Former Philippine President Rodrigo Duterte appeared before the International Criminal Court (ICC) in The Hague on Wednesday, attending a hearing on his crimes-against-humanity case for the first time in more than a year.

The 81-year-old former leader, dressed in a black suit and white shirt, smiled and waved to supporters as he attended the pretrial hearing, which mainly focused on scheduling issues ahead of the formal start of his trial, expected in November.

Duterte is facing charges of murder and attempted murder over his alleged role in dozens of killings linked to his administration's so-called war on drugs. He has denied the allegations.

Duterte was arrested in the Philippines in March 2025 and transferred to The Hague. He initially appeared before the ICC through a video link from the court's detention centre and had not attended another hearing in person until Wednesday.

His lawyers had sought to have the case dismissed on medical grounds. However, ICC judges rejected his request for release and later ruled that he was medically fit to stand trial.

The ICC has been investigating killings linked to anti-drug operations carried out during Duterte's tenure as mayor of Davao and later as president of the Philippines.

Estimates of the number of people killed during his presidential term vary widely. Philippine police put the figure at more than 6,000, while human rights groups have estimated that as many as 30,000 people may have been killed.

Prosecutors allege that police and government-backed hit squads carried out dozens of killings on Duterte's orders, motivated either by financial rewards or fear of becoming targets themselves.

In June, Judge Joanna Korner, who is presiding over the case, told Duterte's lawyers that she expected him to attend the proceedings unless there was a medical reason preventing him from doing so.

His lawyers requested additional medical examinations earlier this week.

Meanwhile, relatives of people killed in the anti-drug crackdown gathered in Manila to watch the hearing together, chanting for justice for the victims.

A small group of protesters also gathered outside the ICC to express support for the proceedings.

The Philippines announced its decision to withdraw from the ICC in 2018, about a month after the court launched a preliminary examination into the alleged killings linked to Duterte's anti-drug campaign.

Last year, ICC judges rejected a bid by Duterte's legal team to have the case dismissed on the grounds that the Philippines had withdrawn from the court. The judges said a country could not use withdrawal from the Rome Statute to shield individuals from accountability for alleged crimes already under consideration by the court.

The ICC has also issued an arrest warrant for Ronald Marapon dela Rosa, who served as Duterte's national police chief, over his alleged connection to the drug-related killings. An attempt to arrest him earlier this year led to a gunfire incident at the Philippine Senate in May, though no one was injured. Dela Rosa subsequently went into hiding and remains at large.

Separately, the Philippine Senate began an impeachment trial in July against Duterte's daughter, Vice President Sara Duterte. She faces allegations including unexplained wealth and publicly threatening the family of President Ferdinand Marcos Jr. She has denied the charges.

If convicted, Sara Duterte could be permanently barred from holding public office.