THE world has been witnessing unprecedented atrocities in Gaza, beginning with the reprehensible attack on Oct 7, 2023, by Hamas militants, which killed 1,139 Israeli nationals and saw 200 taken hostage. The attack was triggered by the situation the people of Gaza have faced since the blockade of 2007. Despite their desperation, Israel resorted to a predictably massive and disproportionate response, leading to destruction and misery in Gaza at a scale not witnessed before.

Over 70 per cent of Gaza`s built structures lie flattened by incessant bombardment and ground assaults. Most of the energy, water and sewerage infrastructure has been destroyed. Conservative estimates suggest that over 60,000 individuals have been killed so far, with one of the highest proportions of child deaths an estimated 17,000 recorded in any modern urban siege or conflict.

The indiscriminate use of force by the Israel Defence Forces and a complete blockade of humanitarian aid has been abetted, if not encouraged, by the Western powers. Protests by neighbouring Muslim countries have been muted and uncoordinated. President Donald Trump`s highprofile visit to the Middle East in May this year has yielded no solution or ceasefire in any negotiation or communiqué. It has been a glaring omission and missed opportunity, with major ramifications.

When negotiations collapsed in March this year, Israel completely blocked the entry of humanitarian assistance, food, medicine and water to Gaza, leading to one of the worst manmade humanitarian disasters in recent memory.

All but one hospital has been destroyed and over 765,000 people displaced since Israel ended the ceasefire on March 18, 2025. Most of Gaza`s population now lives in abysmal circumstances in ruined homes and temporary shelters, squeezed within less than 12pc of the Strip`s total area, with major curbs on their movement. Disruptions in basic services, safe water and access to medications have played havoc with lives. The so-called Gaza Humanitarian Fund, set up by Israel and the US to provide assistance, is not only grossly inadequate but also a death trapfor desperate people seeking food. Children have paid a dispro-portionate price over the last 21 months, given their vulnerability and limited resilience.

Although the full picture of the health and nutrition consequences of the Gaza siege and bombardment will emerge only when the rubble is cleared, conservative estimates show that the death count may be significantly higher than reported. The longer-term effects on survivors will be much greater in terms of injuries, suffering and mental health as they will be on health and development outcomes, especially for children. The deliberate targeting and destruction of Gaza`s health services and facilities has also impacted newborn and child survival and led to an exponential increase in childhood illnesses such as diarrhoea, dysentery and acute respiratory infections. However, some of the most damaging and enduring consequences stem from prolonged undernutrition and starvation, through a despicable policy of food blockade, which is akin to genocide.

The crisis has reached an extreme stage.

According to the most recent figures from the Integrated Food Security Phase Classification report (July 29), the situation in Gaza fulfils two of the three requirements for a famine declaration namely that at least one in three children is acutely malnourished; one in five people suffers from extreme food shortage; and two of every 10,000 people die from starvation or malnutrition and disease, although this level of reporting is impossible in conflict settings without surveys.

In Gaza, some 39pc of the population reports not having eaten for days and rates of severe acute malnutrition have quadrupled over the last two months and exceed 15pc in most areas.

The long-term consequences of such mass starvation on vulnerable women and children are massive and well-documented in the literature.

The blockade of food to Holland`s population in the winter of 1944-45, at the tail end of World War II, was also known as the `Dutch Hunger Winter`. Its consequences continue to be tracked.

Babies born to malnourished mothers in that period have been shown to bear scars of a higher burden of illnesses and mental health issues.

Indeed, they are at a far higher risk of non-communicable diseases for the rest of their lives. All of these consequences in the Gaza conflict willneed long-term follow-up.

As members of the Standing Together for Nutrition Consortium, nutrition scientists across the globe published a comment in The Lancer last month, demanding action for stopping the use of mass starvation as a weapon of war. They have rightly pointed out that undernutrition is not only a consequence of war, it is also the seed for future conflicts. If an entire generation is allowed to grow up hungry, traumatised and without hope, we all are complicit in setting the stage for further suffering.

History will judge the global community harshly for failing Gaza and its people, and permitting this mass violation of humanitarian principles. The use of mass starvation of besieged populations, especially women and children, as a weapon of war is strictly prohibited under international law. But Gaza is not the only recent example where this has happened. We witnessed similar atrocities in the Syrian conflict, and millions of women and children in Sudan today face comparable brutality, in this instance at the hands of fellow Muslims.

We call upon all leaders of the OIC representing 48 Muslim-majority countries to further press for an immediate ceasefire in Gaza and hold a specific emergency session. Apart from calls for an independent Palestinian state, discussions should focus on measures to completely ban the use of food blockades and mass starvation as weapons of war, collective enforcement measures in case of non-compliance, and allocation of appropriate resources for the desperate people of Gaza once the conflict is over. Many eyes are now focused on the upcoming UN General Assembly session in New York this September. If a call is given for an immediate ceasefire and comprehensive humanitarian action in Gaza, it could become a turning point. • Zulfiqar A. Bhutta is a distinguished university professor and founding director of the Institute for Global Health and Development across Aga Khan University campuses in South-Central Asia, East Africa and the UK.

Zafar Mirza is a former health minister and currently a professor of health systems & population health at the Shifa Tameer-i-Millat University