WORKING PAPER (Pre-peer-review preprint)

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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

Note: This working paper is undergoing peer review. The findings are provisional and the conclusions may change

Abstract

Background: The ongoing Hamas-Israel war puts 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 donations entering Gaza through Israeli border crossings from January to July 2024. We aimed to assessed 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 aid delivered to Gaza via air drops and land crossings for the study period from Israel’s Coordinator of Government Activities in the Territories (COGAT).  This registry itemizes daily food shipments, items and estimated weights. It provides more complete data than the UN dashboards because it includes food supplied by state, private, and commercial sector donors, who are not affiliated with the UN aid clusters. Each food item in each shipment was categorized, quantified, and assessed for its nutrient composition. We then summed the energy, protein, fat, and iron content of all shipments, and calculated supply per capita per day, according to the size of Gaza’s population. Finally, we compared it to the Sphere standards for food security and nutrition.

Results: After accounting for food loss, a net total of 478,229 metric tons of food was delivered to Gaza. The average amount of energy available per person per day was 3,004 kcal, with 98 grams of protein (13.0% of energy), 61 grams of fat (18% of energy), and 23 milligrams of iron. Except for February there was a steady increase in the caloric, macronutrients and iron donated into Gaza that was registered by COGAT.  The amounts of energy, protein, and fat exceed Sphere standards and remain consistent even after making adjustments for high food loss and the age distribution of the Gazan population.

Conclusions: This study assessed humanitarian food aid deliveries and availability in the Gaza Strip, the first pillar for meeting nutritional needs of the Gazan population. We found that with the exception of February, food aid delivered to Gaza during January-July 2024 exceeded the minimal daily per capita needs of all the people in Gaza, meeting humanitarian standards. While availability, the first pillar of food security, appears to be adequate, ensuring the food security of the population requires evaluation of the three remaining pillars of food security: access, utilization, and stability. With increased cooperation, the UN Food Security Cluster and COGAT could develop a comprehensive and continuously updated database of available food in Gaza. This would not only improve the transparent and objective assessment of food insecurity, but also ensure that future donations and their distribution could be tailored to meet the population's dynamic needs and circumstances.

Keywords: Hamas-Israel war, Food insecurity, Famine