by definition, limited to events) but are much more complex than that. Conflict, forced migration, environmental catastrophe, economic instability, and disinformation are not separate emergencies but interlocking assaults on life, dignity, knowledge, and the systems that they protect.

The Public Health Impact of War and Displacement

For us, the public health implications are both immediate and long-term. War kills and maims far beyond the battlefield, destroying civic infrastructure, including water systems, transport and communication systems, safe housing, supply chains, and access to basic necessities such as food, health services, education, housing, imposing a massive toll on psychological health and wellbeing. 

War overwhelms and displaces civilians, most of whom are not sheltered by wealthy countries and wealthy people but are left internally displaced in camps, border zones, and fragile transit settings. War turns infectious diseases into epidemics, chronic diseases into crises, and trauma into a generational inheritance. War especially affects the health of women and children, who are usually absent from negotiation tables and routinely ignored. We can see that massive efforts are expended on war, but little thought is given to winning peace.

Public Health Ethics, Truth, and the Role of Journalism

To address these problems, public health work in the spheres of humanitarian aid and crisis response must remain fact- and evidence-based and impartial. But impartial does not mean passive. Truthfully reporting current events is essential in wartime as in every other time. Good journalism is itself a public health good, because when truth is weakened, violence becomes easier to justify and harder to stop. Neutrality is not the same as silence.

Global Threats to Public Health Systems and Institutions

Today’s battles are worldwide assaults on the public’s health, some driven by armed conflict but others by climate disaster, information catastrophe, oligarchic power, and the corrosion of global institutions. Public health cannot remain reactive, timid, and fragmented, but needs solid risk preparedness, stronger international bodies, alongside a renewed ethic of service and equality. Very few of our political leaders are even vaguely prepared for polycrisis, and a lack of planning for prevention and preparation for response to limit the inevitable impact of disasters increases risk to people and environments. 

Science is distorted and distrusted; experts are disdained. Influencers’ opinions receive more public attention than those of public health practitioners, despite the latter’s extended education and training. Public health institutions and professionals face an existential threat (see current government activities in the USA, for example) because the instant voices of modern populism are ranged against considered ideas of public service, vocation, and professionalism.

Public Health Ethics Matter in Times of Crisis

Public health ethics matter because public health is not only about disease prevention. It is also about conflict prevention. It is also about the conditions in which people can live with security in dignity, whether families can stay safe, whether children can thrive, whether truth can still be spoken, and whether vulnerability is protected by institutions. It is about refusing to accept that cruelty, corruption, and authoritarianism are simply the way the world now works.

Public Health Citizenship: Responsibility in a Time of Crisis

The lesson of these frightening days is not to despair but to take on responsibility. Public health applies to everyone, so all citizens have a role to play in resisting all the forces that make populations sick and societies cruel. We need stronger systems thinking, the courage to voice the truth plainly and with evidence, better training on the health consequences of war, public health approaches in peacebuilding, and broader inclusion at decision-making tables. Public health education and training must include political literacy, strategic communication, systems thinking, and ethical negotiation, key competencies recognized by WHO. 

This is a time for collective solidarity, not isolation; for courage, not resignation; for moral clarity, not detachment. Public health is often treated as a technical field. Yes, it is. But it is also a political one: health, especially public health, is a political choice. The public health community must say, and mean, that there is no health without peace, no peace without justice, and no justice without the courage to resist tyranny.

A Collective Civic Task for the Future of Public Health

We generate evidence for health. So, collectively, this is our space and our civic task. The need for preparedness is a public health issue that we must address. To repeatedly tell truth to power, choose solidarity over surrender, and refuse to be silenced, with courage.

Acknowledgements

We gratefully acknowledge the contribution of ideas from our seminar speakers and moderator: Bettina Borisch, Mary Codd, Chuck Johnson, Duha Shellah, Melissa Sweet, and Michael Moore.

Bibliography

• Borisch B, Lomazzi M. Should we still talk about the crisis? Journal of Public Health Policy, Federation’s Pages. Published online 16 March 2023. 
• National workforce capacity for essential public health functions: a Roadmap. WHO, 2024. 
• Middleton J. GNAPH president’s blog, The war on the public’s health. GNAPH, March 10th 2026.
• The link between geopolitics and public health: a WFPHA / GNAPH webinar.

Global Sumud Flotilla: Background, Mission, and Public Health Significance

The Global Sumud Flotilla has become one of the most widely discussed civilian solidarity initiatives linked to the humanitarian crisis in Gaza.

For public health organizations, the issue extends beyond maritime activism. It addresses access to healthcare, food, medicine, and clean water, civilian protection, and the obligations of states under international humanitarian law.

Let’s explore what the Global Sumud Flotilla is, why it began, what previous Gaza flotillas have sought to achieve, and what happened during the previous missions.

What Is the Global Sumud Flotilla?

The Global Sumud Flotilla is an international, civilian-led maritime initiative organized to draw attention to the humanitarian conditions in Gaza and to call for the safe delivery of humanitarian assistance.

The word “sumud” refers to steadfastness or resilience.

Organizers describe the flotilla as a nonviolent civilian mission intended to highlight the impact of Israel’s siege conditions, restrictions on humanitarian access, and the deterioration of living conditions faced by Palestinian civilians. In 2025, the flotilla brought together more than 40 vessels and participants from over 40 countries, making it one of the largest flotilla mobilizations in recent years.

Why Did the Global Sumud Flotilla Begin?

The flotilla emerged in response to the escalating humanitarian emergency in Gaza.

Hospitals and health facilities have faced repeated disruption, while shortages of medicines, fuel, food, and clean water have intensified the public health crisis.

Organizers have framed the initiative around several urgent concerns:

• restricted humanitarian access to civilians;
• the collapse or interruption of essential health services;
• widespread displacement;
• growing international concern over the protection of civilians during armed conflict.

The flotilla’s stated objective has been to draw international attention to these conditions while affirming principles of human dignity, civilian protection, solidarity, and international law.

Earlier Gaza Flotillas: Historical Context

The Global Sumud Flotilla is part of a longer history of civilian maritime initiatives linked to Gaza.

2010 Gaza Freedom Flotilla

The most widely known precedent remains the 2010 Gaza Freedom Flotilla, when Israeli forces intercepted several Gaza-bound vessels in international waters.

That event prompted global debate about:

• maritime interception;
• humanitarian access;
• civilian protection;
• the legal implications of blockade enforcement.

Subsequent Flotilla Efforts

In the years that followed, several additional flotillas sought to deliver aid or symbolically challenge restrictions on access to Gaza.

Most did not reach Gaza, but they kept international attention focused on:

• humanitarian access;
• civilian suffering;
• legal accountability;
• international humanitarian law.

The Global Sumud Flotilla emerged from this broader tradition of civilian international solidarity.

What Happened During the 2025 Global Sumud Flotilla?

The 2025 Global Sumud Flotilla was the largest mission associated with the initiative to date.

Launch of the flotilla

The mission began in late August and September 2025, with vessels departing from ports in Spain, Tunisia, Italy, and Greece.

According to organizers, the flotilla included 42 boats and 462 participants from more than 40 countries. The most notable participant was Greta Thunberg. 

Reported disruptions at sea

During the voyage, participants reported a series of disruptions by Israel, including:

• surveillance;
• delays;
• communication interference;
• drone-related attacks affecting several vessels.

Interception in October 2025

By early October 2025, Israeli forces had intercepted the flotilla before it could reach Gaza.

Reports indicate that multiple participants were detained, tortured, and later deported by Israel. The flotilla did not reach its intended destination, but the mission generated renewed global attention to humanitarian access and civilian protection.

Public Health and Humanitarian Access in Gaza

For the public health community, the humanitarian crisis in Gaza is inseparable from access to lifesaving assistance.

Restrictions on humanitarian access directly affect:

Healthcare delivery

Hospitals and clinics depend on reliable access to medicines, fuel, surgical supplies, and emergency equipment.

Maternal and child health

Interruptions to health services place pregnant women, newborns, and children at particular risk.

Disease prevention

Shortages of clean water, sanitation services, and access to vaccination increase the risk of communicable disease outbreaks.

Nutrition and food security

When food access is restricted, acute malnutrition and long-term health consequences can rapidly intensify.

From a public health perspective, humanitarian access is therefore not simply a logistical issue; it is central to the protection of life and health.

Statement in Support of the Global Sumud Flotilla

The World Federation of Public Health Associations (WFPHA) recognizes the promotion of peace as a central part of its mission, understanding peace as a fundamental determinant of health.

In this context, the ongoing conflict in Gaza remains a matter of deep concern for the Federation.

On September 12, 2025, the WFPHA issued a call for global action in response to the escalating public health crisis in Gaza.

In alignment with this commitment, the WFPHA expresses its support for the Global Sumud Flotilla as a peaceful civilian initiative grounded in human dignity, solidarity, and international law.

The flotilla represents a collective effort to draw international attention to the severe humanitarian conditions faced by Palestinians, particularly in Gaza.

The WFPHA also calls for the safety and protection of all individuals participating in the flotilla, including Juan Garay, coordinator of the Sustainable Health Equity Movement, an organization for which the WFPHA is a founding partner.

The Federation further urges all parties to:

• uphold international humanitarian law;
• ensure the protection of civilians;
• create conditions for the safe, rapid, and unimpeded delivery of humanitarian assistance.

The Global Sumud Flotilla in 2026

In 2026, the Global Sumud Flotilla again became the focus of international concern after Israeli forces intercepted 22 civilian vessels in international waters near Greece and detained approximately 175 crew members and activists participating in the mission. The flotilla had sought to challenge Israel’s blockade of Gaza and deliver humanitarian supplies, including food, infant formula, and medical aid, to civilians facing catastrophic humanitarian conditions.

According to Amnesty International, communication channels were jammed during the interception, raising immediate concerns for the safety of those on board. The organization also called for the immediate and unconditional release of those detained, citing documented allegations of ill-treatment during previous flotilla interceptions in October 2025. For public health and humanitarian actors, the 2026 interception has renewed urgent concern about the protection of civilians, the treatment of humanitarian missions, and the obligation under international humanitarian law to ensure safe, rapid, and unimpeded humanitarian access for the population of Gaza.

A Global Priority

The Global Sumud Flotilla has become a significant civilian initiative at the intersection of humanitarian advocacy, international law, and public health.

For health organizations and public health professionals, the central issue remains clear: protecting civilian life and the safe delivery of humanitarian assistance must remain a global priority.

Read the official statement here.