Do No Harm in the Shadow of COVID19


Authors: Sian Bowen, Analya Romo

The Humanitarian Encyclopedia initiative looks at the convergent and divergent understandings of key humanitarian concepts. This week our Newsletter is focusing on do no harm and how the COVID19 pandemic has intensified the debate around this principle. 

The Humanitarian Encyclopedia researchers have found many definitions for do no harm in the texts of humanitarian organisations. Often doing no harm is seen as a way to examine how aid might increase conflict. Other times it means something broader, like acting responsibly to ensure that aid activities do not adversely affect local communities.

For over a year and a half now, humanitarian organisations have been challenged during the COVID19 pandemic to continue humanitarian programmes and services. For example, the impact of the pandemic has been felt across Médecins Sans Frontières’ 450 projects across some 70 countries.  Like other organisations, they had two priorities, to continue existing programmes wherever possible, and medically respond to the virus directly. 

In addition, organisations needed to factor in the principle of do no harm, into this already very challenging environment. Organisations faced the dilemma between maintaining essential life saving services and the risk of doing harm by increasing vectors of the virus and increasing transmission to vulnerable groups without recourse to adequate prevention or treatment measures.

A similar trade-off has to be made when deciding about the risk faced by staff of humanitarian organisations, who may not feel comfortable being exposed to the virus but whose services are essential to maintaining ongoing live-saving operations.

The ‘do no harm’ concept was applied to humanitarian action by Mary Anderson in the 1990s, specifically as an approach to working effectively in conflict-affected situations. It was later broadly used by the humanitarian sector, including in situations of disasters caused by natural hazards. The use of the term more broadly has steadily been increasing since 1990 in the English language as a whole.

Today, do no harm is thought to be a key humanitarian principle or approach. It is sometimes described as a humanitarian imperative and has roots in medical ethics and the ‘Hippocratic Oath’. However, in the humanitarian sector, it has more technical usages too including as a framework, tool, or type of analysis. Do no harm is based on the fact that despite good intentions, humanitarian activities may have unintended negative repercussions; contribute or lead to conflict; or damage the environment.

Given its importance, humanitarian organisations make efforts to ensure they do no harm, including conducting comprehensive conflict-mapping analyses, environmental impact assessments, and other sensitivity analyses to be sure about the impacts of their actions.

Nonetheless, consistently doing no harm in practice remains a struggle. The COVID19 pandemic highlights the challenges of ensuring do no harm is practiced in complex humanitarian settings. It requires organisations to question themselves repeatedly and consistently asking themselves:

  • What exactly are the potential ‘harms’ that can be caused by humanitarian actions? What are the implications and longer term effects?
  • Can we apply the concept in the development sector from humanitarian points of view, for instance to consider the negative effect of certain forms of development on the environment?
  • What is the right balance between do no harm to staff and populations-in-need during the COVID-19 crisis?

Another pertinent question that was raised as early as 2008 but which remains relevant today, is whether humanitarian organisations, instead of being so focused on doing no harm, should instead, re-centre their efforts on doing more good?

To read more or get actively involved by contributing your expertise to the Humanitarian Encyclopedia project sign up today at

Read our latest newsletter focusing on the concept of do no harm at: