Recent events have shown that despite overwhelming agreement, healthcare institutions are not universally protected during armed conflict. This report will describe historical and contemporary trends in all types of health emergencies (including infectious disease outbreaks, conflicts, natural disasters, chemical or radio-nuclear spills, and food contamination). In addition, this report will explore the relative share of health emergencies and their changes over time, aiming to clarify the impact of armed conflicts over time. The report will also analyze the incidence and frequency of attacks on health during armed conflicts in the period 2020-2024, with geographical disaggregation in accordance to World Health Organization (WHO) regions. The report will highlight the impact of armed conflict on the functioning of health systems, the health and wellbeing of health workers, and the associated consequences on the health of the population. The report will then review United Nations (UN) and multilateral governance mechanisms, their laws, standards, resolutions, and actions, etc. to hold perpetrators accountable. We will examine evidence, existing policy recommendations and calls to action from UN, multilateral bodies, non-state actors, civil society etc. to improve reporting, data, accountability and responses, and finally, assess strengths and weaknesses in the contemporary governance and global architecture. This report will propose actions and measures in response to identified challenges and weaknesses; including clear, concrete, innovative actions for countries of each income level. It will also Identify potential roles for all relevant stakeholders, including regional economic bodies, with particular focus on the WHO Eastern Mediterranean Regional Office (EMRO) region.