Treaties, States Parties and Commentaries
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Commentary of 2016 
Article 43 : Marking of units of neutral countries
Text of the provision*
(1) The medical units belonging to neutral countries, which may have been authorized to lend their services to a belligerent under the conditions laid down in Article 27, shall fly, along with the flag of the Convention, the national flag of that belligerent, wherever the latter makes use of the faculty conferred on him by Article 42.
(2) Subject to orders to the contrary by the responsible military authorities, they may, on all occasions, fly their national flag, even if they fall into the hands of the adverse Party.
* Paragraph numbers have been added for ease of reference.
Reservations or declarations
None
Contents

A. Introduction
2654  Article 43 governs the marking of medical units of National Red Cross and Red Crescent Societies or other voluntary aid societies of neutral countries that have been authorized to lend their services to a Party to the conflict according to the conditions laid down in Article 27 of the First Convention.[1] This type of arrangement has not occurred since the end of the Second World War but nevertheless remains an option.[2]
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B. Paragraph 1: The flag of the belligerent and the flag of the Convention
2655  Article 43(1) states that medical units of neutral countries shall fly, along with the flag of the Convention, the national flag of the belligerent to which they lend their services if the belligerent commander has decided that medical units shall do so (which, under Article 42, is not compulsory).[3] This means that the medical unit of a National Society or other voluntary aid society of a neutral country would fly the flag of the belligerent Party to which it lends its services.
2656  Such units may also display the protective emblem, referred to in the present article as the ‘flag of the Convention’, be it the red cross, the red crescent, or the red crystal.[4] The word ‘flag’ should be interpreted broadly.[5]
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C. Paragraph 2: The flag of the neutral country
2657  The right of the medical units of a neutral country to fly their national flag, in addition to those of the Convention and of the belligerent to which they lend their services, was introduced in 1929.[6] At that time, there were misgivings about the wisdom of allowing the medical unit of a National Society to fly its national flag in such circumstances.[7] In the absence of recent practice, however, it is difficult to assess the likely effects of the display of such flags.
2658  Under the 1949 text, a medical unit of a neutral country may fly its national flag even after it falls into enemy hands. This situation thus differs from that of military medical units, which under Article 42(3) may no longer fly their national flags but only the flag of the Convention after they have fallen into enemy hands.
2659  The option for medical units of a neutral country to continue to fly their national flag, however, is made ‘[s]ubject to orders to the contrary by the responsible military authorities’. This does not mean that the belligerent can decide generally whether or not medical units of neutral countries may or may not fly their national flags.[8] Rather, ordering them not to fly the national flag is restricted to particular cases and for a limited period only, when there are tactical reasons for not displaying the national flag, such as the need to conceal medical units in forward areas. This interpretation flows from a logical reading of the article. With any other interpretation, use of the phrases ‘subject to orders to the contrary’ and ‘they may, on all occasions’ in the same sentence would appear contradictory and the paragraph would have no real meaning.

1 - For a discussion of the requirements for such authorization, see the commentary on Article 27, sections C and D.
2 - See the commentary on Article 27, section B. See also François Bugnion, The International Committee of the Red Cross and the Protection of War Victims, ICRC/Macmillan, Oxford, 2003, p. 517.
3 - See the commentary on Article 42, para. 2636.
4 - Technically, the reference to ‘the flag of the Convention’ in Article 43(1) also includes the red lion and sun as one of the distinctive emblems recognized under Article 38(2) of the First Convention. This symbol, which has only ever been used by one State Party, is no longer in use. See also the commentary on Article 2(4) of Additional Protocol III. With regard to measures to enhance the visibility of the protective emblem, see also Additional Protocol I, Annex I, Regulations concerning identification (as amended on 30 November 1993), and its commentary.
5 - See the commentary on Article 42, section C.
6 - Geneva Convention on the Wounded and Sick (1929), Article 23.
7 - See, in particular, the concerns listed by Des Gouttes, Commentaire de la Convention de Genève de 1929 sur les blessés et malades, ICRC, 1930, pp. 171–172. Among other things, Des Gouttes was particularly concerned that by flying its national flag in these circumstances, a National Society would give the false impression that the State to which it belonged had entered the war. In 1952, however, Pictet wrote that those objections ‘for reasons of principle’ were ‘not convincing’ (Commentary on the First Geneva Convention, ICRC, 1952, p. 323).
8 - See the commentary on Article 42, section D.