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The global public is waiting for the NATO Summit to be held in our capital, Ankara, on 7–8 July.
At the summit, of course, imperialist aggression against Iran and the latest developments in the Russia–Ukraine war will likely be the main issues. But the real key headline is the target of member countries spending 5 percent of their Gross Domestic Product (GDP) on defense.
Except for Spain, all allies have pledged to reach the 5 percent defense spending target by 2035. We had previously written about the burden this would place on countries’ national economies and the possible consequences, especially cuts in social spending. (Source)
However, NATO is, as expected, carrying out its preparations for the so-called ‘big war’—which is now effectively an open secret—through a multi-layered program. The alliance is preparing for the historic summit and the transformation that will take place in the summer through committee and various subcommittee meetings.
Another threshold in this preparation was crossed recently in North Macedonia. This critical development, which did not receive much media coverage, is focused on preparing member states’ health systems as well for the expected ‘big war.’
Who organized the meeting?
The meeting was organized by the NATO Committee of Chiefs of Military Medical Services (COMEDS).
Its origins go back to EUROMED, established in 1970 by the medical services leadership of EUROGROUP, which itself was founded in 1968 for the purpose of logistical coordination among NATO’s European members.
By the 1990s, all EUROGROUP activities except EUROMED were transferred to the Western European Union (WEU)—which would be dissolved in 2011—while EUROMED joined NATO. EUROMED was then institutionalized by the NATO Military Committee in the 1993–1994 period and transformed into today’s COMEDS structure.
Since then, this structure has worked on organizing health services for military personnel, as well as on medical evacuation and related fields. But this structure is also tasked with operating in civilian areas, not only military ones. Epidemics in member countries, natural disasters, emergencies, and the like… In all of these ‘civilian’ events too, this committee is responsible for providing ‘coordination’ on highly sensitive matters such as medical supplies and patient transport.
What was discussed at the meeting?
The meeting, recorded as the NATO COMEDS 65th Plenary Meeting, was held in Skopje, North Macedonia, on 1–4 June.
From the statements made by senior officials speaking at the meeting, it appears that two points were emphasized.
The first of these is accelerating the treatment of the wounded and their return to the front.
In his opening remarks, Belgian Major General Luc Vanbockryck, Director of NATO’s Logistics and Resources Division, said that medical support should be regarded as “a critical capability equivalent to any weapons system.”
Norwegian Brigadier General Petter Iversen, who holds the committee’s chairmanship, also described “a new reality” and stated:
“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.”
In other words, NATO sees its wounded soldiers not merely as patients, but as resources that need to be “repaired” as quickly as possible. This stance is also an indication that NATO anticipates serious losses in the event of a possible war.
Work on the NATO Medical Action Plan (MAP), which entered into force in January 2025, was also one of the main topics at the meeting. Due to the decision on ‘confidentiality,’ the full text of this action plan has not yet been made public, but we can infer the main trends in the plan from meetings of this kind and from the statements of officials.
And this brings us to the second important point:
Civil-military health integration
According to official documents, NATO explicitly describes the MAP through a “Whole-of-government, whole-of-society” approach. In other words, these plans involve not only the military health system, but also the health capacity of the state and society.
We also learn what this integration looks like in practice from NATO documents open to the public.
At NATO’s first joint military-civilian health meeting, held on 7 December 2023, the issues discussed with COMEDS were striking:
National health authorities; mass casualty planning, supply security for blood and blood products and medical countermeasures, patient evacuation and transfer…
The following year, in discussions between COMEDS and NATO’s Joint Health Group, the main topic was again civil-military cooperation.
The most striking aspect of this meeting was NATO’s assessment that “civilian authorities’ civilian health systems need to be able to function for longer in a conflict environment.” In other words, NATO is not aiming to expand the military system in the health field; it is aiming to make civilian health capacity directly resilient to war conditions.
The guidelines contained in the alliance’s health manuals point exactly to the place we are highlighting:
Strategic stocks, shared access arrangements in civilian/military medicine, joint disease/health surveillance, communication lines, and more…
What does all this mean?
The best way to understand the effect of all these regulations and proposed regulations on the public is through a kind of written simulation.
Based entirely on NATO documents, let us imagine that NATO, led by the United States, together with member countries, has started a hot war against a “great enemy,” and that our country is also involved in this war with its military power.
In such a scenario, what will happen in the field of medicine can be summarized as follows:
When our country is involved in any total war of NATO, the first break occurs first in the supply chain, transport, and communications; all of these sectors come under intense pressure. In other words, the war moves from the front to the cities very rapidly, and public services are instantly paralyzed.
The expected picture in Turkey in such a war would be, in addition to injuries and deaths, a contraction in access to health services, shortages of medicines and medical supplies, psychological trauma, migration and internal displacement, price increases, disruptions in transport and communication, and the diversion of public resources to the war.
Turkey’s health infrastructure is redesigned at great speed according to the tempo of war, not according to the needs of the public. City hospitals, state hospitals, military hospitals, university hospitals, and private health chains learn whom they will serve and how not according to the country, but according to the alliance and the laws of the war it is in.
From this point on, the matter is no longer merely a question of medical capacity; it becomes directly a question of sovereignty. Because in wartime, health is not just about “saving the wounded,” but about deciding who will be treated, which wounded person will be moved first, which medicine will be given to whom, and which hospital will operate according to military priorities.
For example, in its medical situation assessment prepared at the center in the first moments of war, COMEDS determines in which countries the health system is under strain, in which regions patient transfer is possible, and in which areas civil-military coordination is needed.
According to the plan to be created under the MAP, some allied countries will take on advanced surgery and intensive care capacity, while others will assume the role of evacuation, rehabilitation, blood products, medicine delivery, or logistics hub. So who will distribute these roles? The answer is again in NATO documents: “Lead nations,” that is, leading countries…
The question not answered in NATO documents is this: On what basis will the division of tasks be made? On military power? On political power? On a country’s place within the alliance? Or according to the Atlantic-centered strategic reflexes that give the alliance its true character?
Let us continue with NATO documents… If military medical services are insufficient on their own—which is expected to be the case—COMEDS begins cooperation with civilian health authorities. This cooperation, which NATO explains through seemingly “health-focused” concepts such as supply security and patient referral and transfer, has one more frightening requirement: the use of national and regional stockpiles.
In other words, when NATO deems it necessary, it can, for example, use the blood stock held by civilian health services for military personnel. This is actually a law applicable in every country. But it is much more than a state’s ability to use its own stock within the country for the sake of its own army and its own interests in war.
In short, let us think about health services, which are at the center of human life…
When health services, militarized by officials who consider them equivalent in importance to weapons systems, are quickly transformed from “burden sharing” into “resource sharing” in wartime due to NATO membership, how much of them will reach whom?
And let us imagine a country…
A country that is not among the “upper ranks” of the imperialist-capitalist system, yet is kept within the alliance by governments at any cost; whose economy is extremely fragile; whose public services, especially health, already run sluggishly; but which has a large military/civilian population. In such a scenario, how many years—not years, but months—could it hold on, and which of its “allies” would have the courage to shoulder the burden of rescuing such a wreck?
