In 2025 alone, MSF teams handled over 100,000 trauma cases; managed the care for over 400 hospital beds; performed 22,700 surgical operations on nearly 10,000 patients; carried out almost 900,000 outpatient consultations; administered 45,000 vaccinations; assisted in more than 10,000 births; provided more than 40,000 individual mental health sessions and group sessions for over 60,000 people; distributed more than 700 million litres of water and produced nearly 100 million litres of clean water. MSF’s programmes are critical lifelines. Medical care and humanitarian assistance on this scale cannot easily be replaced.

Despite the 1 January 2026 deadline for 37 NGOs to leave Palestine, we are committed to remaining to provide assistance. If MSF loses access to Gaza, hundreds of thousands of people will lose access to critical medical care and water.

In Gaza, MSF is currently supporting five public hospitals and running two field hospitals. We also support seven general healthcare centres and work in three clinics. MSF has recently opened six new medical points where we provide wound care and other general healthcare services.

MSF has been working in Palestine since 1988.

For many months, MSF has unsuccessfully sought dialogue with the Israeli authorities on the renewal of our registration to work in Palestine. We remain open to dialogue with the Israeli government to ensure we can continue to address the immense needs in Gaza and the West Bank. We would consult our Palestinian colleagues on any possible next step.

By accusing MSF, as well as other NGOs, of not cooperating and creating smear campaigns against aid organisations, Israel is using unfounded allegations to arbitrarily restrict access to critical care for Palestinians and limit witnessing from independent organisations working on the ground. This type of accusation contributes to the delegitimisation of humanitarian workers who are delivering vital care and services under extremely challenging conditions.

We observe that such accusations fit within a long-standing pattern used by Israeli authorities, alongside numerous physical and bureaucratic obstacles, to restrict the entry and delivery of aid into Gaza. Similar tactics were used in 2024 against UNRWA. Allegations are used to justify actions which stand in clear contradiction to the Israeli government’s claims that it is facilitating the provision of humanitarian assistance to the Gaza Strip.

MSF is fully registered to work in Palestine, under our registration with the Palestinian Authority.

We are working to preserve our humanitarian response in Gaza and the West Bank in an increasingly constrained environment. As an occupying power, the Israeli authorities are obliged to ensure humanitarian assistance is provided. Governments worldwide must ensure International Court of Justice decisions are respected, this includes facilitating the immediate and effective provision of humanitarian assistance.

For 2026, MSF had planned to expand our programme with a budget of 130 million euros.

Since the beginning of January, MSF has been prevented by the Israeli authorities from bringing international staff and additional supplies into Palestine, and by 1 March 2026 all of MSF’s international staff will be forced to leave the territory. This deprives our medical teams of much-needed materials and technical skills.

Our medical programmes are already facing shortages, and our medical teams are particularly concerned for their ability to continue to provide emergency trauma care and rehabilitation services to patients, as well as paediatric care, sexual and reproductive health services, and care for non-communicable diseases and psychiatric conditions. In the longer term, our activities will be uncertain and potentially impossible to maintain under such restrictive conditions.

We remain committed to providing assistance to Palestinians in Gaza and the West Bank. As an occupying power, the Israeli authorities are obliged to ensure humanitarian assistance is provided.

In an effort to explore every possible option – however limited – to continue providing critical medical care, MSF informed Israeli authorities on 23 January that, as an exceptional measure, MSF would be prepared to share a defined list of Palestinian and international staff names, subject to clear parameters, with our staff safety at its core. This position was defined following consultation with our Palestinian colleagues and with the clear understanding no staff information would be shared without the express agreement of individuals concerned.

However, despite repeated efforts, it became evident that we were unable to build engagement with Israeli authorities on the concrete assurances required. 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.

As a result, and in the absence of these clear assurances, we have concluded that we will not share staff information in the current circumstances. We remain open to dialogue with the Israeli government to ensure we can continue to address the immense needs in Gaza and the West Bank.

No, we have not at any moment handed over any list of our national or international staff to Israeli authorities as part of this registration process.

Expelling MSF, alongside dozens of other humanitarian organisations, would deprive hundreds of thousands of people of essential medical care. MSF is one of the few international organisations able to witness and denounce the ongoing genocide and if we are forced to leave, we will lose this ability.

Israeli authorities have forced humanitarian organisations including MSF into an impossible choice – between sharing information about our staff or maintaining critical medical care in a context of staggering humanitarian needs and extreme violence against health workers. 

Facing an increasingly restrictive environment for our operations, MSF wanted to explore all possible chances to continue providing medical care in Gaza and the West Bank. As such, we wrote to the Israeli authorities explaining that as an exceptional measure, under exceptional circumstances, we would be prepared to provide a defined staff list subject to clear parameters with staff safety at its core.

We did not share the personal details of any of our colleagues. Despite repeated efforts, it became evident that we were unable to build engagement with Israeli authorities on the concrete assurances required. As a result, and in the absence of these clear assurances, we have concluded that we will not share staff information in the current circumstances.

This process included dialogue across teams and most critically with our Palestinian colleagues, taking into account their perspectives and concerns, including with respect to their personal safety and the consequences of MSF’s potential withdrawal.

Throughout, we stressed that no information would be shared without the agreement of the individual concerned, and no pressure should be put on anyone regarding decisions affecting MSF’s continuation of operations in Gaza and the West Bank. It was emphasised that not participating would not impact people’s employment with MSF.

We used several channels to gather staff feedback, including focus-group discussions, one-to-one conversations, surveys, and town-hall style exchanges. In these discussions, our colleagues voiced a wide range of concerns, including safety risks, and uncertainty about the implications for our humanitarian principles. Some were worried about possible repercussions of sharing their details, while others questioned whether complying would lead to registration or yet further demands.

We recognise the limitations and difficulty for our Palestinian colleagues to provide proper informed consent in this environment of coercion imposed by the Israeli authorities. Israel knowingly gave MSF and our Palestinian colleagues an impossible choice; either we provide information about our colleagues or risk being forced to abandon the hundreds of thousands of Palestinians who need vital medical care. The lack of assurances from the Israeli authorities also makes it impossible for our staff to know what they would be accepting, should they provide their names.

Despite the challenges of consent, it was not possible or acceptable, to make any decisions without discussing with our Palestinian colleagues. What was conducted was a consultation, not a transfer of institutional responsibility. The intention was never to ask our colleagues to carry the weight of an unbearable decision, but to ensure we heard their views on a question that is existential for their safety and work.

Yes, we are offering financial support to all the families of MSF staff members who have been killed by Israeli forces. We are in touch with all the families to support them, including by providing legal and financial support and health coverage for dependents, and we will continue to do so.

MSF takes these allegations seriously. MSF would never knowingly employ people engaging in military activity. Any employee with links to an armed group would pose a serious risk to our staff and to our patients. For this reason, wherever we operate, all MSF staff are required to commit to the MSF Charter, which includes strict adherence to humanitarian principles, independence, and medical ethics.

Recruitment procedures include rigorous due diligence, background and reference checks, CV verification, and probationary periods. MSF has implemented an enhanced screening and vetting process for all staff recruited in this context. As everywhere else, MSF operates strictly in accordance with the principles of neutrality, impartiality, and independence, providing medical care based on need alone, irrespective of political authority or affiliation. Our support to the health system in Gaza is purely humanitarian and in no way ideological.

MSF works with the Ministry of Health in Gaza, which is part of the Hamas Civilian Administration. The current smear campaign against aid organisations by Israeli authorities' states that “MSF shares information with a terrorist organisation”, when in fact coordinating with medical authorities is standard practice in any place where we operate. These smear tactics attempt to distract attention away from the humanitarian catastrophe on the ground. As everywhere, MSF operates strictly in accordance with the principles of neutrality, impartiality, and independence, providing medical care based on need alone, irrespective of political authority or affiliation.

Our operations are independent, transparent, and strictly monitored. A USAID review found no evidence of widescale diversion of humanitarian aid by Hamas in Gaza. Senior Israeli army officers have also acknowledged that there is no evidence of systematic widescale diversion of humanitarian aid by Hamas in Gaza.

From the beginning of this war, the number of trucks carrying medicine, food, and water which have crossed the borders into Gaza have been entirely insufficient, in comparison to the scale of destruction and need. During the past two years, we have communicated and documented the ways in which Gaza’s supply chain of humanitarian aid has been effectively choked by Israeli authorities. Lengthy bureaucratic procedures and “dual-use items” lists have been put in place. The “dual-use item” prohibition is why some items have not been allowed to enter Gaza, including scalpels and oxygen generators.

We were horrified by the mass killing of 1,200 people in Israel by Hamas, and we unequivocally condemn those attacks. We are horrified by the spiral of violence and the tragedies on both sides. Our communications are driven by what our medical teams see on the ground and their work in the medical facilities we support. Hence, we have been speaking out about the ongoing genocide in Gaza. We speak out when we witness unacceptable suffering, attacks on healthcare facilities, the denial of access to healthcare facilities, and when warring parties fail to protect civilians.

Throughout our activities in Gaza since 7 October 2023, we have never encountered a patient who was presented as being among the hostages. Our work as medics is to provide healthcare to anyone who needs it – any patient is a patient. It is a fundamental principle of medical ethics to provide medical care in the best interest of any patient. We feel for the suffering endured by those who were taken hostage on 7 October 2023, as well as the anguish of their loved ones. Not only since October 2023 but in all contexts and in any situation of conflict, MSF calls for the protection of civilians.

United under a single charter, MSF teams bring together health professionals, logisticians, and administrative staff from dozens of nationalities, both international and locally employed colleagues. After assessing the needs of affected communities, we provide assistance in accordance with medical ethics and the principles of humanitarian action.

Impartiality is the cornerstone of MSF’s’ mission. We deliver aid without discrimination, prioritising those most immediately at risk. MSF operates with a spirit of neutrality and does not take sides in armed conflicts. However, we may publicly denounce and criticise obstacles to our humanitarian work and violations of international law.

In conflict situations, MSF bears witness to the plight of victims, particularly civilians, and in this respect, we are outspoken.

Our teams report what they see with their own eyes, and what they themselves experience, in Gaza and the West Bank. Numerous observers, legal experts, human rights organisations, and several United Nations reports also describe the total destruction of the Gaza Strip. This includes Israel’s dismantling of the health system, siege imposed on the territory, disregard for civilians and civilian infrastructure, and man-made famine, which are all part of a genocidal campaign.

MSF made the difficult decision to suspend all non-critical medical operations in Nasser Hospital, the largest functional facility in Gaza, as of 20 January 2026 due to concerns regarding the management of the structure, the safeguarding of its neutrality and security breaches.

In recent months, in Nasser Hospital in Khan Younis, patients and MSF personnel have seen armed men, some masked, in the different areas of the large compound of the hospital. This had not been in areas where MSF has activities, but in other parts of the hospital compound. With an uptick since the ceasefire, MSF teams have reported a pattern of unacceptable acts including the presence of armed men, intimidation, arbitrary arrests of patients and a recent situation of suspicion of movement of weapons. These incidents pose serious security threats to our teams and patients.

MSF formally expressed its strong concern to the relevant authorities and emphasised the incompatibility of such violations with MSF’s medical mission. Hospitals must remain neutral, civilian spaces, free from military presence or activity, to ensure the safe and impartial delivery of medical care.

MSF’s concerns are heightened by past attacks on hospitals during the conflict, as health facilities have been regularly and deliberately targeted by the Israeli forces, resulting in loss of life and damage to infrastructure. MSF calls on all armed groups, as well as Israeli forces, to respect medical facilities and ensure the protection of staff and patients.