The Red Cross and Red Crescent movements on Thursday gained an additional emblem that will let Israel join the global relief network to end a decades-old dispute.
"The protocol has just been adopted. Unfortunately it was not possible to adopt the protocol by consensus," a spokesman for the Swiss government told reporters.
Switzerland, the depositary state for the conventions, had been pressing for a consensus, saying it was more in keeping with humanitarian activity.
But it could not overcome differences, particularly between Arab states and other members, surrounding the running of emergency services in the Golan Heights, which Israel seized from Syria in the 1967 Arab-Israeli war.
Signatory states to the 1949 Geneva Conventions, in a rare vote, adopted a new symbol - a diamond-shaped red crystal on a white background - into which the Red Star of David of the Israeli relief agency Magen David Adom (MDA) can be placed.
"The most important thing is the result. Tomorrow, nobody will remember the numbers, the votes. Everybody will have the third protocol and more protection," said Noam Yifrach, president of Israel's MDA relief service.
The Swiss called the conference to approve a new protocol to the conventions to include a third emblem alongside the movement's Red Cross and the Red Crescent symbols.
"Unfortunately, it is the first time in the history of international human rights law that an international convention of this importance has been put to a vote. It is a real pity"
The vote was 98 in favour, 27 against, with 10 abstentions.
"Unfortunately, it is the first time in the history of international human rights law that an international convention of this importance has been put to a vote. It is a real pity," said Syrian ambassador Bashar Ja'afari.
Palestinians given recognition
The way to an accord appeared to have been cleared late last month when the MDA and the Palestinian Red Crescent reached a deal making the Palestinians the internationally recognised emergency service within occupied Palestine.
Muslim states insisted the question of responsibility for the occupied territories had to be resolved before they would consider creating a new emblem custom-made for Israel.
Syria wanted similar treatment for the Golan Heights, which Israel seized along with the occupied territories, and then annexed.
Diplomats said there was no chance of such a pact being hammered out in Geneva - not least because Israel does not regard the Golan to be under occupation.
The decision means Israel will now have an emblem that is recognised internationally - the one condition it could not previously meet for membership of the movement.
But it still needs the movement's various national societies to also approve the step in a conference expected next spring.
The American Red Cross has been withholding $5 million a year in subscriptions to the movement since 2000, the last time an attempt was made - and failed because of the Intifada (Uprising) - to revise the statutes and adopt a new emblem.
For years Muslim states, whose crescent emblem was added to that of the cross as a joint symbol for the movement in 1983, have resisted recognition of the Israeli body's red star.
Syrian Red Crescent President
Abd al-Rahman had objected
However, some improvement in Arab-Israeli relations since Israel's pullout from the Gaza Strip after a 38-year occupation in September had encouraged the Swiss to think that the time had come for another try.
"It will improve protection for those that need it. It is a very good step," said International Committee of the Red Cross (ICRC) president Jakob Kellenberger.