Doctors Without Borders (MSF) joined a statement with more than 100 other organisations to sound the alarm that lifesaving aid must enter Gaza, Palestine.

As the Israeli government’s siege starves the people of Gaza, Palestine, aid workers are now joining the same food lines, risking being shot just to feed their families. With supplies now totally depleted, humanitarian organisations are witnessing their own colleagues and partners waste away before their eyes.

Exactly two months since the Israeli government-controlled scheme, the Gaza Humanitarian Foundation, began operating, more than 100 organisations are sounding the alarm, urging governments to act: open all land crossings; restore the full flow of food, clean water, medical supplies, shelter items, and fuel through a principled, UN-led mechanism; end the siege; and agree to a ceasefire now. 

Massacres at food distribution sites in Gaza are occurring near-daily. As of 13 July, the UN confirmed 875 Palestinians were killed while seeking food, 201 on aid routes and the rest at distribution points. Thousands more have been injured. Meanwhile, Israeli forces have forcibly displaced nearly two million exhausted Palestinians with the most recent mass displacement order issued on 20 July, confining Palestinians to less than 12 per cent of Gaza. The World Food Programme warns that current conditions make operations untenable. The starvation of civilians as a method of warfare is a war crime.

Just outside Gaza, in warehouses - and even within Gaza itself - tonnes of food, clean water, medical supplies, shelter items and fuel sit untouched, with humanitarian organisations blocked from accessing or delivering them. The Government of Israel’s restrictions, delays, and fragmentation under its total siege have created chaos, starvation, and death. An aid worker providing psychosocial support spoke of the devastating impact on children: “Children tell their parents they want to go to heaven, because at least heaven has food.” 

Doctors report record rates of acute malnutrition, especially among children and older people. Illnesses like acute watery diarrhoea are spreading, markets are empty, waste is piling up, and adults are collapsing on the streets from hunger and dehydration. Distributions in Gaza average just 28 trucks a day, far from enough for over two million people, many of whom have gone weeks without assistance.

The UN-led humanitarian system has not failed; it has been prevented from functioning.

Humanitarian agencies have the capacity and supplies to respond at scale. But, with access denied, we are blocked from reaching those in need, including our own exhausted and starved teams. On 10 July, the European Union and Israel announced steps to scale up aid. But these promises of ‘progress’ ring hollow when there is no real change on the ground. Every day without a sustained flow means more people dying of preventable illnesses. Children starve while waiting for promises that never arrive.

Palestinians are trapped in a cycle of hope and heartbreak, waiting for assistance and ceasefires, only to wake up to worsening conditions. It is not just physical torment, but psychological. Survival is dangled like a mirage. The humanitarian system cannot run on false promises. Humanitarians cannot operate on shifting timelines or wait for political commitments that fail to deliver access.

Governments must stop waiting for permission to act. We cannot continue to hope that current arrangements will work. It is time to take decisive action: demand an immediate and permanent ceasefire; lift all bureaucratic and administrative restrictions; open all land crossings; ensure access to everyone in all of Gaza; reject military-controlled distribution models; restore a principled, UN-led humanitarian response, and continue to fund principled and impartial humanitarian organisations. States must pursue concrete measures to end the siege, such as halting the transfer of weapons and ammunition.

Piecemeal arrangements and symbolic gestures, like airdrops or flawed aid deals, serve as a smokescreen for inaction. They cannot replace states’ legal and moral obligations to protect Palestinian civilians and ensure meaningful access at scale. States can and must save lives before there are none left to save.