Accepted by Israel Journal of Health Policy Research, Download Pre-Proof version In Press

Download PDF

Naomi Fliss-Isakov^1,2,3, Dorit Nitzan⁴, Moran Blaychfeld Magnazi^3,5, Joseph Mendlovic^3,6 Sharon Alroy Preis³, Gilad Twig ^2,7,8, Aron M. Troen⁹, Ronit Endevelt^3,10

1. Department of Health Promotion, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
2. The Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Ramat Gan, Israel
3. Israel Ministry of Health, Jerusalem, Israel
4. Master's Program in Emergency Medicine, School of Public Health and Food Systems, One Health and Resilience Research Center (BGU-FOR), Ben Gurion University of the Negev, Beer Sheva, Israel
5. Braun School of Public Health and Community Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
6. Department of Pediatrics, Shaare Zedek Medical Center, affiliated with the Hadassah University School of Medicine, Jerusalem, Israel
7. The Institute of Endocrinology Diabetes and Metabolism, Sheba Medical Center, Ramat Gan, Israel
8. Department of Preventive Medicine and Epidemiology, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
9. Institute of Biochemistry Food and Nutrition Science, The Robert H. Smith Faculty of Agriculture Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
10. Faculty of Welfare and Health, School of Public Health University of Haifa, Haifa, Israel

Corresponding author: Naomi Fliss-Isakov

Email: naomi.fliss@moh.gov.il

Abstract

Background: The ongoing Hamas-Israel war has put the civilian population in Gaza at risk of severe food and nutrition insecurity. Our goal was to provide objective, verifiable data to ascertain amounts and nutritional content of food supplied to Gaza through Israeli border crossings from January to July 2024. We aimed to assess their compliance with Sphere international humanitarian standards for food security and nutrition maintenance in crisis affected populations.

Methods: We obtained the registry of all food supplied to Gaza via air drops and land crossings from Israel’s Coordinator of Government Activities in the Territories (COGAT) from January to July 2024 . This registry itemizes daily food shipments, items and estimated weights. Food items in shipments were categorized, quantified, and assessed and summed for energy, protein, fat, and iron content, based on food labels and composition tables. We then calculated supply per capita per day supplied to the Territory, according to the most recent population census of Gaza. Finally, we compared it to the Sphere standards for food security and nutrition.

Results: Adjusting for projected food losses, a net total of 478,229 metric tons of food was delivered to Gaza over the seven consecutively studied months. The average amount of energy available per person per day was 3,004 kcal, with 98 grams of protein (13% of energy), 61 grams of fat (18% of energy), and 23 milligrams of iron. Except for February, when entries dropped from January, there was a steady increase in the tonnage, energy, macronutrients and iron content of donated foods supplied to Gaza registered by COGAT. The amounts of energy, protein, and fat, but not dietary iron, in food crossing the border into Gaza consistently exceeded Sphere standards after making conservative adjustment for high food loss and the age distribution of the Gazan population.

Conclusions: This study assessed food deliveries by type, amount and nutrient composition, supplied to Gaza from January to July 2024. We found that, except in February, food crossing the borders into Gaza exceeded the per capita minimum for humanitarian aid. While reliable data do not exist for critical dimensions of food access and consumption across Gaza, these estimates suggest that adequate amounts of nutritious food were being transported into the Territory during most of the 1^st half of 2024. We propose that with increased cooperation of all partners and shared efforts to overcome barriers, communication and data sharing, the UN Food Security Cluster, COGAT and humanitarian assistance agencies can develop a comprehensive, continually updated database to gauge food availability, access, nutritional value, and gaps to address, especially in the areas most disrupted by conflict in Gaza. This will also help ensure that food donations supplied to Gaza reach populations in greatest need.

Keywords: Hamas-Israel war, Food insecurity, Famine