WHA78 Analysis: Countries Vote in Support of Palestine at World Health Assembly, as Humanitarian and Health Crises Worsen in Gaza
By Ben Verboom, PHM's WHO Watch Team
Contributions by Priti Patnaik, Founding Editor of the Geneva Health Files
Originally published at Geneve Health Files
I. WHA78: ANALYSIS
Countries Vote in Support of Palestine at World Health Assembly, as Humanitarian and Health Crises Worsen in Gaza
By Ben Verboom
Priti Patnaik contributed to this story
Palestine loomed large at the recently concluded World Health Assembly. Two items on the agenda at the Assembly focused specifically on the health situation in the occupied Palestinian territories, both of which attracted heated debates, votes, and concluded with the adoption of measures in favor of Palestine. Two further measures – one proposing to notify Palestine to the International Health Regulations (IHR) regime, and another, in favour of flying the flags of non-member Observer States such as Palestine at WHO headquarters – were also adopted following roll-call votes.
An Appeal from WHO
During his opening remarks to the 78th World Health Assembly (WHA), which was held in Geneva from May 19th to 27th, World Health Organization Director-General Tedros Adhanom Ghebreyesus painted a grim picture of the humanitarian and health catastrophe facing the people of Gaza.
“Two months into the latest blockade, two million people are starving, while 116,000 tons of food is blocked at the border just minutes away,” Tedros noted at the Assembly’s opening plenary on May 19th, referring to the complete blockade imposed on the Gaza Strip by the Israeli government, which had entered its tenth week by the start of the WHA.
“The risk of famine in Gaza is increasing with the deliberate withholding of humanitarian aid, including food, in the ongoing blockade,” he added, without mentioning the state of Israel by name. “People are dying from preventable diseases, as medicines wait at the border, while attacks on hospitals deny people care and deter them from seeking it.”
Speaking later, (see clip below), he also asked Israel to have mercy.
Source: WHO, May 2025
Heated debate on the health emergency in Palestine, Israeli denials take centre stage
On the third day of the Assembly, a familiar agenda item – entitled Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan – was taken up in the WHA’s Committee B, one of the bodies that considers agenda items at the Assembly.
One version or another of this agenda item has been included in every WHA since at least 1968, when a resolution was adopted calling on the Director-General to study and report on “health conditions amongst displaced persons” in Palestine following the 1967 Six-Day War.
Every year, the item inflames tensions between member states, and this year’s Assembly was no different.
Member states debated a five-page draft decision backed by China, Egypt, South Africa and others, requesting that the Director-General report on the health implications of the humanitarian crisis, the state of malnutrition, food insecurity and famine, and “the wanton destruction of health facilities.” The draft decision also demanded “unhindered passage for medical personnel and humanitarian personnel” and called on Israel “to fulfill its obligations under international law.”
Sponsors of the decision hope that it might play a small part in mobilizing resources and motivating a stronger international response to the devastating health and humanitarian crisis facing Palestinians.
The draft was nearly identical to a decision passed by last year’s Assembly, save for the modification of a paragraph to remove language included in the 2024 version that “condemn[ed] the use, by armed groups, of health facilities, including hospitals and ambulances.” The excised text, a reference to the alleged use of health facilities in Gaza by Hamas fighters and other armed groups, was added via an amendment introduced by Israel which was narrowly approved in a roll-call vote at last year’s Assembly. (See from us in June 2024: Countries Voted Eight Times in a Politicized World Health Assembly Revealing Geopolitical Fissures [WHA77])
The draft decision this year was met with contempt by the Israeli delegation, which called for a roll-call vote on the measure. “Hamas is the first and foremost cause of the civilian suffering in Gaza” Israeli Ambassador Daniel Meron argued. “Israel [has] facilitated the entry of aid into Gaza throughout the war, including the entry of medications and medical equipment.”
“Israel does not target civilians. Israel does not target medical or humanitarian personnel. There is no famine in Gaza.”
Despite Israel’s protestations, the decision was adopted by the Assembly with overwhelming support, in a vote of 104 to 4, with 19 countries abstaining. The four countries voting against the decision were Israel, Hungary, Germany and the Czech Republic.
In a briefing to reporters on the sidelines of the Assembly, WHO’s Regional Director for the Eastern Mediterranean Region (EMR), Hanan Balkhy, described the situation in Gaza as “catastrophic.” (The briefing was organized by the Association of Accredited Correspondents at the United Nations)
“One in five Gazans faces starvation,” Balkhy said, as she called for “international humanitarian law to be upheld, for the blockade to be lifted, and for a ceasefire and durable peace.”
Explaining the situation on the ground to reporters, Balkhy said:
“…Imagine a surgeon needing to fix a broken bone with very minimum equipment, no anesthesia, no sanitizers, no facilities to do sterilization. So the medical or the intra-operative equipment requires sterilization and cleaning. You need IV fluids. You need cannulas, needles, bandages, those are just the basic minimum. They do not exist in the quantities nor the numbers that are required…..the basic medications, the basic antibiotics, the basic sedatives, the basic painkillers.
Also, the basic medications for the chronic diseases, even in conflict and war time, there are patients that have hypertension, they have diabetes, they have mental diseases that they need treatment for, chronic diseases, rheumatoid arthritis, rheumatological diseases, seizures in childhood…
All types of basic medications that we are so privileged to have without even thinking about where it's coming from, they are struggling to serve to have the basics. Imagine if, just if any of you as a parent, I'm a pediatrician by training, and I'm a mother….just not having fever medication to reduce the shivering of your child with a temperature. That's the simplest thing. A child with colic, a child that's having an ear infection. You're talking about the lack…. zero stock of the basic medications, not talking about the biosimilars. We're not talking about, you know, the fourth and fifth line of therapeutics for anti hypertension or some of the rheumatological diseases, it is the basics, and, more critically, the basics needs for conducting surgery, because the biggest problem now is the traumas that are taking place. The traumas are extremely devastating…”
A Vote on the Humanitarian Situation in Gaza Strip
The subject of Palestine continued to dominate the following day of the proceedings, as the Assembly debated a draft resolution expressing “grave concern about the catastrophic humanitarian situation in the Gaza Strip” and “the intense damage on the public health sector,” while denouncing the “large-scale destruction of health facilities including hospitals and ambulances.” The measure – which is an update to a resolution passed unanimously by a WHO Executive Board Special Session in December, 2023 – also mandates WHO to solicit and secure funds for the health emergency response in Gaza and for the rebuilding of the enclave’s devastated health system.
In his floor statement, Meron expressed frustration about apparent “duplication” and “politicizing [of] health,” noting that the resolution “calls on the [Director-General] to report on the health situation in Gaza to three different bodies on four different occasions over the course of one year.”
Ibrahim Khraishi, Palestine’s representative in Geneva, responded, “Israel must live up to and respect its obligations, and should stop using forced starvation against innocent Palestinian civilians.”
Israel once again requested a roll-call vote on the resolution.
The resolution was adopted with 114 member states voting in favour, 15 abstaining, and only Israel and Hungary voting against it.
WHO rejects Israeli assertion on diversion of aid
The accessibility of humanitarian aid and medical supplies to Gaza’s civilian population was a key point of contention in Assembly discussions.
Israel condemned the alleged large-scale theft of aid by Hamas, but provided no evidence in support of the allegation.
“Available humanitarian aid in Gaza is misappropriated by Hamas time after time and this has turned into a thriving industry, siphoning resources meant for civilians to fund its terrorist infrastructure and prolong the war,” said Meron, the Israeli delegate.
Mike Ryan, outgoing head of WHO’s health emergencies program, disputed the claim. “There has been no diversion of WHO aid in Gaza,” said Ryan. “There is no evidence of aid diversion in the health space in terms of WHO supplies, and we can stand over the integrity and the effectiveness of the current humanitarian medical delivery modality in safeguarding essential medical assistance and ensuring it reaches the intended patients and health workers.”
“We have demonstrated, as the UN system, that we can deliver when facilitated [by Israel]. And other mechanisms, especially those used in private subcontractors, have proven themselves to be utterly ineffective and sometimes laughable.”
Balkhy also clarified in her responses to questions from reporters, “…all of the medical aid going into Gaza is not going to any national warehouses. It's going to the hospitals directly. All the aid goes to the WHO warehouses. From the WHO warehouses, it goes directly to the hospitals where they're being used. Over the past months, since October 2023 there has been no evidence of any of the equipment that the WHO has brought in, has been diverted anywhere.”
Last month, Israel began distributing food aid in Gaza through a controversial private entity known as the Gaza Humanitarian Foundation (GHF), bypassing established United Nations aid delivery channels. The scheme has been criticized for militarizing aid distribution and failing to adhere to humanitarian principles.
At a WHA side event in Geneva on May 21st, WHO’s country director for Palestine Rik Peeperkorn described the aid plan as “too insane for words.”
Over 60 Palestinians have since been killed by Israeli forces while seeking aid at GHF food distribution sites in southern Gaza. UN Human Rights Chief Volker Türk described the attacks on civilians as a war crime.
Member states overwhelmingly agree to ‘notify’ the International Health Regulations to Palestine
Also discussed in the course of the Assembly was a proposal to request the Director-General to “notify” the International Health Regulations (IHRs) to Palestine. The IHRs are the chief international legal instrument through which states cooperate to monitor and report infectious disease outbreaks, and which governs WHO’s responsibility to declare international public health emergencies. The draft decision – which was proposed by 22 countries, including China, Iran, Pakistan and Turkey – is the first step toward Palestine becoming a full participant in, or State Party to, the IHRs.
The decision was approved by the Assembly in a 112 to 2 vote, with 19 abstentions and only Israel and Hungary opposing the measure.
“Global health security requires the participation of all peoples,” argued the delegate from Egypt, one of the co-sponsors of the decision. “Palestine’s exclusion [from the IHRs] undermines both regional stability and international preparedness. Palestine’s access to the IHR framework would enable timely reporting and response to public health threats.”
The Yemeni delegation used their speaking time to go further, arguing that “notifying the International Health Regulations to Palestine is the most symbolic measure we can adopt for a country which is facing a war and a genocide.” Yemen added, “we all need to work to ensure that not only does Palestine join the IHR, but that they become a full member of the WHO.”
“Including Palestine in IHR communications eliminates a blind spot in global surveillance,” said Balkhy, WHO’s EMR Regional Director. “Palestine, like any other territory, can experience or be the origin of outbreaks.”
While the decision was widely-supported, some member states – particularly developed countries – went to strenuous lengths to emphasize that their votes should not be interpreted as bilateral recognition of Palestinian statehood. The representative from New Zealand, which supported the decision, noted that they “voted in favour of this resolution with the clear intention that our support does not imply recognition of Palestinian statehood,” while Germany, which abstained, added that they “wish to formally state…our understanding that the adoption of this resolution is without prejudice to the status of Palestine.”
Australia’s representative took a similar position, stating that their “vote in support does not constitute bilateral recognition of Palestinian statehood.” However, they added that “Australia no longer accepts that the recognition [of Palestinian statehood] can only come at the end of the peace process
.,” marking a shift from the previously long-held stance that any formal recognition of Palestine should only emerge from a negotiated settlement with Israel.
Last year, the governments of Ireland, Spain and Norway announced their formal recognition of Palestinian statehood, joining some 75% of United Nations member states. Later this month, UN members will gather in New York for a conference co-hosted by France and Saudi Arabia aimed at charting the path forward to a two-state solution to the decades-long conflict between Palestine and Israel.
Countries voted for flying the Palestinian flag at WHO
Agenda item on flying flags of non-member Observer States
Last year’s WHA was seen as an especially politicized one at the time, largely because of a series of agenda items related to Palestine which divided the Assembly and resulted in multiple roll-call votes. On the penultimate day of WHA77, the Assembly voted to confer new rights on Palestine’s delegation to the WHA, including the right to submit and co-sponsor proposals and the right to sit amongst other member states in alphabetical order, aligning Palestine’s participation in WHO with recently-won privileges in the United Nations General Assembly.
As this year’s Assembly wound down, a final item with implications for Palestine was once again considered.
On Monday, the WHA overwhelmingly voted in favour of flying the flags of non-member Observer States like Palestine at the WHO’s headquarters and offices. The decision passed by a vote of 95 to 4, with 27 abstentions. Israel opposed the measure, alongside the Czech Republic, Germany and Hungary.
The decision does not confer new substantive rights on non-member observers, but it was largely interpreted as a strong statement of support for Palestine from much of the Assembly’s membership.
“The state of Palestine has faced immense health challenges under prolonged occupation,” Nurhafiza Hamzah, the delegate from Malaysia, said during her intervention during the proceedings. “Raising the Palestinian flag at the WHO acknowledges the contributions of Palestinian health professionals, the suffering of their patients, and the responsibility of this organization to ensure that no one is left behind in our collective pursuit of health equity and justice.”
“This gesture is more than symbolic.”
Gaza in numbers
[Source: WHO, May 25, 2025]
Aid
• 43% essential medicines are at zero-stock levels in addition to 64% of medical supplies and 42% of vaccines. Patients with chronic and life-threatening conditions—including kidney failure, cancer, blood disorders, and cardiovascular disease—are among the most affected, Ministry of Health.
• WHO’s stocks in Gaza are dangerously low and will run out soon. This includes: Antibiotics, IV fluids, blood units, anesthetic drugs, insulin, high blood pressure medicines, pain management medications, inhalers, catheters, gauzes and bandages, hemodialysis filters and consumables, hygiene products, heart failure medicines, medicines for cancer and autoimmune conditions, wheelchairs and other assistive devices, laboratory supplies (reagents), blood transfusion supplies, surgical instruments for bone, face, ribs, skin grafts, vascular surgery, sutures, cesarean kit, scabies treatment.
Food insecurity
• The entire 2.1 million population of Gaza is facing prolonged food shortages, with nearly half a million people in a catastrophic situation of hunger, acute malnutrition, starvation, illness and death.
• Since 2 March, 57 children have reportedly died from the effects of malnutrition, MoH.
• 71 000 children under the age of five are expected to be acutely malnourished over the next eleven months.
• Pregnant and breastfeeding mothers are also at high risk of malnutrition, with nearly 17 000 expected to require treatment for acute malnutrition over the next eleven months.
Displacement
• 81% of the Gaza Strip is under displacement orders.
• Since May 15, over 34,000 people displaced.
Casualties
• 54 000 deaths.
• 130 000 injuries.
Hospitals
• Only 19 of Gaza Strip’s 36 hospitals remain operational — 18 partially and one minimally functional. Of the 19 hospitals, 12 provide a variety of health services, while the rest are only able to provide basic emergency care.
• Four major hospitals in Gaza (Kamal Adwan Hospital, Indonesia Hospital, Hamad Hospital for Rehabilitation and Prosthetics, and European Gaza Hospital) have had to close recently due to their proximity to hostilities or evacuation zones and attacks.
• The hostilities and new evacuation orders issued across northern and southern Gaza threaten to push even more health facilities out of service. This includes 1 hospital, 11 primary care centres, and 13 medical points within the evacuation zones, and an additional 5 hospitals, 1 field hospital, 9 primary care centres, and 23 medical points within 1000 meters of those zones.
• Ambulance services across the Gaza Strip are shrinking due to damage and lack of access to fuel. Prior to the collapse of the ceasefire on 18 March, 149 ambulances were operational, of which only 48 are now functional, severely limiting emergency medical transport and outreach capacity.
Attacks
• 1,504 attacks on healthcare have been verified in Gaza and West Bank since October 2023, on average 3 attacks per day.
Medical evacuations
• 7369 patients, including 5,075 children evacuated for medical treatment abroad to 19 countries. Over 10,500 still in need of evacuation, including more than 4000 children.
Maternal health
• 500 000 women of reproductive age lack access to essential services including antenatal care, postnatal care, family planning, and management of sexual transmitted infections.
WHO missions
• Between 18 March and 11 May 2025, 20 out of 31 planned WHO field missions (65%) to deliver fuel and supplies to hospitals were completed, with the remaining either denied (8) or cancelled (3).
Polio
• The fourth polio campaign is on hold due to insecurity. 561,000 children under 10 received 3 doses during 2024 and early 2025. 46,000 children vaccinated for first time in early 2025 and still vulnerable.
Emergency medical teams (EMT)
• EMT deployment denial rates to the Gaza Strip have reached nearly 50%. In March and April 2025, 58 EMT team members, including plastic and vascular surgeons, were denied access.
Physical disabilities
• At least one quarter those injured in Gaza are estimated to have life-changing injuries that require rehabilitation services now and for years to come, according to a WHO analysis.
• Severe limb injuries, estimated to be between 18 192 and 23 729, are the main driver of the need for rehabilitation. Many of those injured have more than one injury.
• Between 4198 and 5476 limb amputations have also occurred. Large surges in spinal cord injury, traumatic brain injury and major burn injuries all contribute to the overall number of life-changing injuries, which includes many thousands of women and children.
Noncommunicable diseases
• 2000 people diagnosed with cancer each year, including 122 children.
• 45 000 patients living with cardiovascular disease.
• 1500 patients need kidney dialysis to maintain life.
• 650 000 people with raised blood pressure.
• 60 000 people with raised blood glucose.
• Over 485 000 people with mental health disorders.