Patricia Pinckombe
Private Practice, Philadelphia, Pennsylvania
PatPinckombe@gmail.com

Since August 2021, the de facto authorities in Afghanistan have imposed a series of nationwide restrictions affecting women’s access to education, employment and healthcare.¹ Secondary education for girls has been suspended,² and women have been barred from universities, including professional programmes in medicine and healthcare. In December 2024, authorities reportedly prohibited women from attending medical institutes that trained female nurses and midwives.³

United Nations reporting indicates that women in certain areas have faced barriers to accessing healthcare,⁴ including requirements to be accompanied by a male guardian.⁵ Although Taliban officials have stated that male doctors may be considered permissible guardians when treating female patients, restrictions on women’s mobility and on female medical education continue to limit effective access to care.⁶

These measures raise the question of whether the cumulative denial of healthcare access to women may amount to the crime against humanity of persecution under Article 7(1)(h) of the International Criminal Court Rome Statute.

Legal framework: Article 7(1)(h)

Article 7(1)(h) of the Rome Statute defines ‘persecution’ as the intentional and severe deprivation of fundamental rights contrary to international law by reason of the identity of a group or collectivity. The Elements of Crimes require:

• severe deprivation of fundamental rights;
• targeting of an identifiable group;
• discriminatory intent; and
• conduct committed as part of a widespread or systematic attack directed against a civilian population.

Gender is explicitly recognised as a protected ground under the Statute.⁷ The analysis below considers whether restrictions on women’s healthcare access in Afghanistan may satisfy these elements.

Severe deprivation of fundamental rights

The right to health is recognised under international law, including under Article 12 of the International Covenant on Economic, Social and Cultural Rights. While persecution under Article 7 does not require proof of death or physical violence, the deprivation must be severe.

Prior to 2021, Afghanistan already faced high maternal mortality⁸ and limited healthcare infrastructure.⁹ The removal of women from medical education¹⁰ and professional practice¹¹ further constrains the availability of female healthcare providers. In settings where women are restricted from being treated by male physicians and required to be accompanied by male guardians¹² to access services, the cumulative effect may render healthcare practically inaccessible for significant portions of the female population.

The foreseeable consequences of these measures are substantial. UN Women¹³ reporting has projected significant increases in maternal mortality and adolescent pregnancy if current restrictions persist. Where policy decisions predictably expose a protected group to preventable morbidity and mortality, the threshold of severe deprivation may be engaged.

Targeting of an identifiable group

The restrictions described above are expressly gender-based. Women and girls are singled out for exclusion from secondary and higher education, including medical training programmes.¹⁴ The prohibition on female attendance¹⁵ at medical institutes directly affects women’s participation in the healthcare workforce.

Mobility restrictions¹⁶ and guardian requirements¹⁷ apply specifically to women, limiting their independent access to medical services. These measures identify women and girls as a distinct group subject to differential treatment on the basis of gender.

Discriminatory intent

Article 7(1)(h) of the Rome Statute requires that deprivation occurs by reason of the identity of the group. The education bans,¹⁸ professional prohibitions and mobility restrictions are explicitly directed at women.

Public statements by authorities¹⁹ indicate that the measures are grounded in their interpretation of religious principles.²⁰ For the purposes of Article 7(1)(h), the relevance of such statements lies not in their theological basis but in demonstrating that the restrictions are deliberate and directed at a specific group. The cumulative effect of these measures supports the inference that their impact on women’s access to healthcare is intentional rather than incidental.

Widespread or systematic attack

For conduct to constitute a crime against humanity, it must be committed as part of a widespread or systematic attack directed against a civilian population. The restrictions affecting women in Afghanistan²¹ are nationwide in scope and intersect across multiple domains, including education, employment and freedom of movement.

Reporting indicates that a significant majority of Afghan women are currently excluded from education or employment.²² The prohibition on female medical training and the imposition of guardian requirements are not isolated incidents but form part of a broader pattern of gender-based exclusion.

These measures have been articulated through official decrees²³ and public statements by authorities and are implemented across multiple sectors, indicating that they operate as a matter of state policy²⁴ rather than isolated or localised practice.

The cumulative and coordinated nature of these measures may satisfy the requirement that persecution be committed as part of a systematic attack directed against a civilian population.

Conclusion

The denial of healthcare access to women in Afghanistan results from intersecting policies that restrict education, professional participation and independent access to medical services. Where women are prevented from training as healthcare providers while simultaneously facing barriers to receiving treatment, the practical consequence may be the elimination of meaningful access to care.

Whether these measures ultimately meet the evidentiary threshold for establishing criminal responsibility would depend on further factual development, including documentation of enforcement patterns and proof of intent. However, the cumulative restrictions on women’s access to healthcare, implemented nationwide and directed explicitly at a protected group, warrant careful scrutiny under Article 7(1)(h) of the Rome Statute.

The situation demonstrates how severe deprivation of fundamental rights may arise not only from direct physical violence but also from structured regulatory measures that systematically exclude a civilian population from essential services.

Notes

1     UN Women, ‘Gender Index 2024: Afghanistan’ (2025), available at: www.unwomen.org/en/digital-library/publications/2025/06/afghanistan-gender-index-2024. Accessed 8 June 2026.

2     UN Women, ‘State of Women’s Rights in Afghanistan’ (11 August 2025) available at: www.unwomen.org/en/articles/in-focus/afghanistan.  Accessed 8 June 2026.

3     UN News, ‘Afghanistan: UN Condemns Taliban Ban on Women Attending Medical Classes’ (5 December 2024), available at: https://news.un.org/en/story/2024/12/1157866.  Accessed 8 June 2026.

4     UN Women, ‘FAQs: Afghan women three years after the Taliban takeover’ (20 August 2024. available at: https://eca.unwomen.org/en/stories/explainer/2024/08/faqs-afghan-women-three-years-after-the-taliban-takeover-0. Accessed 8 June 2026.

5     See n 2 above.

6     AMU, 'Taliban Minister Says Male Doctors Are “Mahram” to Female Patients ‘ (18 February 2026). Available at: https://eca.unwomen.org/en/stories/explainer/2024/08/faqs-afghan-women-three-years-after-the-taliban-takeover-0. Accessed 8 June 2026.

7     International Criminal Court, ‘Rome Statute of the International Criminal Court’ (2021), available at: www.icc-cpi.int/sites/default/files/2024-05/Rome-Statute-eng.pdf.  Accessed 8 June 2026.

8     World Health Organization, ‘Reducing Maternal, Neonatal and Child Deaths in Afghanistan’, at: www.emro.who.int/afg/afghanistan-news/action-plan-reduction-mortality.html#:~:text=Afghanistan%20has%20some%20of%20the%20highest%20maternal,Health%20plan**%20*%20**Every%20Newborn%20Action%20Plan.  Accessed 8 June 2026.

9     UNICEF, Health: ‘Ending Preventable Maternal, Newborn and Child Deaths’, available at: www.unicef.org/afghanistan/health. Accessed 8 June 2026.

10   Public Seminar, ‘The Taliban’s Systematic Erasure of Women Is Crippling Afghan Society’ (7 April 2025), available at: https://publicseminar.org/2025/04/taliban-erasure-of-afghan-women/#:~:text=After%20the%20Taliban%20banned%20girls,company%20of%20a%20male%20chaperone. Accessed 8 June 2026.

11   See n 1 above.

12   See n 2 above.

13   See n 1 above.

14   Ibid.

15   Doctors Without Borders, ‘Excluding Afghan Women From Medical Institutes Threatens the Future of Health Care in the Country’ (6 December 2024): www.doctorswithoutborders.org/latest/excluding-afghan-women-medical-institutes-threatens-future-health-care-country#:~:text=%E2%80%9CThere%20is%20no%20health%20care,impartial%20provision%20of%20health%20care.%E2%80%9D.  Accessed 8 June 2026.

16   See n 4 above.

17   See n 2 above.

18   International Crisis Group, ‘Taliban Restrictions on Women’s Rights Deepen Afghanistan’s Crisis’ at: www.crisisgroup.org/rpt/asia/south-asia/afghanistan/329-taliban-restrictions-womens-rights-deepen-afghanistans-crisis. Accessed 8 June 2026.

19   United States Commission on International Religious Freedom, ‘Issue Update: Religious Freedom and Women’s Rights in Afghanistan’ (August 2023), available at: www.uscirf.gov/sites/default/files/2023%20Religious%20Freedom%20and%20Womens%20Rights%20in%20Afghanistan%20Issue%20Update_Final.pdf. Accessed 8 June 2026.

20   Human Rights Watch, ‘Religious Freedom in Afghanistan: Three Years After the Taliban Takeover – Testimony to the US Commission on International Religious Freedom (19 March 2025), available at: www.hrw.org/news/2025/03/20/religious-freedom-afghanistan-three-years-after-taliban-takeover. Accessed 8 June 2026.

21   European Union/UN Women, ‘Gender Index – Afghanistan’ available at: www.unwomen.org/sites/default/files/2025-06/gender-index-2024-afghanistan-en.pdf. Accessed 8 June 2026.

22   AMU, ‘UN Warns Situation for Women, Girls in Afghanistan Increasingly “Untenable”’ (12 August 2025): https://amu.tv/192020. Accessed 8 June 2026.

23   UN, Report on the Implementation, Enforcement and Impact of the Law on the Propagation of Virtue and Prevention of Vice in Afghanistan (April 2025), available at: https://unama.unmissions.org/sites/default/files/unama_pvpv_report_10_april_2025_english.pdf. Accessed 8 June 2026.

24   Human Rights Council, Study on the so-called ‘Law on the Promotion of Virtue and the Prevention of Vice’, (24 February–4 April 2025), available at: www.ohchr.org/sites/default/files/2025-02/a-hrc-58-74-pvpv-study.pdf. Accessed 8 June 2026.