The humanitarian situation in Gaza is catastrophic; it is amongst the worst we have witnessed and will likely only get worse as hostilities continue. The large majority of the civilian population is in desperate need of humanitarian assistance and protection.

Over 1.8 million people in Gaza, or nearly 80 per cent of the population, are estimated to be internally displaced. The majority of them are sheltering in over-congested UNRWA facilities across Gaza with extremely poor access to hygiene facilities. All of Gaza’s 2.3 million inhabitants lack sufficient food and clean water, and face malnutrition.

Given the extent of damage to civilian infrastructure in Gaza, including health facilities, water, and sanitation, the risk of disease outbreaks is very high. The disruption of vaccination activities, as well as lack of medicines for treating communicable diseases, further increase the risk of an accelerated spread of infectious diseases.

We, the undersigned, met during the Aqaba Process Informal Meeting on Coordinating Gaza Emergency Relief, held in Amman in the Hashemite Kingdom of Jordan on 30 November 2023, and had frank discussions on the gaps and challenges in the current response, and certain mechanisms, systems, and restrictions in place which are hampering relief efforts.

As humanitarian actors, neutrality and impartiality are defining principles of our work. Our guiding objective is to alleviate human suffering. No effort is being spared by all humanitarian organisations and agencies engaged in the ongoing relief response; however, the current scale of assistance amounts to only a fraction of escalating needs.

First and foremost, we call for an end to the hostilities to prevent further human suffering. Until such time, the scale and scope of humanitarian aid must be dramatically expanded and sustained.

Our top priorities include:

• Scaling up all relief efforts through additional access points into Gaza—including by opening the Kerem Shalom crossing point—and the streamlining of approval and inspection processes. This is pertinent as the Rafah crossing was not built to accommodate such capacity.

• Continuing to prioritise the safe, unimpeded, and unconditional provision of safe water, food—including fresh produce—and shelter.

• Expediting the screening and transport of the critically wounded, particularly children, to medical facilities outside Gaza.

• Significantly scaling up the delivery and regular resupply of essential medicines, medical supplies, and equipment, including, but not limited to, wound dressings, anesthesia, and antibiotics.

• Expanding the delivery of fuel into Gaza, as it is a pre-condition for humanitarian relief in almost all priority areas.

• Addressing the water and sanitation needs in Gaza through the rehabilitation of existing infrastructure, in addition to the provision of toilets and shower units for over-congested shelters, small desalination units, and compactors for solid waste.

• Expanding the capacity of health services and medical operating rooms in Gaza through both new field hospitals and the rehabilitation of existing health facilities, where possible.

• Addressing women’s specific needs, such as maternal care, and safeguarding the rights of children, including the right to education, protection, nutrition and health.

• As temperatures drop, prioritising the provision of warm clothing, blankets, and other winter items.

• Facilitating the regular rotation of humanitarian and medical staff in and out of Gaza.

• Making available reliable telecommunications networks to enable humanitarian and emergency staff to stay connected during the coordination of response efforts. 

Gaza was facing severe humanitarian challenges even before the recent escalation, and the situation now has escalated to unprecedented levels. The proposed priorities are feasible, practical, and will alleviate the suffering of 2.3 million civilians; there is no reason not to implement them. We must provide the people of Gaza with the essential humanitarian aid and services they need, at the scale they need.

United Nations Children’s Fund (UNICEF)

United Nations Office for Project Services (UNOPS)

United Nations Office for the Coordination of Humanitarian Affairs (OCHA)

United Nations Relief and Works Agency (UNRWA)

United Nations Women (UN Women)

United Nations World Food Programme (WFP)

World Health Organisation (WHO)

American Near East Refugee Aid (Anera)

CARE International

Doctors Without Borders (MSF)

Egyptian Red Crescent

Handicap International

International Rescue Committee

Jordan Hashemite Charity Organisation

Jordanian Red Crescent Society

King Salman Humanitarian Aid and Relief Centre

Kuwait Red Crescent Society

Medical Aid for Palestinians

Mercy Corps

Norwegian Refugee Council

Oxfam

Palestine Children’s Relief Fund

Palestine Red Crescent Society

Qatar Charity

Reel Foundation

Save the Children International

Turkish Red Crescent