NATO plans to seize civilian health systems for war – turning hospitals into military logistics hubs, Erkin Oncan writes.
The world awaits the NATO Summit scheduled for 7–8 July in Ankara, our capital.
The main agenda is expected to focus on imperialist hostility toward Iran and ongoing events in the Russia–Ukraine conflict. Yet, a crucial aspect remains the commitment by member nations to allocate 5 percent of their Gross Domestic Product (GDP) towards defense.
With the exception of Spain, every member state has pledged to meet this 5 percent defense spending goal by 2035. We have previously highlighted the strain this will impose on national economies and the likely cuts to social programs as a result. (Source)
As anticipated, NATO is actively preparing for what it terms the ‘big war’—a reality no longer hidden—via a complex, multi-faceted strategy. The alliance’s buildup for this historic summit and ensuing transformations are progressing through various committee and subcommittee sessions.
A significant milestone in this preparation was recently achieved in North Macedonia. Despite minimal media attention, this development centers on readying the health infrastructure of member states for the anticipated ‘big war.’
Who organized the meeting?
The NATO Committee of Chiefs of Military Medical Services (COMEDS) convened the meeting.
Originating from EUROMED, established in 1970 by the leadership of EUROGROUP’s medical services—formed in 1968 to coordinate logistics among NATO’s European allies—this body has evolved substantially.
By the 1990s, all of EUROGROUP’s functions except EUROMED shifted to the Western European Union (WEU), which itself dissolved in 2011, while EUROMED became part of NATO. From 1993 to 1994, NATO’s Military Committee institutionalized EUROMED, transforming it into the present-day COMEDS.
Since then, COMEDS has overseen health services development for military personnel, including medical evacuation and related areas. However, its responsibilities extend beyond military contexts into civilian domains, covering epidemics, natural disasters, and emergencies in member states. In all such cases, COMEDS coordinates sensitive aspects like medical supplies and patient transfers.
What was discussed at the meeting?
The NATO COMEDS 65th Plenary Meeting took place in Skopje, North Macedonia, from 1–4 June.
Senior participants emphasized two core issues during the event.
The first focus is on enhancing the speed of medical treatment and return of injured soldiers to active duty.
Belgian Major General Luc Vanbockryck, NATO’s Logistics and Resources Division Director, highlighted in his opening statement that medical support should be viewed as “a critical capability equivalent to any weapons system.”
Norwegian Brigadier General Petter Iversen, chair of the committee, described “a new reality” and declared:
“Military medical services are no longer just a broad support domain; they are becoming a fundamental element just like any weapons system. We must accelerate the process of returning soldiers to the front. This has strategic importance.”
This perspective treats wounded soldiers not simply as patients but as assets requiring rapid ‘repair,’ signaling NATO’s expectation of heavy casualties in any potential conflict.
Another major point was the NATO Medical Action Plan (MAP), which will come into effect in January 2025. Although the full document remains confidential, insights can be gleaned from such meetings and official remarks.
Leading to the second critical topic:
Civil-military health integration
Official sources depict the MAP as a “Whole-of-government, whole-of-society” approach. This strategy encompasses not only military healthcare but also integrates the state and public health infrastructure.
NATO’s available documents shed light on this integration in action.
At the first NATO joint military-civilian health conference on 7 December 2023, discussions with COMEDS tackled national health authorities, mass casualty planning, securing supplies like blood and medical countermeasures, and patient evacuation logistics.
In the following year’s talks between COMEDS and NATO’s Joint Health Group, civil-military cooperation remained the centerpiece.
One of NATO’s starkest assessments was that “civilian authorities’ civilian health systems need to be able to function for longer in a conflict environment.” Essentially, NATO’s goal is not to enlarge military healthcare but to strengthen civilian health systems to endure wartime conditions.
The alliance’s health manuals underscore this point through references to strategic stockpiles, shared civilian-military medical access, joint health surveillance, communication systems, and more.
What does all this mean?
To grasp the public consequences of these policies, envision a hypothetical scenario drawn entirely from NATO documents.
Imagine NATO, spearheaded by the United States and supported by member nations, engaging in a hot war against a “great enemy,” with our country actively participating militarily.
In such a case, medical services would be affected as follows:
Total war involving our country would first severely strain supply chains, transportation, and communication networks. Warfare would rapidly spread from battlefronts into cities, swiftly crippling public services.
For Turkey, the likely outcomes would include injury and fatalities, reduced access to healthcare, shortages of medicines and supplies, widespread psychological trauma, population displacement, inflation, disruptions in transport and communication, and the diversion of public funds toward the war effort.
Health infrastructure in Turkey would be rapidly restructured to align with wartime priorities rather than public health needs. Hospitals—whether city, state, military, university, or private—would operate according to NATO alliance demands and war laws, not solely based on national considerations.
At this juncture, the issue transcends mere medical capacity; it challenges national sovereignty. In warfare, healthcare shifts from purely “saving lives” to making decisions about which injured receive care first, which medicine is allocated to whom, and which facilities prioritize military needs.
For example, COMEDS produces real-time assessments at the onset of conflict evaluating which countries face healthcare pressures, where patient transfers are feasible, and where civil-military coordination is essential.
Under the MAP, allied nations are assigned roles such as advanced surgery and intensive care, evacuation, rehabilitation, blood product supply, medication distribution, or logistic hubs. These responsibilities are determined by “Lead nations”—dominant countries within the alliance.
However, NATO documents do not clarify the criteria for distributing these tasks. Are they based on military strength, political influence, alliance standing, or Atlantic-centric strategic priorities that define the alliance’s nature?
Further, if military medical services alone prove insufficient—which is expected—COMEDS initiates collaboration with civilian health authorities. Although cloaked in “health-oriented” language like securing supplies and patient referrals, this collaboration carries a concerning implication: the use of national and regional stockpiles.
This suggests that, when deemed necessary, NATO can access civilian blood reserves for military use. While such authority exists in all countries, this policy extends beyond a state’s rights to support its own forces in wartime.
In essence, considering healthcare—a fundamental human need—being militarized and equated by officials with weapons systems, and rapidly transitioning from “burden sharing” to “resource sharing” in wartime due to NATO membership, one must ask: who ultimately benefits?
And let us imagine a country…
A nation not among the dominant imperialist-capitalist powers, yet kept in the alliance by its government at all costs; with a fragile economy; public services, especially healthcare, already under strain; but possessing a large military and civilian population. Under such circumstances, how long—likely months rather than years—could such a country endure, and which “ally” would be brave enough to bear responsibility for its rescue?
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