Israel has recently revoked the licences of 37 humanitarian organisations providing humanitarian assistance to people in desperate need in Gaza, with Médecins Sans Frontières (MSF – Doctors Without Borders) being one of them.
What are some of the consequences of the decision to revoke the licence of Médecins Sans Frontières?
What this is about is the manipulation and instrumentalisation of humanitarian assistance. That is a fact that we’ve seen throughout this war. Essentially, it is a distraction from the [real] situation in the Gaza Strip. There is a propaganda campaign being conducted against MSF and other humanitarian organisations that is undermining our work and as a consequence putting our staff and activity in acute danger.
What are the current difficulties your organisation is facing on the ground in delivering aid to the people of Gaza?
The first thing to say is that since the ceasefire agreement came into effect the killing hasn’t stopped. We have reliable figures up until a few weeks ago. We are aware that more than 375 Palestinians were killed in the period since the ceasefire was supposed to have come into effect. By 8 December nearly a thousand people were injured as well. At the same time, the aid supply is unpredictable at best and often still subject to relatively arbitrary restrictions when it comes to “dual use items,” for example. This is in a situation where we are going into the winter and the living conditions of often-displaced Palestinians in Gaza is getting worse by the day. That is having a direct impact on their health.
We see wounds that have become infected. These are often simple things that, if not treated, end up having big effects. There is no access to proper laboratories, for example. Diagnosis of bacterial infection can be very difficult, and therefore it can be difficult to prescribe the right type of antibiotic, which increases the prevalence of antimicrobial resistance.
Just last week 29 babies died in the Nasser Hospital just two hours after arriving at the pediatric ward that we were supporting due to hypothermia. Children are losing their lives because of the lack of basic items for survival. So, the killing hasn’t stopped. And, at the same time, there is still a critical healthcare emergency that is impacting the population, many of them often displaced and living in tents in very difficult weather.
Are you facing specific difficulties in your ability to deliver aid to the Gazans?
It remains a very difficult exercise. We are still struggling with supply. One of the key messages we have for the world is that the blockade on Gaza must end. There must be unconditional, unrestricted and impartial aid allowed into the Gaza Strip. There is still a systematic and intentional deprivation of aid. All of this must stop.
If MSF is not allowed to operate, what will happen to Gazans who are in desperate need?
That is essentially our question, too. Let me put that in context, as [MSF is] one of the dozens of humanitarian organisations still trying to operate in Gaza. We do want to continue to be able to provide emergency medical assistance to the population.
In 2025 alone, MSF carried out 800,000 outpatient consultations. We treated 100,000 trauma cases. We supported 10,000 deliveries, and we provided over 700 million litres of water. We support one in five of the hospital beds in Gaza, and we support one in three of the mothers giving birth daily in Gaza. What we need to see in the Gaza Strip is an increase in humanitarian assistance, not a decrease. Humanitarian assistance is a fundamental obligation under international humanitarian law. It is not optional; it is not to be caveated or made conditional.
Have you come across cases of corruption in the distribution of humanitarian aid?
We’ve heard of trucks being looted. It’s unsurprising [that it is happening]. But we haven’t experienced that in a significant way ourselves. It’s unsurprising that people are desperate in Gaza. We’ve seen the fabric of society targeted and pulled apart. So, there is a degree of societal breakdown.
Can you comment on the work of humanitarian workers operating in Gaza?
Unfortunately, we’ve had 15 staff members killed in Gaza since the 7 October operation. In Sudan, there were 128 aid workers killed. There are many things we need to do to protect our aid workers. There are many practical things in terms of ensuring people know where we are, so that we are not targeted and make sure that everyone understands what we are doing.
Fundamentally, for me, it is a question of accountability. We always try to inform our staff of the risk involved in the work, so nobody is unaware of the situation they are in. But unless there is a real prospect of accountability when things do go wrong, we are not fundamentally addressing the issue. I see a direct link between the safety of aid workers and the need for accountability for all crimes that are committed, whether that’s directly towards aid workers or the destruction of health facilities in places like Gaza or Sudan, for example.
Do you believe there has been a decline in respect for international humanitarian law?
Yes, I could say there has been a decline… because of the lack of accountability associated with it. It is true that the law is there, and that it should be applied to make sure everyone is held accountable where there are violations. Fundamentally, this requires [UN] member states to hold each other accountable when there are violations and to make sure that they are not putting their national interests ahead of the law or of the need for accountability.
What are the difficulties that MSF is facing on the ground in Sudan?
I think the biggest difficulty is the scale and the brutality of the conflict. There has been a war on people there. Since the beginning of the conflict, civilians have been targeted. The patterns being used are of ethnic targeting, very similar to the ones used in Darfur, particularly in West Darfur around Al-Genina. Or, as we have seen more recently, towards and around Al-Fasher where a lot of the non-Arab tribes have been subject to the most brutal violence.
We are terrified about what happened in Al-Fasher, but we don’t have access so we can’t even see what the needs are. We are very concerned about where people might have fled to after the recent attacks of which they have been victims. The huge amount of uncertainty is one of the very difficult factors involved in operating in Sudan.
Where do you feel progress needs to be made for humanitarian organisations like MSF to work and deliver in a more effective manner?
I think the main thing is political and is around accountability. If there is accountability for crimes, we can do our job, even in very difficult circumstances. We don’t need the UN Security Council to allow us to go do our work. But what we do need from the Security Council and from states more generally is to hold each other to account when violations of international humanitarian law happen or when aid workers are killed.
[This] is also about allowing access, whether in Sudan or Gaza, to humanitarian aid, not just in terms of supply, but also in allowing people to move around. Because if we reduce aid to simply trucks crossing borders, then we are not in any way understanding the complexity of the work that needs to be done. Otherwise, we are just pretending that we can solve the problem by [sending in aid] trucks. We need doctors; we need nurses. We need all these people to reach and touch patients individually.
We are in an age of budget cuts when governments are taking funds away from humanitarianism causes to allocate to defence. How is this affecting the work of organisations like MSF?
It is true that, sadly, governments are increasingly cutting the funding of humanitarian aid for areas in desperate need of it and diverting their spending to areas considered more of a priority such as defence. In our case at MSF, we are 98 per cent privately funded. So, in terms of the direct impact [of these cuts], we are still able to operate because of our lack of dependence on governments. But this does not necessarily mean that people around the world are rowing back on their desire to show solidarity with [others]. I should say that there is still a message of hope.
Looking at the aid sector more broadly, it is very clear that [government aid budget cuts] are having a huge impact in terms of being able to address needs… We are getting more patients coming to our clinics, and at the same time it is getting more expensive to carry out the same activities. The challenge is the increasing costs of care as well as the number of patients we need to help. But this is not just a numerical issue. It is also a rollback in [our] activities in support of sexual and gender-based violence.
* A version of this article appears in print in the 22 January, 2026 edition of Al-Ahram Weekly
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