A contentious debate at the World Health Organization’s Executive Board exposed the continued deep divisions between Israel and most other member states over the health situation in Gaza and the occupied Palestinian territory, with delegates trading starkly different assessments of humanitarian conditions, access to aid, and the reliability of WHO reporting.

Saudi Arabia’s delegate, speaking on behalf of Eastern Mediterranean member states, described a catastrophic death toll from the two-year Israel-Hamas conflict, saying, “More than 70,000 killed and more than 170,000 injured. Over 18,000 patients are left with life threatening conditions. 4000 of them children, and they await medical evacuation.”

Israel countered that the reporting on aspects of the Gaza situation was outdated as well as distorted, asserting it had approved the exit of thousands of injured Palestinians for medical treatment but there were insufficient places in countries abroad to receive them. Hungary echoed those concerns, with its delegate stating it did “not consider the report comprehensive, as it does not include statistical data beyond September 2025 and does not meaningfully assess the impact of the ceasefire.”  The US-brokered Israeli Hamas ceasefire entered into force in October 2025. A second phase was announced by the United States in January, which is supposed to lead to the demilitarization of the enclave, a new technocratic governance authority, and ultimately physical reconstruction.  

The EB debate culminated in a failed Israeli proposal to consolidate reporting on health conditions in the occupied Palestinian Territories back into one annual WHO report – instead of two – a situation that evolved since the start of the 7 October 2023 war.  

After a long roster of procedural disputes — including a rejected attempt to hold a secret ballot — the proposed Israeli amendment to cancel the second annual report was defeated, and the Executive Board approved the existing two-reportframework by 26 votes to one with four abstentions.   The mandate is unique among WHO health emergencies, where a dedicated report on Ukraine has been produced since 2022, but otherwise, WHO’s emergencies work in 72 other countries and territories, including about 18 other conflict zones, is consolidated into one single annual report. 

Health system remains in shambles  

Delegates from member states in WHO’s Eastern Mediterranean region, as well as Europe, painted a dire picture of Gaza’s health sector, repeatedly emphasizing the widespread destruction of hospitals and clinics in the 365 square kilometer, repeated displacement of most of the population to tent camps cluttered with rubble, waste and inadequate sanitation, and a wide range of infectious disease and chronic disease risks with which the crippled health system cannot effectively cope.

While massive aid deliveries have resumed since the October cease-fire, it remains “humanitarian access remains dangerously constrained” the Saudi delegate said, adding: “In the 80 days following the ceasefire, only 19,764 aid trucks entered the Gaza Strip. That’s fewer than half of the 48,000 that were agreed upon.”

Added Palestine’s delegate to the EB, Ambassador Ibrahim Khraishi, “It’s difficult to describe the catastrophic health situation in Palestine…More than 1600 health workers killed,  over 90% of hospitals destroyed by Israel. More than 200 ambulances attacked.”

Describing living conditions, Saudi Arabia stated, “Over 80% of all infrastructure in the Gaza Strip is damaged. People are living in flooded tents without clean water, sanitation or heating.” Disease risks were described as “extremely high, including acute respiratory infections, hepatitis and measles.”

The report also cites problems with physical barriers and restrictions on movement hindering access to health care for West Bank Palestinians, particularly for specialized services mostly available in East Jerusalem.

Calls to Israel for free access to health facilities in Jerusalem and West Bank

Palestine’s Khraishi also underscored evacuation constraints, stating, “More than 18,000 patients are in need of medical evacuation. Just about five every day are allowed to be evacuated.”

Bulgaria, speaking on behalf of the European Union and eight other member states, called for Israel to expedite medical evacuations via all available routes, saying, “Medical evacuations of patients from Gaza should be facilitated, which requires additional evacuation routes to hospitals in East Jerusalem and the West Bank, and the ability for patients to voluntarily return to Gaza.”

Norway added, “Patients requiring treatment in East Jerusalem and Ramallah should be provided with access in and out of Gaza.” It added, “Also, patients in the West Bank should be granted safe and unhindered passing to health facilities.”

Now that the Rafah border crossing to Egypt has reopened, medical evacuations also must be expedited via that route Canada said, saying it, “welcomes the reopening of the Rafah border crossing, a key element under the gas at peace plan, their crossing must remain open without undue restrictions to enable freedom of movement for Palestinians.”

The appeals were also echoed by the African Group of 47 member states that called for “setting up permanent, safe, predictable mechanisms… to ensure rapid evacuation of patients and critical situations, particularly children, on the basis of medical conditions,” and for “setting up coordinated medical transport system supported by the international community.”

Israel says WHO report is outdated and misleading 

Israel argued that the report, which only covers January-31 August 2025,  failed to reflect changing realities following the October 2025 ceasefire – which included a dramatic increase in aid deliveries, and just this week, a reopening of the Rafah crossing from Gaza to Egypt.

“By focusing largely on the first half of 2025 the report is irrelevant to the current needs,” said Israel’s political counsellor in Geneva, Waleed Gadban. “It fuels yet another politicized discussion, while deliberately ignoring crucial facts on the ground.” 

Gadban insisted that Israel had continued to facilitate medical assistance and patient evacuations: “In relation to the facilitation of the departure of patients from Gaza Strip… this claim is a clear distortion of fact,” the delegate said, arguing that “thousands of patients have been cleared for exit to Gaza the delays occur on the receiving side.”

With respect to food security, hunger and malnutrition, he also criticized the WHO report for relying on data from earlier in 2025, before aid deliveries increased.  “Most bluntly, it ignores the most recent UN publication confirming that 100% of food needs are met.” In a 5 January statement by UN Spokesperson Stephané Dujarric stated:  “The January round is the first since October 2023, in which partners had sufficient stock to meet 100 per cent of the minimum caloric standard.”

Finally, as the cease fire enters a second phase, he called for attention to “demilitarization, de radicalization, allowing the reconstruction of Gaza.” 

Egypt’s heated rebuttal 

Egypt, meanwhile, forcefully rejected Israeli suggestions that the continued slow pace of medical evacuations were largely related to “delays on the receiving side” – an allusion to Egypt, which shares Gaza’s Rafah border crossing. 

“Egypt rejects in the strongest terms, the allegations made by the delegation of Israel regarding Egypt’s position on humanitarian evacuations from Gaza,” Egypt’s representative said. “These claims are not only factually incorrect, but represent a deliberate attempt to deflect responsibility.

“The primary obstacle to safe evacuation is not Egypt,” he underlined.  ““Egypt has consistently worked under extremely difficult circumstances to facilitate humanitarian access, protect civilians and support life saving medical evacuations.”

Militarization of health facilities 

Israel also argued that its critics had ignored evidence of Hamas militarization of Gaza’s health facilities.

“If anyone here actually cared about the health situation in Gaza, someone would surely condemn the systematic use of ambulances by Hamas to move terrorists and weapons…the deliberate strategic strategy of using medical facilities to military purposes,” Gadban asserted. 

The remarks triggered another heated response from Egypt which said it “categorically rejects allegations that hospitals and ambulances in Gaza are being used systematically for military purposes,” calling such claims “unproven, politicized.”

“Any claim to the contrary requires independent verification, which hasn’t been once provided,” the delegate said, adding, “Health care is not a battlefield.”

New Israeli requirements that Gaza NGOs register names of local staff 

Related to that, Israel’s Gadban defended its new requirement that international NGOs register the names of their local employees in Gaza, as a means of ending “the abuse of humanitarian organizations by Hamas. …We call on organizations to check who they employ.”

On Monday, Médecins Sans Frontières said it had not found a way to comply with the new Israeli rules, citing a lack of assurances that the information they might provide would not be misused.

“We were unable to build engagement with Israeli authorities on the concrete assurances required,” MSF said. “These included that any staff information would be used only for its stated administrative purpose and would not put colleagues at risk; that MSF would retain full authority over all human resource matters and management of medical humanitarian supplies; and that all communications defaming MSF and undermining staff safety would cease.”

MSF, which operates a network of Gaza health clinics and field hospitals, as well as supporting six public hospitals, made no statement of its own during the Executive Board debate, despite being a WHO-recognized non-state actor entitled to speak. Reached for comment by Health Policy Watch, two MSF spokespeople did not reply in time for the publication of this article. 

Member states push back

During the EB discussion, however, several member states pushed back against Israel’s new requirements for NGOs operating in Gaza – requirements that have thrown the continued activities of some three dozen NGOs, as well as MSF, into jeopardy. 

Canada urged Israel “to reverse its policy on deregistration of international NGOs and its policies intended to undermine the UN’s work throughout Palestine, noting that many of these INGOs work in the health sector.” 

Added Saudi Arabia: “37 international non governmental organizations have been notified by Israel that their work will be forced to stop across the occupied Palestinian territory. The consequences are very severe, particularly for the health sector.”

Spain and Norway, meanwhile, protested the recent Israeli destruction of the Jerusalem headquarters of the UN Palestinian Refugee organization (UNRWA), saying it impinges on UN diplomatic  privileges as well as hindering Palestinian  aid relief.  

Israel decided to close down UNRWA”s operations in Jerusalem after identifying some 19 UNRWA employees alleged to have participated in the initial 7 October 2023 Hamas invasion of Israeli communities near Gaza, which triggered the wider war.  Following an internal UNRWA investigation, nine employees linked to alleged involvement were fired.   

“We have condemned the new aggressions against the UNRWA facilities perpetrated by the Israeli authorities, which are an unacceptable violation of the privileges and amenities of the United Nations,” Spain said.

Norway urged Israel “to respect the mandate of UNWRA, which was renewed by the UN General Assembly as recently as December, and to allow the organization to operate and provide services to the Palestinian people.”

Together, the statements highlighted the gap between Israel’s stated security rationale for tighter controls on UN and NGO operations – and the concerns of member states that the measures would further undermine humanitarian and health activities in the West Bank as well as Gaza.

Amendment to cancel dual Palestine reporting requirement defeated after procedural fight

As for the defeated proposal to cancel the second WHO reporting requirement on health conditions in the ‘Occupied Palestinian Territory, including East Jerusalem’, both Israel and its challengers accused each other of wasting WHO time and resources. 

Egypt described Israel’s proposal as procedural maneuvering leading to “a waste of time, and it’s just procrastination for the whole process.”

Israel, meanwhile, said that the creation of a second report on the Palestinian territories after the October 2023 war began is redundant – in light of the fact that a dedicated report on Palestinian health conditions has been produced annually for  the World Health Assembly  – since Israel first took over the West Bank and Gaza in the 1967 Arab-war.

“When it comes to Israel, there are endless funds and resources for duplicity and exceed reporting,” Israel’s Gadban said. “The members of the board are saying that when it comes to Israel, they want to discuss three times rather than one.”

In his closing remarks, Khraishi came to a different conclusion:  “This reaffirms that Palestine is still in an emergency situation. We need all of you. We need your organization. We need your efforts, WHO efforts to improve the health conditions in Palestine.”

Meanwhile, the Central African Republic appealed for more understanding on all sides in the bitter conflict, Speaking on behalf of WHO Africa’s 47 member states, the delegate said: 

 “We can have various religions, various languages. I’d like too say different ideologies, different colors of skin. But we are all humans. We’re all we all belong to the human race. We all have the same royal blood in our body.”

Image Credits: Palestinian Water Authority , X/@Dr Tedros.