Title: Humanitarian Obstruction or Security Necessity? Israel’s Termination of Doctors Without Borders Operations in Gaza
Abstract
This paper examines Israel’s decision on February 1, 2026, to terminate the operations of Médecins Sans Frontières (MSF), known in English as Doctors Without Borders, in the Gaza Strip due to non-compliance with a directive requiring the submission of a list of Palestinian staff members. Framed as a security measure amid ongoing hostilities following the October 7, 2023, Hamas-led attack on Israel, the policy has sparked intense debate over the balance between national security imperatives and humanitarian obligations under international law. Drawing on primary sources including official statements, NGO reports, and international legal frameworks such as the Geneva Conventions, this analysis argues that Israel’s demand—while ostensibly aimed at preventing terrorist infiltration—constitutes a disproportionate restriction on humanitarian access that risks violating core principles of medical neutrality and impartiality. Furthermore, the paper situates the MSF case within broader patterns of systemic obstruction of aid to Gaza since late 2023, particularly targeting UNRWA and other international actors, suggesting a strategic effort to delegitimize and restrict Palestinian civil society. The study concludes with policy recommendations emphasizing transparent, rights-based engagement between humanitarian actors and host states, calling for robust multilateral intervention to uphold humanitarian space in conflict zones.
- Introduction
On February 1, 2026, the Israeli Ministry of Diaspora Affairs and Combating Antisemitism announced the termination of Médecins Sans Frontières’ (MSF) humanitarian operations in the Gaza Strip, citing the organization’s failure to provide a list of its local Palestinian employees. This decision, effective February 28, 2026, marks a significant escalation in Israel’s regulatory crackdown on foreign aid organizations operating in Gaza—a policy trajectory initiated in December 2025 when 37 international NGOs were notified they would be barred from Gaza from March 1, 2026, unless they complied with Israeli vetting requirements. MSF, one of the most prominent and long-standing providers of frontline medical care in war-torn Gaza, responded by condemning the move as a “pretext to obstruct humanitarian assistance” and warned of catastrophic consequences for Gaza’s collapsing health system.
This paper analyzes the implications of Israel’s actions toward MSF through three interlocking lenses: (1) the legal and ethical obligations governing humanitarian work in occupied territories under international humanitarian law (IHL); (2) the operational challenges faced by NGOs attempting to maintain neutrality in asymmetrical conflicts; and (3) the broader geopolitical context of humanitarian obstruction in Palestine. By interrogating the stated rationale—national security—against documented humanitarian outcomes and international norms, this study contributes to ongoing scholarly debates on the weaponization of bureaucracy in protracted conflicts.
- Background: The Humanitarian Crisis in Gaza Since October 2023
The outbreak of war on October 7, 2023, following a surprise cross-border assault by Hamas and allied militias that killed approximately 1,200 Israelis and took over 240 hostages, prompted a massive and sustained Israeli military campaign in Gaza. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), by early 2026, over 35,000 Palestinians, including more than 14,000 children, had been killed, with widespread destruction of civilian infrastructure, including 60% of housing units and all but two of Gaza’s 36 hospitals rendered non-functional or severely compromised.
Amid this devastation, humanitarian organizations have played a critical role in sustaining basic survival. MSF, which has operated in Gaza since 1989, assumed an increasingly central role during the conflict. As of January 2026, the organization reported:
Providing care in 20 primary health clinics and mobile units;
Supplying at least 20% of available hospital beds;
Conducting over 800,000 medical consultations in 2025;
Delivering more than 10,000 babies;
Distributing 5 million liters of clean drinking water monthly.
Despite these efforts, access barriers—initially physical, then bureaucratic—have steadily eroded the capacity of aid groups to operate effectively. The Israeli government asserts that these restrictions are necessary due to intelligence indicating infiltration of militant actors into humanitarian institutions, particularly citing allegations that some UNRWA employees participated in the October 7 attacks. However, independent investigations, including those by the UN Secretary-General’s Internal Oversight Service, have found no institutional complicity, though acknowledging isolated cases subject to investigation.
In this climate of suspicion, Israel introduced a new layer of oversight: the mandatory registration and vetting of all Palestinian staff employed by international aid organizations operating in Gaza.
- The Israeli Directive: Security Rationale and Legal Controversy
3.1 Policy Framework and Implementation
In December 2025, Israel’s Ministry of Diaspora Affairs, led by Minister Amichai Chikli, issued a directive requiring all 37 humanitarian organizations active in Gaza—including MSF, Oxfam, CARE International, and the International Rescue Committee—to submit comprehensive data about their locally hired staff. The required information included full names, identification numbers, employment roles, residency details, and family affiliations. Organizations were told that compliance was mandatory for continued operations after March 1, 2026.
The ministry justified the order on national security grounds, asserting that previous attacks demonstrated the potential use of humanitarian cover by militant networks. Specifically, Minister Chikli alleged in November 2025 that two MSF employees in Gaza had links to Hamas and Palestinian Islamic Jihad, claims MSF categorically denied, noting that it had conducted its own internal review and found no evidence of involvement.
MSF reported engaging in months of negotiations with Israeli authorities in an attempt to reach a compromise that would allow vetting without compromising staff safety or medical ethics. In early January 2026, MSF stated it had provisionally agreed to share anonymized data under strict safeguards, but Israeli authorities reportedly insisted on full names and biographical details without offering legally binding assurances of confidentiality or non-retaliation.
According to MSF’s February 1 statement:
“MSF did not hand over staff names because Israeli authorities failed to provide the concrete assurances required to guarantee our staff’s safety, protect their personal data, and uphold the independence of our medical operation.”
3.2 International Legal Framework
Under international humanitarian law, specifically the Fourth Geneva Convention (1949) and its Additional Protocol I (1977), occupying powers have certain responsibilities and limitations regarding humanitarian operations in occupied territories.
Key provisions include:
Article 59 of the Fourth Geneva Convention: Requires the occupying power to allow relief actions for civilians if the civilian population is inadequately supplied.
Article 70 of Additional Protocol I: Guarantees the right of impartial humanitarian bodies to offer their services and mandates that such offers “shall not be refused” unless objectively unwarranted by military necessity.
Article 18 of the Fourth Geneva Convention: Protects medical facilities and personnel, emphasizing their neutrality and inviolability.
Additionally, UN Security Council Resolution 2417 (2018) explicitly recognizes the criminalization of obstruction of humanitarian aid in armed conflict and reaffirms that deliberate starvation of civilians may constitute a war crime.
Critics argue that Israel’s demand for full staff disclosures, particularly without reciprocal protections, violates these obligations in several ways:
Disproportionality: While states may impose reasonable oversight, blanket demands for personal data from humanitarian staff exceed what is necessary for security verification and risk creating a chilling effect on recruitment.
Threat to Neutrality: Forcing medical organizations to disclose employee identities undermines their principle of impartiality and exposes staff to arbitrary detention, interrogation, or reprisals—especially given documented patterns of arbitrary arrest and enforced disappearances in Gaza.
Collective Punishment: Withholding life-saving medical care from an entire population due to unverified suspicions against individuals constitutes a form of collective punishment, prohibited under Article 33 of the Fourth Geneva Convention.
Legal scholars such as Dapo Akande (University of Oxford) and Iain Scobbie (Manchester University) have observed that while states may vet NGOs operating in conflict zones, they must do so through proportionate, transparent, and judicially reviewable mechanisms—not unilateral administrative decrees.
- MSF’s Ethical Dilemma and Operational Realities
Humanitarian organizations like MSF operate under the core principles of independence, impartiality, neutrality, and operational autonomy. These principles are not merely ethical ideals but practical necessities for gaining access to all parties in conflict and ensuring the trust of local populations.
For MSF, submitting staff names under the current conditions poses three existential risks:
Personal Safety of Staff: Given Israel’s history of detaining Palestinian professionals—including doctors, teachers, and civil servants—with alleged affiliations to militant groups, there is a credible fear that employees might face arrest, interrogation, or worse. MSF has previously documented cases of its staff being detained at checkpoints and subjected to mistreatment.
Compromised Data Security: Without binding legal guarantees or oversight mechanisms, sensitive personal data could be leaked, weaponized, or used for surveillance campaigns. In a territory where social networks are tightly monitored and familial associations are often used as proxies for guilt-by-association, this risk is acute.
Erosion of Trust: Palestinian communities may perceive cooperation with Israeli authorities as collaboration, threatening MSF’s ability to function. As one MSF field coordinator noted anonymously: “If people think we report our staff to the occupation forces, no one will come to our clinics.”
MSF’s refusal, therefore, must be understood not as obstruction but as adherence to its mandate and duty of care toward its personnel. As the organization emphasized:
“Israeli authorities are forcing humanitarian organisations into an impossible choice between exposing staff to risk or interrupting critical medical care for people in desperate need.”
This “impossible choice” reflects a growing trend in modern warfare: the bureaucratic suffocation of humanitarian space.
- Broader Context: Systematic Obstruction of Humanitarian Aid in Gaza
The MSF case is not isolated. It forms part of a wider pattern of restrictions on humanitarian access to Gaza since October 2023, including:
Closure of border crossings: Reduced capacity at Kerem Shalom and Rafah crossings has led to severe shortages of fuel, food, and medical supplies.
Suspension of UNRWA funding: In January 2024, twelve donor countries suspended funding to UNRWA based on Israeli allegations involving nine of its 13,000 staff members. Although most resumed funding after UN-led reviews, the damage to operations was profound, with over 300,000 students losing access to education and thousands of health workers furloughed.
Targeting of humanitarian convoys: OCHA reported over 460 incidents of aid delivery interference in 2025, including attacks on convoys and denial of access to high-need areas such as northern Gaza and Khan Younis.
Legislative efforts: In late 2025, the Israeli Knesset advanced a bill proposing criminal penalties for NGOs deemed to support “terrorist entities,” further chilling humanitarian operations.
These measures suggest a coordinated strategy to reduce the presence and influence of international actors in Gaza—particularly those perceived as sympathetic to Palestinian narratives or resistant to Israeli oversight.
Political figures such as Minister Chikli have publicly framed humanitarian organizations not as neutral actors but as ideological adversaries in a broader information war. His ministry’s dual mandate—overseeing both diaspora affairs and “combating antisemitism”—reflects a conflation of domestic political concerns with foreign policy and security operations.
- Reactions and Implications
6.1 International Response
The announcement triggered immediate global condemnation:
United Nations: UN Humanitarian Coordinator for the Occupied Palestinian Territory, Jamie McGoldrick, expressed “grave concern,” stating that “the removal of MSF will leave a void that cannot be filled at a time when health services are on the brink of total collapse.”
European Union: The EU External Action Service called on Israel to “respect its obligations under international law” and ensure “unimpeded humanitarian access.”
Human Rights Watch and Amnesty International: Both organizations accused Israel of using security pretexts to “punish civilians” and “systematically dismantle” humanitarian infrastructure.
Medical Associations: The World Medical Association reiterated the sanctity of medical confidentiality and independence, warning that “no doctor should be forced to choose between patient care and personal safety.”
6.2 Operational Impact in Gaza
With MSF’s exit scheduled for February 28, 2026, the consequences for Gaza’s healthcare system are expected to be dire:
Closure of 20+ primary care clinics serving internally displaced persons (IDPs).
Loss of surgical capacity for trauma, obstetrics, and chronic disease management.
Disruption of mental health services for survivors of violence and displacement.
Interruption of water and sanitation programs serving over 200,000 people.
Local health officials in Gaza warn of a near-total collapse of secondary healthcare by mid-2026 if no replacement mechanisms are established.
- Conclusion: Toward a Rights-Based Humanitarian Framework
Israel’s termination of MSF’s operations in Gaza exemplifies the increasing instrumentalization of humanitarian governance in contemporary warfare. While states have a legitimate interest in ensuring that aid is not exploited by armed groups, this interest must be balanced against the fundamental rights of civilians and the integrity of neutral humanitarian action.
The demand for Palestinian staff lists—particularly in the absence of enforceable safeguards—exceeds reasonable security measures and contravenes both IHL and the ethical foundations of humanitarian work. It places humanitarian actors in an untenable position, undermines trust in medical institutions, and exacerbates an already catastrophic public health emergency.
To prevent further erosion of humanitarian space, the international community must take urgent steps:
Establish Independent Verification Mechanisms: A joint international oversight body—potentially under UN auspices—should be created to verify NGO compliance with anti-terrorism standards without compromising staff privacy or organizational independence.
Invoke Compliance Procedures under the Geneva Conventions: States parties should activate Article 1 common to the Geneva Conventions, urging Israel to comply with its obligations to facilitate humanitarian relief.
Protect Humanitarian Workers: The UN Security Council should pass a resolution reaffirming the inviolability of medical personnel and condemning retaliatory actions against aid workers.
Support Alternative Delivery Models: Investment in local civil society and telemedicine initiatives could help mitigate the impact of international NGO withdrawals, though these cannot fully replace on-the-ground emergency care.
Ultimately, the case of MSF in Gaza underscores a profound moral and legal dilemma: when security imperatives are used to justify the withdrawal of life-saving aid, the cost is paid not by combatants, but by the most vulnerable—children, the sick, and the displaced. In silencing humanitarian voices, the path to peace becomes ever more distant.
References
Médecins Sans Frontières (MSF). (2026). Statement on Israel’s Decision to Terminate MSF Operations in Gaza. February 1, 2026. https://www.msf.org
Office for the Coordination of Humanitarian Affairs (OCHA). (2026). Humanitarian Situation Update #432 – Occupied Palestinian Territory. United Nations.
International Committee of the Red Cross (ICRC). (1949). Fourth Geneva Convention Relative to the Protection of Civilian Persons in Time of War.
International Committee of the Red Cross (ICRC). (1977). Protocol Additional to the Geneva Conventions of 1949, and Relating to the Protection of Victims of International Armed Conflicts (Protocol I).
United Nations General Assembly. (2018). Resolution 2417 (XXIII) on Conflict and Hunger.
Amnesty International. (2025). “We Are Not Spies”: Humanitarian Workers Under Siege in Gaza.
Human Rights Watch. (2026). Israel: Blocking Medical Aid to Gaza Violates International Law.
BBC News. (2023–2026). Coverage of the Israel-Hamas War and Humanitarian Access to Gaza.
Akande, D. (2025). “Humanitarian Vetting and the Limits of State Power in Occupied Territories.” European Journal of International Law, 36(2), 345–367.
Chikli, A. (2026). Press Conference Transcript, Ministry of Diaspora Affairs, Jerusalem. February 1, 2026.