UN Warns Gaza Aid at Risk Amid Insecurity, Access Limits

After nearly two years of conflict between Hamas and Israel, displaced Palestinians in Gaza have begun returning home as humanitarian organisations work to restore essential, life-saving services. Despite recent progress, the United Nations (UN) and its partners continue to face major obstacles in reaching the most vulnerable populations due to ongoing insecurity and heightened restrictions. With winter fast approaching—and expected to further worsen living conditions—sustained aid operations remain critical.

Roughly one month into the ceasefire, the Office for the Coordination of Humanitarian Affairs (OCHA) has reported daily bombardments of residential areas in zones where Israeli forces remain deployed, particularly in eastern Khan Younis and eastern Gaza City. The agency has also documented multiple ceasefire violations along the “Yellow Line,” resulting in numerous civilian casualties.

According to Gaza’s Ministry of Health, between 29 October and 5 November, bombardments caused 15 Palestinian deaths and 24 injuries. An additional 31 bodies were recovered from the rubble of collapsed buildings. The Ministry further reports that since the start of the ceasefire, 241 Palestinians have been killed and 609 injured.

Philippe Lazzarini, Commissioner-General of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), noted that the humanitarian situation in Gaza depends heavily on the stability of the ceasefire. “A ceasefire that merely prolongs the absence of war without charting a viable path to peace would only repeat the disastrous mistakes of the past,” Lazzarini wrote in a Guardian op-ed on 10 November. “A truly peaceful future requires a genuine investment in a definitive political solution to the Israel-Palestine conflict.”

Lazzarini also underscored the urgent need for an international stabilisation force to protect key civilian infrastructures, facilitate humanitarian operations, and ensure accountability for violations of international humanitarian law. On 12 November, he told reporters at UN headquarters that accountability is crucial for establishing a sustainable end to violence and a path to recovery for Palestine as a whole.

“The starting point could at least be a board of inquiry,” said Lazzarini. “More broadly, if we want to promote any lasting peace, I don’t think we will succeed if we are not working towards justice, healing, and a recognition of the scope of atrocities committed.”

Despite the UN noting improvement in Gaza’s humanitarian situation, conditions remain dire, with famine and disease still imminent threats. The UN and its partners continue to face severe access constraints imposed by Israeli authorities. UN Secretary-General António Guterres said the UN is far from having “what is necessary to eliminate famine quickly and create conditions for the people in Gaza to have the very, very minimum that is necessary for dignity in life.”

OCHA also reports that access to humanitarian aid and agricultural fields beyond the Yellow Line remains prohibited, with yellow-painted concrete blocks marking restricted areas, as ordered by the Israeli Defence Minister. Access to the sea also remains barred, and Israeli forces have detained at least five fishers since 4 November.

According to OCHA, several essential aid items remain blocked from entering Gaza—including humanitarian vehicles, solar panels, mobile latrines, x-ray machines, food supplies, educational materials, and generators—many of which Israeli authorities classify as outside the scope of humanitarian assistance. OCHA further reports continued restrictions on tools needed for maintaining water, sanitation, and hygiene (WASH) systems. Dozens of UNRWA vehicles and pieces of equipment, including water tankers and jetting trucks, have yet to be authorised for entry.

UNRWA and its partners have expressed alarm over the continued restrictions during the ceasefire, especially with winter expected to worsen living conditions for Palestinians in shelters. The Shelter Cluster estimates that at least 259,000 Palestinian families—over 1.45 million people—will be adversely affected by winter if adequate protective measures are not implemented soon.

In a 5 November joint statement, several UN agencies—including UNRWA, UNICEF, and the World Health Organization (WHO)—said they are working with Gaza’s Ministry of Health on an “integrated catch-up campaign” for immunisation and nutritional support to reach approximately 44,000 children who have been cut off from life-saving services since the conflict began.

An estimated one in five children under age three has received no vaccinations or is under-vaccinated, leaving them highly vulnerable to preventable disease outbreaks. The campaign will consist of three rounds to provide missed routine vaccines, including Pentavalent, Polio, Rota, Pneumococcal, and two doses of MMR.

Vaccination services will be available at 149 health facilities and 10 mobile units, with the first round scheduled for 9–18 November. The second and third rounds are planned for December 2025 and January 2026.

Alongside vaccinations, UNICEF and partners will screen children for malnutrition, provide treatment and follow-up, and refer severe cases to WHO-supported stabilisation centres. UNICEF is also rehabilitating 15 health centres, while WHO is restoring an additional 20 partially or fully damaged facilities.

“This immunisation campaign is a lifeline, protecting children’s health and restoring hope for the future,” said Dr Richard Peeperkorn, WHO Representative in the occupied Palestinian territory. “It is a crucial step in strengthening essential health services and protecting vulnerable children in Gaza who have been cut off for far too long. Yet this is only one piece of the puzzle. Much more is needed, and WHO is working to rebuild Gaza’s fragile health system so every child, every community, can access the care they deserve.”

Lazzarini added on 12 November that UNRWA has been a lifeline for Gaza throughout the crisis. Over the past two years, it has supported more than 15 million primary health consultations—an average of 14,000 per day.

UNRWA has also played a critical role in preventing Gaza’s water system from collapsing, with Lazzarini noting that roughly “40 per cent of clean water is thanks to the work of UNRWA engineers on the ground.” Furthermore, the agency has supported more than 48,000 children across 96 UNRWA schools five days a week, while restoring online learning for around 300,000 children.

“I believe that we are and remain an extraordinary asset for the international community, especially in securing critical services for Gaza’s population and supporting stabilisation efforts,” said Lazzarini. “The main challenge is safeguarding UNRWA’s operational space in Gaza. That is challenge number one—to acknowledge that the agency is a vital partner and an invaluable asset in helping consolidate the ceasefire and ensuring a successful recovery.”