One year into the conflict, the risk of Famine persists across the whole Gaza Strip. Given the recent surge in hostilities, there are growing concerns that this worst-case scenario may materialize.

Violence has displaced nearly 2 million people, decimated livelihoods, crippled food systems, destroyed 70 percent of crop fields, severely restricted humanitarian operations and resulted in the collapse of health services and Water, Sanitation and Hygiene (WASH) systems. Catastrophic acute food insecurity and concerning acute malnutrition levels will continue to prevail if the conflict continues, and humanitarian activities are restricted. 

Between September and October 2024, the whole territory is classified in IPC Phase 4 (Emergency). About 1.84 million people across the Gaza Strip are experiencing high levels of acute food insecurity classified in IPC Phase 3 (Crisis) or above, including nearly 133,000 people facing catastrophic food insecurity (IPC Phase 5) and 664,000, in IPC Phase 4 (Emergency). Acute Malnutrition is at serious levels (IPC AMN Phase 3), ten times higher than before the escalation of the hostilities.  

Nearly the entire population has been displaced multiple times, often under continued shelling and aerial bombardments. Many households, especially the most vulnerable,  are unable to relocate or find safe shelter. The majority are living in temporary makeshift camps with an alarming density of almost 40,000 people per square kilometer. The evacuation orders and the military offensive, which further intensified in the past weeks have significantly disrupted humanitarian operations, and repeated displacements have steadily worn-down people’s ability to cope and access food, water and medicine, deepening the vulnerability of entire communities.  

A temporary surge of humanitarian assistance and commercial supply between May and August 2024 partly alleviated acute food insecurity and malnutrition conditions. However, September saw the lowest volume of commercial and humanitarian supplies entering Gaza since March 2024. This sharp decline will profoundly limit food availability and the ability of families to feed themselves and access services in the next few months. The upcoming winter season is expected to bring colder temperatures along with rain and potential flooding. Seasonal diseases and increasingly limited access to water and health services are likely to worsen acute malnutrition, especially in densely populated areas, where the risk of epidemics is already high. 

The population classified in IPC Phase 5 (Catastrophe) is expected to nearly triple in the coming months. Between November 2024 and April 2025, almost 2 million people, more than 90 percent of the population, are classified in IPC Phase 3 (Crisis) or above, of which 345,000 people (16 percent) are in Catastrophe (IPC Phase 5), and 876,000 people (41 percent) in Emergency (IPC Phase 4). Although less populated, Rafah and the northern governorates will likely face more severe acute food insecurity. 

Only by ensuring widespread access to adequate food, medical supplies, water, and basic services across the Gaza Strip can the risk of a rapid descent into famine be contained.

• Cessation of Hostilities: Call for an immediate, unconditional and sustained  ceasefire. 

• Humanitarian Access: Allow for humanitarian access for the provision of lifesaving, multi-sectoral assistance. Address the high severity and magnitude of acute food insecurity and acute malnutrition by allowing assistance in sufficient quality and in a sustained manner, ensuring safe movement within the Gaza Strip. It is essential to have unimpeded and safe entry of sufficient humanitarian supplies, ensuring that supply chain barriers, including security on the supply routes within the strip and storage capacities are minimized. Assistance needed is not only limited to household food assistance, but also the restoration of health services, WASH, and non-food items. Additionally, ensuring the safety and protection of humanitarian aid workers, health facilities, and shelters is crucial. Civilians must also be safeguarded with unobstructed access to essential humanitarian assistance.

• Protection and Rehabilitation of Food Systems: Protect remaining infrastructure, rehabilitate local food production, restore market system and essential services (telecommunication, electricity, financial services, etc.). Advocate for the protection of remaining productive assets and infrastructure such as markets, shops, roads, farmland, poultry farms in order to protect livelihoods and rehabilitate local markets and food systems. Allow safe access to agriculture land, horticultural greenhouses, and sea for fishing. Provide inputs and equipment such as seeds, animal feed, tools and services like basic veterinary services. Restore the function of remaining markets and bakeries, encouraging access for the delivery of commercial goods. This should be combined with cash-based interventions where feasible, in order to help strengthen cash liquidity and cash transfers.

• Prevention and Management of Acute Malnutrition: Provide acute malnutrition prevention services and treatment. Scale up the prevention of acute malnutrition by improving coverage of blanket supplementary feeding programme and infant and young child feeding programmes, including promotion of breastfeeding practices and care for non-breastfed infants. In addition, increase coverage and access to health and wash services across Gaza strip, as prevention of outbreaks of communicable diseases. Sustain efforts in inpatient and outpatient management of acute malnutrition, including monitoring of site performance and better referral between the different level of care.  Strengthen the nutrition information system to detect early the fluctuations in risk factors for acute malnutrition among vulnerable groups, and inform action to prevent a further deterioration.