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‘’The clock is ticking fast towards famine… [in Gaza]’’[i]

We are appalled.

As organisations that have historically worked on issues of health justice and access to medicines for millions of people around the world, for decades, focusing on HIV/AIDS, TB, cancer, and COVID, we share the urgent concern and outrage of aid organizations (NGOs) that the sudden decision by global north donor countries, including Canada, Australia, UK, Germany, Italy, the Netherlands, Switzerland, Finland, Estonia, Japan, Austria, and Romania, to suspend funding for the United Nations Relief and Works Agency (UNRWA) ‘’comes amid a rapidly worsening humanitarian catastrophe in Gaza’’.

UNRWA is the main aid provider for millions of Palestinians in Gaza and the region. This decision represents an act of collective punishment targeting Palestinian civilians and will certainly lead to even more death and suffering.

The defunding decision represents a new level of depravity in the approach of several global north countries in the face of evidence of repeated war crimes, and worse, comes just days after the International Court of Justice (ICJ) ruled on 26 January 2024 that it is plausible to claim that Israel is committing genocide in Gaza (among others). That interim ruling should have caused member states to assess and remedy their potential complicity in genocide. Instead, by defunding UNRWA, these countries have exacerbated their complicity.

In taking the decision to pause funding to UNRWA at this CRITICAL time when a real risk of hunger, disease, starvation, and famine looms in Gaza, these countries and donors are enabling a worsening humanitarian disaster and a genocide that cruelly depends on aid deprivation. They are not standing on the right side of history or for humanity – and their double standards must now be called out by more of us in the global health community – they are not acting in our name!

There are legitimate alternatives to pausing UNRWA funding. We note how multiple donors including Norway, Ireland, Spain, New Zealand have stated that they will maintain their contributions while UNRWA undertakes a formal investigation of the allegations against it.

Countries which have failed to implement alternatives should be prepared to be held accountable for their complicity in what risks being the total destruction of the aid and health system in Gaza, and the ethnic cleansing it is precipitating.

While we hope that this defunding conduct will be reported to the ICJ we also call on:

  • All governments to immediately resume and increase funding for the critical work of UNRWA, to uphold their duties towards the Palestinian people and scale up humanitarian assistance for civilians in dire need in Gaza and the region;
  • Patient advocacy groups to write to their respective ministers, parliaments, representatives, and lawmakers to demand funding reinstatement –to help avert an even greater humanitarian crisis;
  • The global health community to make donations, however small or big, for the work of UNRWA. Donation details can be found here:

Issued by: (for queries please use:

  1. Health Justice Initiative -South Africa
  2. Peoples Health Movement -South Africa
  3. Global Justice Now -UK
  4. African Alliance -Africa
  5. Just Treatment -UK
  6. Health GAP -USA
  7. Treatment Action Campaign (TAC) -South Africa
  8. ABIA (BrazilianInterdisciplinary AIDS Association) 
  9. Initiative for Medicines, Access & Knowledge (I-MAK) -USA
  10. ITPC Global
  11. SECTION 27–South Africa
  12. Treatment Action Group (TAG) -USA

Notes for editors:

  1. According to the UNRWA’s website, ‘’the right of return for refugees’’ is enshrined in UN General Assembly Resolution 194, and UNRWA was established to provide assistance and protection to Palestinian refugees pending the implementation of that resolution, consistently reaffirmed by the General Assembly since 1948.
  2. MSF Statement UNRWA:
  3. Joint aid organisations Statement UNRWA:
  4. The United Nations (UN) has reported and the ICJ has accepted that at least 25 700 Palestinians have been killed, 63 000 injured, over 360 000 housing units destroyed or rendered unliveable, and 1.7 million people internally displaced as of 24 January 2024.[ii]
  5. On 12 January 2024, the UN Under-Secretary-General for Humanitarian Affairs reported that ‘’134 UN Relief facilities have been hit by the Israeli army and 148 UN personnel and NGO staff killed by Israeli attacks’’.[iii] (the number killed has since increased to 154)
  6. The health system in Gaza is being obliterated: Of Gaza’s 36 hospitals, a minority are fully functional, 122 ambulances have been seriously damaged, and 20 facilities needed for water provision, sanitation and hygiene are non-functional due to military attacks.
  7. Medical convoys including clearly marked Medecins Sans Frontières (MSF) vehicles and staff[iv] have been attacked, injuring and killing humanitarian workers and their families.
  8. The Committee to Protect Journalists reports that at least 83 journalists have been killed by Israeli forces, at least 25 have been arrested, 16 are missing and many others have been subjected to assaults, threats, cyberattacks, censorship and killing of family members.[v]
  9. The Bureau of Investigative Journalism describes this as an “unprecedented attack on the truth” (foreign media are not generally permitted by Israel to freely report from Gaza).[vi]




Para 46: ‘’The Court notes that the military operation being conducted by Israel following the attack of 7 October 2023 has resulted in a large number of deaths and injuries, as well as the massive destruction of homes, the forcible displacement of the vast majority of the population, and extensive damage to civilian infrastructure. While figures relating to the Gaza Strip cannot be independently verified, recent information indicates that 25,700 Palestinians have been killed, over 63,000 injuries have been reported, over 360,000 housing units have been destroyed or partially damaged and approximately 1.7 million persons have been internally displaced (see United Nations Office for the Coordination of Humanitarian Affairs (OCHA), Hostilities in the Gaza Strip and Israel reported impact, Day 109 (24 Jan. 2024)).’’



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