• John Haltiwanger

August 8, 2025, 4:59 PM View Comments ()

The humanitarian situation in Gaza has been dire throughout Israel’s 22-month war against Hamas, but the crisis has reached new heights in recent months amid ongoing Israeli restrictions on aid. The world’s leading global hunger monitor warned last week that the “worst-case scenario of famine” is playing out in Gaza, and the World Food Program (WFP) recently said that 1 in 3 people in the enclave are going multiple days in a row without anything to eat.

Caroline Willemen, a project coordinator at the Doctors Without Borders (Medecins Sans Frontieres, or MSF) clinic in Gaza City, painted a grim picture of what she’s witnessed in the Palestinian territory since arriving roughly six weeks ago.

“It’s completely dystopian,” Willemen told Foreign Policy. “I’ve been doing this work for nine years. I’ve never in my life seen a scale of destruction and desperation like what I’ve seen here.”

Israel has faced rising global condemnation as Gazans, including children, die from malnutrition amid near-daily reports of fatal incidents involving Israeli forces opening fire on desperate Palestinians seeking aid. These deadly shootings have been linked to a controversial aid system run by the Gaza Humanitarian Foundation (GHF), a recently formed organization backed by the United States and Israel.

“What we are witnessing is a genocide. Hunger is part of that,” Willemen said, describing the situation as “apocalyptic” and “engineered chaos.”

“We don’t use the word ‘genocide’ lightly at all, but here we use it because of what we see—people being starved on purpose, being people being shot at when they look for food, people being deprived of sufficient water,” she added. Israel maintains that there’s no policy of starvation in Gaza, though the hunger crisis comes at a time when far-right Israeli cabinet ministers are openly calling for depopulating and resettling the Palestinian territory.

Amid the mounting international criticism over the crisis, including from some of its closest allies, Israel recently said it would take steps to allow more aid into Gaza. But the United Nations and other humanitarian groups are raising alarm bells that what’s coming in is still not nearly enough while warning that the airdrops that Israel has recently permitted are ineffective, costly, and dangerous. Palestinians in Gaza have been injured or killed by airdrops at various points in the war.

“When there is an airdrop, my colleagues at the field hospital get their emergency room ready to receive patients,” Willemen said.

Meanwhile, there is a lot of disinformation swirling around the hunger crisis as well as competing claims about who or what is to blame. Gaining a clear picture of the conditions on the ground can also be difficult—particularly given that, with rare exceptions, Israel has barred foreign media from reporting in Gaza over the course of the war.

To break through the noise, it’s helpful to examine what we know—and don’t know—about the humanitarian crisis in Gaza right now based on the available information.

Are people starving in Gaza?

Many of Israel’s claims about the humanitarian situation, such as Prime Minister Benjamin Netanyahu’s recent assertion that there is “no starvation in Gaza,” are contradicted by data and other evidence.

The World Health Organization said this week that roughly 12,000 children under the age of 5 are suffering from acute malnutrition. Nearly a quarter of Gaza’s population—approximately half a million people—are facing famine, according to the WFP. The Gaza Health Ministry said on Thursday that 197 Palestinians, including 96 children, have died from malnutrition since the war began.

The prices of basic goods in Gaza have also increased exponentially. Sugar, for example, reportedly now costs $106 per kilogram (2.2 pounds) on average as of late July. By comparison, it was just 89 cents before the war.

It’s not possible to fully verify all of the numbers coming out of Gaza at present. But even the Trump administration, which continues to be supportive of Israel more broadly, has disputed  Netanyahu’s claims.

“You’ve got little kids who are clearly starving to death,” U.S. Vice President J.D. Vance recently said to reporters.

Accounts from aid workers on the ground also undermine Israel’s efforts to downplay the extent of the problem. More and more patients are entering the malnutrition program at MSF’s Gaza City clinic, Willemen said, but none are exiting it. “We can hardly discharge anyone because they’re simply not eating enough to be able to be considered cured of their malnutrition,” she said.

The hunger crisis has gotten “significantly worse” in the past six weeks, Willemen said, adding that MSF now has five times more patients in its malnutrition program—including children under 5 as well as pregnant and lactating women—than it did in May.

The lack of food has also exacerbated the problems surrounding Gaza’s health system, and experts have emphasized the need for more intensive care supplies.

Many of the patients seen in MSF’s Gaza City clinic with wounds such as burns or orthopedic injuries are unable to heal because of the lack of food. “They’re not eating properly, and so their bodies can’t heal themselves,” Willemen said.

Though there is widespread agreement among humanitarian workers and experts that Gaza should be flooded with food, they also warn that conditions have deteriorated to a point where this won’t be enough.

In more severe cases of malnutrition, Willemen said that food alone can’t solve the problem.

“They need highly specialized medical care,” she said, because the vast majority of them are children, and their bodies “can’t take in the food anymore.” But flooding Gaza with more food supplies is still vital “because it could stop more people from reaching that stage,” she added.

How did the situation get this bad?

Even before the war, Israel’s yearslong blockade on Gaza made life difficult for Palestinians, and food insecurity was already a problem. Restrictions on goods and services into Gaza rose dramatically after the Hamas-led attack on Israel on Oct. 7, 2023, with then-Israeli Defense Minister Yoav Gallant ordering “a complete siege on Gaza” on Oct. 9.

“There will be no electricity, no food, no water, no fuel. Everything is closed,” he said.

Throughout the war, Israel has consistently faced pressure from the international community to allow more aid into the enclave; in January 2024, for instance, the International Court of Justice ordered Israel to “take immediate and effective measures to enable the provision of urgently needed basic services and humanitarian assistance.” And in March of that year, the court ordered Israel to take additional measures “to address famine and starvation” in Gaza, including working with the United Nations and opening additional land crossings into the enclave.

Israel responded by allowing in additional aid, but observers maintained that it was not nearly enough to address the situation. And then, after a cease-fire collapsed in March of this year, Israel again imposed an 11-week blockade on all aid into Gaza. This exacerbated the already challenging humanitarian situation and is directly tied to the current crisis. Israel lifted the blockade in May, but aid has still been slow to make its way into the territory. (More on that below.)

Experts also contend that the steps that Israel has taken to upend the humanitarian system that’s operated in Gaza for years, which are linked to the country’s contentious dynamic with the United Nations, have worsened the situation.

“The U.N. and so many other aid organizations have been doing humanitarian relief work in the [Gaza] Strip for a long time. They know how to operate in these situations. They have experienced staff, and that’s just been wiped out by all of this,” Rebecca Wolfe, a conflict and humanitarian response expert at the University of Chicago, told Foreign Policy. Israel’s sidelining of the U.N. means that “the actual knowledge about how to do it right” is not being put to good use, Wolfe said.

In January, Israel imposed a ban on the U.N. Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), which has long been the primary U.N. aid agency for Palestinians. UNRWA is now prohibited from operating on Israeli soil, and Israeli authorities are barred from cooperating with the agency. Israel has accused UNRWA of being “infiltrated by Hamas” and alleged that employees of the agency were involved in the Oct. 7 attack. A U.N. investigation found that nine staffers (out of roughly 30,000 total employees)“may have” had ties to Hamas, and those employees were dismissed.

But UNRWA has vehemently rejected the notion that it’s an arm of Hamas, and the agency continues to urge Israel to resume cooperation with it. A number of countries that stopped providing funds for UNRWA after Israel initially made the allegations of ties to Hamas have since reversed course. (The United States is not among them.) And Western governments, including France, the United Kingdom, and Germany, have expressed serious concerns over Israel’s UNRWA ban.

“The manmade famine in #Gaza has been largely shaped by the deliberate attempts to replace the UN coordinated humanitarian system through the politically motivated ‘GHF,’” UNRWA chief Philippe Lazzarini said in a recent post on X, adding that UNRWA has now been prevented from bringing aid into Gaza for five months. Lazzarini said Israel’s “weakening” of UNRWA is part of a “deliberate measure to collectively pressure & punish Palestinians for living in Gaza.”

What is the GHF? 

The U.N. and other humanitarian organizations—such as MSF, Mercy Corps, and the International Rescue Committee—all remain active in Gaza. But their operations are far more restricted and limited than in the past, and the previous U.N. humanitarian system—which featured hundreds of aid sites—is no longer in place.

Since Israel ended its total blockade on aid in May, aid distribution in Gaza has primarily run through GHF—a U.S.-funded organization with a hazy background. GHF’s executive director is Rev. Johnnie Moore, an evangelical Christian leader with close ties to U.S. President Donald Trump. The U.N. and other humanitarian organizations have boycotted GHF—which is working with armed security contractors and coordinating with the Israeli military—over concerns about neutrality and humanitarian principles.

The aid system under GHF has been marred by violence and chaos from the start. Hordes of desperate Gazans have repeatedly flooded the group’s few aid sites, making it difficult for them to receive proper assistance.

Hundreds of Palestinians have been killed, primarily by the Israeli military, in the vicinity of GHF sites, according to the U.N. Israel has repeatedly said that its forces fired “warning shots” at Palestinians heading to the aid sites. But Israel Defense Forces (IDF) officers and soldiers told Haaretz that they’ve been ordered to fire at unarmed crowds near aid distribution sites, even in instances when they did not pose a clear threat. And in a recent report, Human Rights Watch accused Israel of committing war crimes at GHF sites.

A retired U.S. special forces officer who worked with the GHF in Gaza, Anthony Aguilar, has also said that he witnessed IDF and U.S. personnel fire at unarmed civilians near aid sites in Gaza. Aguilar said what he witnessed constituted “war crimes.” GHF rejected Aguilar’s allegations and has referred to him as “a disgruntled former contractor who was terminated for misconduct.” Aguilar denied this.

Part of the problem with the new system, experts say, is that the GHF system operates out of just four sites in militarized areas near Israeli troops. Experts say that this is unnecessarily dangerous and a recipe for disaster.

“Generally, in a war zone, you don’t want people traveling far. That just makes it much more dangerous for them,” Wolfe said. “The more time people spend on the road, the more at risk they are.” Wolfe also highlighted that it’s unusual to have a military force operating so close to aid distribution sites, which goes against humanitarian principles.

“It’s a chaotic environment,” Wolfe said, adding that there are no reasons to “have guns there” because it “creates a flash point that is unnecessary when people are starving.”

People have also been crushed to death in stampedes at GHF sites, which critics have decried as death traps.

Experts have emphasized that many of the problems surrounding GHF—and the chaotic scenes at its distribution sites—are linked to a lack of experience in coordinating assistance in a conflict zone.

“This is why we’ve been advocating that this should be coordinated by the U.N., like we do everywhere else in the world,” Willemen said.

In a statement to Foreign Policy, GHF conceded that “it can be chaotic” at its aid sites due to “widespread food insecurity.” But GHF maintained that there has been “no violence” within its distribution sites and pushed back on the notion that it lacks expertise.

“GHF consists of a robust team of career humanitarians on the ground in Gaza who are working hand-in-hand with local Palestinian aid workers to deliver on our mission of feeding people. These include former USAID [U.S. Agency for International Development] and United Nations (UN) personnel who helped develop GHF’s humanitarian distribution model,” the GHF statement read.

GHF said it’s delivered more than 110 million free meals to Palestinians and called for the U.N. and other humanitarian organizations to begin working with it to “scale even more aid across Gaza.”

In late July, a group of Senate Democrats called on the Trump administration to stop funding GHF and “resume support for the existing UN-led aid coordination mechanisms.” MSF and U.N. experts have also called for GHF to be shut down. In a scathing report released this week based on medical data, patient testimonies, and accounts from witnesses at two Gaza clinics, MSF referred to GHF’s distribution hubs as sites of “orchestrated killing.”

When asked about the report, GHF said that MSF’s allegations are “false and disgraceful,” accusing the organization of “aiding Hamas” with its claims. The Israeli Defense Ministry did not respond to a request for comment.

What other factors are preventing aid from getting to Gazans?

The Israeli government has repeatedly made the case that the GHF-run system is necessary because Hamas steals aid, but it has not provided evidence that this is happening on a widespread scale. Israeli military officials have also pushed back on the assertion, and a USAID analysis completed in late June found no evidence of large-scale aid theft by Hamas.

The pandemonium surrounding GHF’s system has also raised questions about how it could verify who is receiving aid and avoid the problem that Israel has cited to justify backing the controversial group. The verification process under the United Nations is far more robust. U.S. Ambassador to Israel Mike Huckabee, who visited a GHF site in Gaza last week, acknowledged in a recent interview that GHF “can’t absolutely guarantee” it’s not giving out aid to Hamas.

There is also clear evidence of U.N. aid trucks routinely being looted, including by criminal gangs. But a lot of the looting appears to be a product of sheer desperation.

Willemen said that her clinic has treated patients who’ve been among the “hungry individuals” who’ve been wounded as they stopped aid trucks near the Zikim border crossing. Last week, she spoke with a 22-year-old man who was desperate to get food for his family and suffered a “horrendous” leg injury when he was hit by an aid truck. The man told Willemen that seven young men he was with were run over by the truck and killed.

“The truck drivers get forced by the Israeli forces to continue driving,” she said.

Critics of Israel’s handling of the humanitarian crisis have said that significantly ramping up aid deliveries into Gaza and allowing more access for distribution would help address the looting problems by decreasing desperation.

As the humanitarian crisis in Gaza worsens, Israel has also accused the U.N. of allowing huge amounts of aid to rot.

A U.N. official who spoke to Foreign Policy on the condition of anonymity over concerns for the safety of their colleagues said that the organization is not deliberately allowing aid to fester, emphasizing that delivering assistance has become increasingly complicated and difficult due to an array of factors—including the Israeli military often rejecting requests for access to delivery routes.

“We are as frustrated as anyone,” the official said. “If aid is sitting at a gate somewhere outside of Gaza, there isn’t anything that the U.N. hasn’t done to get it inside. Once it’s inside, there are really bad days, there are bad days, and there are no good days. It’s not easy anymore.”

After cease-fire talks with Hamas collapsed once again, there are also growing concerns about the potential for conditions to get even worse—including for the living hostages still held by the militant group—now that Israel has announced that it will move to take over Gaza City and Netanyahu has expressed a desire to occupy all of Gaza.

“I literally cannot fathom what that will mean here, because we cannot imagine how it can deteriorate even further,” Willemen said.

Palestinians in Gaza generally cannot leave due to restrictions imposed by both Israel and Egypt. Israel controls almost all entry points into the enclave. Roughly 85 percent of Gaza is either occupied by Israeli forces or under evacuation orders. Groups such as MSF have been operating in the remaining 15 percent of Gaza, in so-called “safe zones.”

“If the 15 percent gets even smaller, at some point, there will be hardly any space left for us to work, let alone for the 2 million people of Gaza to live,” Willemen said.