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The American Public Health Association (APHA) is urging President Biden and Congress to demand an "immediate ceasefire" in the Israel-Hamas conflict.

During the APHA's on Tuesday, its Governing Council adopted the following policy statement proposed by the Palestine Health Justice Working Group in a vote of 158-18:

"In light of the continuing escalating of civilian casualties in Gaza and Israel and the collapse of the healthcare infrastructure in Gaza, APHA calls upon President Biden and Congress to urgently demand an immediate ceasefire and to call for de-escalation of the current conflict by securing the immediate release of hostages and those detained; the restoration of water, fuel, electricity and other basic services; and the passage of adequate humanitarian aid to the Gaza Strip."

Renee Odom, MPH, a member of the Palestine Health Justice Working Group, noted in an email to 番茄社区app that several health and humanitarian organizations including , the , and the , have already made similar statements.

"This is not a fringe view for public health globally," Odom said.

Yara Asi, PhD, a member of the APHA's International Health Section and co-chair of the Palestine Health Justice Working Group, said a contingent of APHA members have been calling on the association to "condemn the violence and occupation of the Gaza Strip and the West Bank" for several years.

"But this year ... as we saw many other medical and health institutions either say nothing, or put out kind of obscuring, equivocating statements that were depoliticized [and] de-contextualized, we just felt that the American Public Health Association ... should make the obvious stand for a ceasefire to end this unbearable violence and destruction," Asi said.

"It wasn't just about the humanitarian crisis as a whole -- as important as that is -- but as a public health association, we wanted to show support and solidarity specifically with the health workers working there," she added.

On Saturday, the American Medical Association, at the interim meeting of its House of Delegates, declined to debate a similar resolution in a vote of 136-458; however, a statement on this issue could still be presented at a future meeting.

Rachel Rubin, MD, MPH, a governing councilor for the APHA, said the policy was introduced as a "late breaker" resolution to the meeting, where it was discussed in public hearings and debated on the floor of the Governing Council for roughly 2 hours.

What began as an 11-page resolution was whittled down to a one-sentence policy statement because the longer statement included language around the history and context of the region that Asi said "proved contentious."

Linda Landesman, DrPH, MSW, a governing councilor from the Health Administration Section of the APHA, characterized the original resolution as "inflammatory."

"It was a policy of rhetoric, fear, and hate," she said.

Ultimately, Rubin said the council landed on compromised language that "calls for a ceasefire, a release of hostages, and allowing aid to go into Gaza that includes food, water, fuel ... and other life-sustaining aid."

That "friendly substitution" passed with support from roughly 90% of the Governing Council, Rubin said.

Asi said the working group is "relieved" that a version of its resolution was adopted. While the group would have liked the original to pass, "at the end of the day, the headline is the same, which is that APHA calls for a ceasefire and immediate distribution of needed humanitarian aid."

Landesman's assessment of the vote was more tempered.

"I would say that everybody wanted a resolution that was not going to damage the association. And this was a resolution that would not damage the association," she said. "I do not know if people signed it because they wanted an immediate ceasefire," or to end the "acrimony" of the debate.

APHA's Executive Director Georges Benjamin, MD, confirmed that the resolution had been through an "exhaustive-evidenced based policy process," and is now "official association policy."

"Clearly, what Hamas did was horrible, and unacceptable, and inhumane. And we believe Israel and the Israelis have a right to defend themselves. Having said that, war is a tragedy, and we work very hard to avoid it at all costs ... Innocent people who have nothing to do with the conflict ... are severely and unexpectedly impacted by war," he told 番茄社区app in a phone call.

"The number of people dying ... from both the clear direct impacts of war, bombs, bullets ... and all the indirect things that harm people are absolutely terrible," Benjamin continued. "And so we're hoping and demanding that the elected leaders on literally all sides of this war, and its supporters, find a peaceful resolution, and we're encouraging them to do it yesterday."

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