So let's continue with the press briefing of the UN in Geneva today, 22nd of August.
As I said before, we are going to continue speaking about the report of the IPC on Gaza at 11:00 when the embargo will will, will fall, I will end and in the in between let's remain with Ocha.
Yens has kindly brought us Mr Adam Abdemullah, who is the UN Resident and Humanitarian Coordinator for Syria.
Mr Abdemullah, you are connecting in from Damascus, I understand, to tell us about your recent visit to Auswayda.
So you have the floor, Alice, Jens from something.
OK, so let's go straight to you.
And then we will open the floor to questions.
We can, but I'd like to ask my colleague in the if they can put up the volume in the room, please.
Yeah, I'm trying to find this.
Yeah, I'm having a little technical difficulty here.
Good morning, colleagues.
And it's always a pleasure to meet with you, even if only virtually.
This past Wednesday, I LED AUN delegation to Aceveda to assess the humanitarian situation there.
We met with the local community, displaced families, local officials, doctors and NGOs.
What we saw on here was deeply alarming.
More than 185,000 people are displaced across Azueta.
There are a rural Damascus where people sought refuge.
Many are sheltering in schools, therefore raising urgent concerns as the academic year approaches.
In some sites, displaced communities outnumber their hosts, putting them under significant strain.
With the little resources available, families are surviving on dwindling food stocks.
Very few shops remain open and the little that is available is sold at exorbitant prices.
At the National Hospital in a Sueda, there is an acute shortage of medicines, diagnostic equipment and surgical tools.
The hospital is self sustained some damage due to the fighting at the Shabba National Hospital, doctors have been forced to take extreme measures with no anaesthetics available.
Even ambitations are carried out without them.
Across the governorate, there is a serious shortage of essential medicines including insulin.
Fuel is almost nonexistent.
On the way to Al Suede, we saw destruction everywhere.
Hardly a single house was left untouched.
The UN and humanitarian partners had been responding since day one, as much as conditions allowed.
In coordination with the Syrian Arab Red Crescent, the United Nations and humanitarian partners have dispatched so far 12/8 convoys today delivering a broad range of life saving assistance.
Over 300,000 people are currently being reached each month with some form of humanitarian aid.
Much more is still needed.
While humanitarian aid is critical, restoring full commercial access and reopening trade routes is crucial.
We appreciate the Syrian government for its support and facilitation of the mission.
We also appreciate the facilitation of humanitarian access, which will allow us to scale up our response.
We call on donors to step up their support to allow humanitarian partners to respond in an adequate manner.
Unfortunately, the humanitarian response in Syria remains severely underfunded, getting only 13% of the $3.2 billion needed for 2025.
The EN remains committed to ensuring the sustained and principal delivery of humanitarian assistance to all communities in need.
Thank you very much, Sir.
So, OK, so let's open now the floor to questions.
I'm looking at the journalist.
Her, yes, sorry, very childish question.
How do you compare that situation in Syria with the situation in Gaza?
So if you want to answer our journalists here.
The magnitude of the the needs in Gaza is obviously much bigger than it is in, in, in Syria.
But this, this is a crisis that is more recent while the Gaza 1 is more protracted.
But human needs everywhere are, I mean humanitarian needs everywhere need to be addressed and responded to because these are people's lives that are are at stake.
Any other question in the room or online?
So I don't see any other question to you, Sir.
Thank you so very much for spotlighting this incredibly difficult situation.
Thanks for being with us and and briefing the journalist here in Geneva.
So I'll now ask Jeremy Lawrence to come to the podium.
We will continue with the OHCHR.
Jeremy, you have two items on your list.
Maybe you want to start with that.
Brutal attacks by the Rapid Support Forces on the besieged city of Al Fascia and the adjoining Abu Shuk camp for displaced persons in North Darfur, Sudan resulted in the killing of at least 89 civilians over a 10 day period up until the 20th of August.
We fear the actual number of civilians killed is likely higher.
In the latest attacks documented by our office between the 16th and 20th of August, at least 32 civilians were killed.
At least 57 civilians were killed in previous attacks on the 11th of August.
Such attacks are unacceptable and must cease immediately.
We are particularly horrified that among the most recent spate of civilian killings, 16 appear to have been cases of summary executions.
Most of the victims were killed in Abu Shuk camp and belonged to the African Zagawi tribe, according to information gathered by our office.
In another case in the Alfasha area, a victim was asked which tribe he belonged to.
He was killed after responding that he was from the African Bertie tribe.
This pattern of attacks on civilians and wilful killings, which are serious violations of international humanitarian law, deepens our concerns about ethnically motivated violence.
We have also received disturbing reports from the ground that during attacks on the 16th of August, at least 40 internally displaced men were abducted.
Their whereabouts remain unknown.
The humanitarian situation in Alfascia has reached a critical point.
After more than a year of siege, there is a growing risk of famine in both the city and other areas of North Darfur.
In this context, we are appalled by accounts that those trying to deliver much needed aid have once again come under attack.
On the 20th of August, a humanitarian convoy consisting of 16 trucks carrying essential food supplies was hit by aerial strikes in Mallet in North Darfur.
This incident follows a previous attack on Aun humanitarian convoy in Alcoma N, Darfur on the 2nd of June.
Humanitarian assistance and workers are protected explicitly under international humanitarian law and must not be targeted.
Attacks on humanitarian efforts only worsens the human rights situation for civilians.
UN High Commissioner for Human Rights Volcker Turk calls on all parties to the conflict to take concrete measures immediately to ensure the protection of all civilians, including safe passage for those wishing to leave conflict affected areas and to facilitate unimpeded humanitarian assistance for those in need.
I hope that from home you don't see the problems we have with the screens, but sorry for that.
So I'll I'll open now the floor to questions.
Sudan is so important and we really need to to keep it in the in the light.
So any question on this particular situation in the room and see any hands up?
Sorry, I only can again ask a very childish question.
Don't misunderstand me, I am as everyone appalled what with what happens in Gaza.
But I am surprised by the difference in rhetorics, in narrative, both from the civil society or occasionally from UN agencies, when it comes to Gaza and when it's about other humanitarian disasters.
How do you explain or justify or perceive this?
It's, it's a real issue for those listening, for journalists who want to be fair and cover equally comparable horrors.
Yes, first of all, I wouldn't be here to speak on behalf of civil society, but when it comes to messages from not only our office but the UN at large, we are quite emphatic.
It's whether when it comes to human rights, and particularly when it comes to international human rights law and international humanitarian law, regardless where these breaches occur, we will call them out.
Sudan, Gaza, Myanmar, Ukraine and there are sadly many other conflicts where these breaches occur and we will continue to call them out.
Christian, I see that you have something to add on Sudan, so I'll give you the floor.
Yeah, thank you very much Alessandra.
And I think it's thank you Jeremy for taking the the lead on this and a very and another very important crisis.
And so let me add a few points here as as they have been indeed very important and and very much not too much in the media.
Like, like Boris has just pointed out, all Sudan's 18 states are reporting cholera cases, over 100,000 cases and more than 2740 deaths have been reported since July 2024.
So that's in the last year, 62% of all cases and 55 of all deaths.
So that's more, much more than half are from Khartoum, from Jazeera, Gadarev and White Nile states.
12% of cases are in children under 5 and 10% of deaths are also in children under 5.
Since the reports of the first case in South Tafur on 29 May this year 2025, the disease has grown, has now spread to 28 localities across all the five Darfur states.
Efforts are on the way to urgently launch a colour cholera vaccination campaign in priority localities in South before cholera has spread to 22 localities across the three Codolphin states, with again nine more than 9000 cases and up to 500 deaths having been reported.
And just a reminder, cholera is an ancient disease, easy to treat.
It would not have to be around.
El Fasher in Darfur state is suffering a severe humanitarian and public health crisis, driven by, of course, the active conflict, blockade and mass displacement.
Civilians in and around the city, including Abu Shuk the the IDP camp there, face severe food shortages, rising malnutrition, deaths and severely limited access to healthcare.
The large cholera outbreak is ongoing across Darfur state and has hit communities and displacement sites, adding pressure to already fragile services.
Access to healthcare across Sudan continues to be severely constrained due to the insecurity, the attacks on healthcare, shortage on medicines and medical supplies, and shortage of health personnel and cash to cover health facilities operational costs.
38% of all health facilities are non functional and 62 are partially functioning.
Child vaccination rates have declined from over 90% at the end of 2022 to 48% as of now.
The disruption of childhood vaccinations, disease surveillance and vector control, coupled with the access issues that we have and the natural disasters, has created conditions for the spread of disease outbreaks, namely, of course, cholera.
Acute malnutrition is also ongoing and surging.
Between 1 January and 31 July through the first big half of the year, nearly 20,000 children have been admitted to stabilisation centres for the treatment of severe acute malnutrition with medical complications.
W Jo is supporting 142 Nutrition Stabilisation Stabilisation Centres in this year for the management of severely acute malnourished children with medical complications.
Attacks on healthcare continued to mark the conflict in Saddam since 15 April 2023.
So in the last, what is it, 2 1/2 years, W Joe has verified 177 attacks on healthcare which led to over 1000 deaths and injuries.
Gender based violence has dramatically increased.
We have seen reports on this all over 12 million people, 1/4 of the population are at risk.
According to UNFPA, this is a 200% increase in just one year.
WGO currently supports 60 primary healthcare centres and 142 nutrition stabilisation centres.
WGO also delivered 488 metric tonnes of medical supplies in 2025 and reached over 12 million people with oral coral vaccines since 19 August 2024 last year this time.
Christian, thank you very much for this further information on the situations, really dire situation in Sudan.
I'll ask the question again if there's any question that you would like to ask, whether it's OHCHR or WHO it's.
Olga from UNHCR, Olga Serrado, she also might have something to add on the situation in Sudan.
Olga, I'll give you the floor.
Just very quickly and to compliment as well what Christine was saying on cholera, I think it was about a week and 1/2 or a couple of weeks ago that we could confirm that cholera had spread now to Eastern Chad.
So at that time when we briefed, when our colleagues briefed, there was only one of the refugee camps that was impacted and had confirmed cases.
Now there is a cumulative number of 735 cases with 50 deaths, already more than half among the refugee population.
And now the what the outbreak is spreading, spreading rapidly is affecting already 6 refugee camps, with Fartana being the latest camp that was that is affected.
And there is a high case fatality rate which indicates that containing the spread of the disease is going to be difficult.
And it's likely that it will spread further because as we highlighted, I mean, mainly due to the, to the funding cuts and the situation we are the, the, the number of water that has been delivered to, to refugees is much lower than the emergency standards.
There is only one doctor per 50,000 refugees in Easter Chad.
And also the hygiene and shelter capacity is overcrowded.
So I just wanted to, to add that to, to what Christian was mentioning on cholera and give an update on the situation.
Olga, thank you very much for for this.
Thanks for complimenting.
I still see no question if this is the case.
Let's go to your second point, Jeremy, about Myanmar.
As we near the passing of another year with no justice for the violence which started on the 25th of August 2017 in Myanmar, we are left to ask the question of when the enduring misery for those and on when the enduring misery, sorry for these and ongoing crimes will end, particularly for the long-suffering Rohingya community.
Ending impunity and ensuring the Rohingya's rights to security, citizenship and equality are essential for breaking the cycle of violence.
Since November 2023, the human rights and humanitarian situation in Rakhine have sharply deteriorated, further deepening the already life threatening conditions faced by the Rohingya.
Both the military and the Arakan Army have committed and continue to commit serious atrocity crimes against the Rohingya with impunity in flagrant violation of international law, including the provisional measures ordered by the International Court of Justice.
Amidst a global funding crisis, Rohingya in both Myanmar and Bangladesh are enduring dire conditions, compounded by drastic cuts to food assistance.
We implore the international community to step up support for the Rohingya by increasing humanitarian funding to secure access to basic needs and essential services to resolutely support international accountability processes.
Thank you very much, Jeremy, for this point.
And now let's go back to the situation of hunger in Gaza.
I'm just going there, sorry.
From the ipcinfo.org website, the Integrated Food Security Phase classification has been publishing just now.
They've gone live with the report on the Gaza Strip and the colleagues the IPC analysts say famine confirmed in Gaza governator.
Famine confirmed in Gaza governorate and projected to expand.
To speak more about this, we have with us today Jean Martin Bauer from the World Food Programme.
Jean Martin, I see you are connected.
You are the Director of Food Security and Nutrition Analysis at WFP.
And we also have with us Doctor Rick Peppercorn, who as you know is The Who representative in the Occupied Palestinian Territory.
And you, Rick, are connecting from Gaza.
And then we also have Jeremy who will have some comments on behalf of the Office of the Human Rights.
So officially, because I'm receiving, while I'm talking, I'm receiving tonnes of messages from your colleagues.
The embargo has now been lifted.
We can you can report on that as you have already started doing it.
But I really like to thank our colleagues that are here to give you more information about what you have read.
So I'll ask now maybe to Jean Martin to start as you may tell us a little bit more about the situation on hunger and then we go to Rick and to Jeremy Shamarta.
In today's release, the IPC confirms that the famine is no longer a risk in Gaza City.
It's a reality, the IPC, it's the most consensus based rigorous assessment we have in the humanitarian sector and it tells us that unless immediate steps are taken as will be lost at large scale.
When a famine is declared, it means that there is widespread starvation, widespread illness and widespread mortality.
The IPC classification of famine only happens when 3 thresholds are met, extreme food deprivation, acute malnutrition and starvation related deaths.
And all three have now been breached in Gaza City.
And as you mentioned, these conditions are forecast to spread to Daryl Bala and Khan Yunus before the end of September.
Now the findings we have show that in Gaza City, the number of people facing extreme food consumption deficits that tripled between May and July, reaching famine thresholds.
The malnutrition rates in Gaza City have also tripled between May and July.
And the assessment of the experts, the independent experts, is that mortality, mortality also exceeded famine thresholds.
We're very worried about the malnutrition among children, which is accelerating.
We're seeing geometric entries, increases in malnutrition rates.
What we need to know is that a famine requires more than the usual response.
And with the increase in malnutrition, we need much more skilled medical practitioners in Gaza to treat malnutrition and its impacts on on children.
So what we're witnessing right now is the most severe deterioration since the IPC began analysing Gaza and its, and we're at this point in the 5th formal famine declaration of in the entire IP CS history.
The IPC was created more than 20 years ago.
And in that time there's been a famine confirmed first in Somalia in 2011, South Sudan in 2017, South Sudan again in 2020, Sudan in 2024, and now in Gaza.
So for the first time, we have two famines taking place at the same time.
For the first time we have a famine in the Middle East.
And this all shows how unique the situation is in Gaza City with the breach of these thresholds.
So this demands a response on a scale and urgency we haven't seen before.
Thank you very much, Jean Martin.
That's really very, very strong information that you're giving us.
So Rick, now from you are in Gaza at the moment.
So not only you can see with your eyes what's happening, but maybe you can also comment on the IPC report, please.
Thank you very much, Alexandra.
Yeah, let me start of course with everything related to the IPC report and then I will focus specifically on some other health and related health topic.
So first of all, I mean famine confirmed in Gaza Governorate, we know that and according to the new Integrated Food Security Classification analysis released today, it is actually staggering that is famine.
The so-called IPC Phase 5 is confirmed in Gaza covenant with over half a million facing catastrophic conditions characterised by starvation, destitution and death.
This marks the first time that famine has been officially confirmed in the Middle East region.
Between mid August and the end of September 2025, conditions are expected to further wars, with famine even projected in the areas where I am now, Deraballa and Hanunes.
Acute malnutrition is projected to continue worsening rapidly.
In July alone, the nutrition cluster reported that more than 12,000 children were identified as acutely malnourished.
It was the highest monthly figure ever recorded and a six fold increase since the start of the year.
Nearly one in four of these 12,000 children were suffering from severe acute malnutrition, the deadliest formed with both short and long term impacts.
In 25 alone, 206 people have died due to the effects of malnutrition as verified by WHO, and also nearly 55,500 malnourished pregnant and breastfeeding women.
I want to remind we've said this before, that before this crisis exploded, there was no malnutrition in gas.
There was no malnutrition about lactating women.
So this report, I see report only confirmed the alarm.
I think the UN has been ringing for a long time.
I think we've consistently reported on how during the visits to Gaza, my colleagues, my teams, including myself witnessed people starving, bodies frail that you witnessed children who were five who were actually were were were five years olds and they looked like 2 years, two years old.
Children visibly malnourished and health workers as well health workers weak and exhausted.
This is the human phase of a collapsing health, nutrition and water and a sanitation system.
Hungary and malnutrition are not only about empty stomachs, it weakens bodies, fuels disease, cripples health systems and rob children of their future.
Situation will certainly get worse quickly as famine stalks all the part of gas of the gas strips chew.
So we should not forget this is a man made crisis so it must and can be reversed.
Time for action is now, without delay nor excuses.
To enable life humanitarian operations, we need an immediate and sustained ceasefire, release all the hostages and unimpeded access for a mass influx of assistance to reach people across Gaza.
We need greater amounts of diverse and nutrition food aid, along with dramatically improved delivery and distribution and accessibility, as well as shelter, fuel, cooking gas and food production inputs.
We need protection for healthcare and access to support, rehabilitation of the health system, maintenance and revival of essential health services, including primary healthcare.
We need the restoration of commercial flows and scales, market systems, essential service and local food production, which is also vital if the worst outcomes to famine are to be avoided.
UNICEF and WHO, we're working to scale up the entry of life saving nutrition supplies including therapeutic food and infant formula.
Current stocks in Gaza can only meet the needs of a very limited number of children, few 1000 less than a month hospitals.
My second point, the hospitals currently remaining partially functioning hospitals, minimal function.
Hospitals are under immense pressure in Gaza City, actually all of especially in Gaza City.
Ongoing evacuation orders in part Gaza City combined with a massively escalating violence have forced people into even smaller areas, piling unbearable pressures into hospital.
Al Shifa now left the hospital.
They're operating at nearly 300% overcapacity with a cold stand influx of complex trauma injuries.
Last Tuesday, sorry, I was in Gaza City and we were collecting the patients for a medevac.
On Wednesday, we also assessed Siva Hospital discussions with staff.
Now I was there also six weeks ago, when already Siva Hospital had turned into, there was an enormous increase in trauma patients.
There's trauma patients literally everywhere, in the corridors, even on the stairs, a new newly opened department like a modern child at the opsin, gynae department, et cetera.
Trauma patients everywhere.
The same applies for Al Ahli and also in the in Kanunis national medical compounds.
All of them operate on 250 or 300% capacity.
We also deeply concerned about currently now now on Al Ahlian patient friendly hospital in the north because they lie close to the evacuation zone and the risk of becoming non functional if not protected.
And we have gone through this many times already in this horrific crisis.
So what is the impact of an intensified Gaza City on offensive and military incursion and further mass displacement?
Every pillar of life in Gaza is being torn apart.
Food, water, healthcare, sanitation, dignity, nothing is sparred.
So as WHO, we warned that a plan to intensify military operations, military incursion, however you call it, in Gaza City will have a horrific Unitarian impact on people and a near collapse health system.
We will witness many more civilian skills and injured in an environment of malnutrition and I would say general exhaustion from all.
Also, together with all partners, the UNWHL, we've poured immense effort into reviving what remains of Gaza shattered health system.
Yet every search in violence pushes closer to collapse, crossing red lines that must never be crossed.
WHL will stay in Gaza City and deliver where people are.
The UN will not be part of any forced displacement of people to the South.
We want to remind parts to the clear conflict of their obligation under international law to protect civilians, including humanitarian workers and those who cannot or choose not to move, and to safeguard humanitarian facilities and other civilian infrastructure.
My last part is on European Gaza Hospital which is located is Han Yunus just east of Saladin Rd.
So on 16 August, WHO partners visit the European Gas Hospital.
While numerous previous attempts to access the facilities have been denied.
Maybe you remember there was a already I think a couple of months ago WHO organised and a medevac from from European Gas Hospital.
That hospital was attacked then we could carry out a medevac.
We we evacuated the patients, the staff etcetera.
Since then the hospital have been non functional, but we assessed that the roads are severely damaged and possible possibly impossible for trucks and ambulances.
Areas outside hospital premises are heavily damaged, particularly outside of the emergency department and the outpatients department infrastructure is damaged, especially in the prefabricated extension and some ancillary buildings.
And the initial findings suggest it may take up to three months to resume.
If we talk about secondary care services, not primary care services.
Alexander, I want to stop here.
Sorry, we are trying to at the same time do 20 things.
Just wanted to inform you that the statement of the Secretary General on this terrible announcement of this morning is now out.
And the Secretary General is saying just when it seems there are no words left to describe the living hell in Gaza, a new one has been added.
For me, this is not a mean, it's a mystery.
It is a man made disaster, a moral indictment and a failure of humanity itself.
For me it's not only about food.
It is the deliberate sorry.
It is the deliberate collapse of the systems needed for human survival.
People are starving, says the Secretary General.
Children are dying and those with the duty to act are failing.
As the occupying power Israelis unique local obligations under international law, including the duty of ensuring food and medical supplies over the population.
We cannot allow this situation to continue with impunity, says the Secretary General, and he concludes by saying no more excuses.
The time for action is not tomorrow, it is now.
We need an immediate ceasefire, the immediate release of all hostages and full unfettered humanitarian access.
You have it in your e-mail boxes.
It has been published on the social media accounts.
We'll finish this part of the briefing with Jeremy, who also has a comment on behalf of the OHCHR, and then I will open the floor to questions.
You should have all received the the statement issued by the UN High Commissioner for Human Rights, Volcker Turk.
It was issued a short time ago.
In it, he says the famine declared today in Gaza Government Gaza Governorate by the IPC is the direct result of actions taken by the Israeli government.
It has unlawfully restricted the entry and distribution of humanitarian assistance and other goods necessary for the survival of the civilian population in the Gaza Strip.
We have already seen deaths from starvation and malnutrition across the Gaza Strip.
The Israeli military has destroyed critical civilian infrastructure.
Almost all agricultural land banned fishing and forcibly displaced the population, all drivers of this famine.
It is a war crime to use starvation as a method of warfare, and the resulting deaths may also amount to the war crime of wilful killing.
The Israeli authorities must take immediate steps to end the famine in the Gaza government and prevent further loss of life across the Gaza Strip.
They must ensure immediate entry of humanitarian assistance in sufficient amounts and full access to UN and other humanitarian organisations.
And more reactions on the IPC report is coming now from our colleague in UNRWA, and I've been asked to read this to you.
This is the statement by Philippe Ladzarini, the commissioner general of UNRWA, who has just published a post where he says months of warnings have fallen on the deaf ears.
Famine is now confirmed in Gaza City.
This is starvation by design and man made by the government of Israel.
It is the direct result of banning food and other basic supplies for months, including from UNRWA.
The spread of famine can still be controlled by a ceasefire and allowing humanitarian organisation to do their work and reach starving people with aid.
And he concludes by saying time for political will.
And you also have the possibility of reading this post on CG Ladzarini's tweet account X account.
So we now go to the questions.
I see already quite a few hands online, but let me start with the room.
Following this declaration, we might well now see countries rushing to do air drops to show that they are doing something about the situation.
To what extent is that useful or even dangerous compared to delivering aid by land?
I don't know who would like to take this on, maybe Jean Marc.
I start with Jean Martin Beaver.
Jean Martin Robin is our AFP correspondent.
I'd really like to focus on the situation in Gaza and how serious it is.
According to the findings that we have, air drops are a solution that's, that's not going to resolve this problem.
What we had is a, a famine taking place.
We need to make sure that we address a famine in the way it needs to be addressed.
And that means looking at the the malnutrition rates, looking at supporting the systems on the ground.
When you move from a food crisis to an outright famine, there's there's a step change that occurs.
We need to think about a response that meaningfully addresses the needs of the most vulnerable, and that's the needs of little children.
I'd like to perhaps pass it on to my colleagues in Gaza.
Rick, would you like to also answer this question please?
Yeah, I think we've gone through this before and we've had, we shouldn't forget we are we are almost two years in this horrific crisis and and and I think having been also part of The Who Rep, we've seen this constant it's almost like a squeezing a strangling of the Gaza and this population and then a little bit of a release and then again strangling etcetera.
We've also seen air drops in the past.
I think it's all well intended.
So I don't want to, you know, belittle all it etcetera.
And in extreme emergencies and if people cannot read be reached in any other way, they potentially can be useful, but not in that sense.
In Gaza, there's a system in place.
We have proven as the UN and its partners even before during this whole crisis and specifically when there was this temporary ceasefire, that when, when, when actually humanitarian assistance is even a little bit facilitated as it never been properly facilitated all along, that people are reached, they are reached in a way, way more cost effective way than this air drops.
And, and it would be good for somebody to make an analysis about the cost of the air drops during this crisis, including now and, and then, for example, the humanitarian community here we are struggling to get a sustained flow of fuel, just to mention one thing, it probably could have had sustained a flow of fuel for, for, for the coming year to come, etcetera, when you offset it against the cost against these air drops.
So these air drops are definitely in the gas situation extremely cost ineffective.
They're occasionally dangerous.
We also have seen, at least I've seen it in my own eyes with a former air drop, so I didn't see it this time that sometimes medical supplies are included, which can be very dangerous because they, they are just dropping everywhere and they are not like collected for somewhere and then they go to, to to an hospital, etcetera.
I remember the in this first range of air drop we even saw some sessions with with morphine we we identified.
So in short, well intenders not needed in Gaza.
There's a system there, there's a system in place and I really would back, you know, invest those those funds in a proper humanitarian approach etcetera and UN and partners are very much ready for that.
As we heard this morning by from Tom Fletcher, we are ready to go and we should let be in at this point in time and very strongly.
I'll go now to Emma, Emma Farge, our correspondent of Reuters.
Question for WFP and for WHO?
I'm wondering whether the first steps in the Gaza City military operation or are already making aid flows more difficult either into Gaza or within Gaza.
Are there extra impediments because of this campaign?
And for Doctor Peppercorn, please, I'm wondering how famine is affecting other patients, trauma patients in hospitals who will need a certain amount of calories to recover.
Can you tell me how other patients are being affected by starvation?
Jean Martin, you want to start with the first question?
What we've seen in the past few weeks in Gaza City has been an exponential increase in child malnutrition and acute malnutrition.
This is a very worrying situation and it's one of the reasons why we're not talking about a a famine in Gaza City.
The data is there and shows how urgent it is to devote specific attention to the children in Gaza City.
And the the worry is that along this path, the numbers could get worse.
I told you that the acute malnutrition in Gaza City has tripled since May, between May and July.
And because it is a geometric increase, we could have a doubling very quickly.
This, this needs to to end right now because of its very real impacts on many children in that in that part of the Gaza Strip.
And Rick, maybe on the second question.
Yeah, let me add another little bit on the first one.
So what we of course see happening in the, in the, in the north of Gaza and this increased hostilities which are already going on.
And then I think the the, the, the I would say almost the mass casualties incidence surrounding any food distribution.
We see this huge increase in, in, in trauma and, and trauma patients and, and what I, what I reported that I reported on and, and just to give some figures, situations escalate sharply in July with daily fatalities of an averaging 190, so nearly double the average recorded in May.
So with as if we were back in the 1st 6 to 8 months of this conflict.
Injuries also surged dramatically with, with nearly 14,000 in July compared to 6000 in in May.
And, and a reflection of that you see in yeah, we see actually in this, well, we see that in all the hospitals is completely that, that all those hospitals have become massive, massive trauma wards.
I just want to say something about malnutrition because we get this question as well.
So how do we then support malnutrition?
And then we'll address the question how it impacts.
So as we all know that malnutrition we can can be a direct cause of death or a contributing factor and that often weakens the immune system, making the body more vulnerable to infectious and other diseases.
And, and, and as such, malnutritions may be the primary cause of death or the E Colt factor, you know, and increases the risk of mortality and conditions.
So we are supporting actually the hospitals Ministry of Health and verifying malnutrition related deaths and using agreed technical guidelines special committees are formed at each hospital.
This committee review all non trauma deaths from the previous 24 hours and check if malnutrition may have been a factor.
And to do this they assess such as the midst upper arm circumference, weight for height, accessory body mass in index etcetera, and any reason, signs of severe weight loss and other diseases underlying conditions.
And the criteria are adapted for each age group.
So and the death report from WHO or by the Nutrition Stabilisation Centre also reviewed together with those committees on the same criteria.
So why do I want to be clear on this one?
Of course the generalised malnutrition which you see everywhere infects everything.
So we see for example and and having witnessed so many trauma patients and talking to the medical specialists and surgeons etcetera, recovery takes way more time for every patients and people don't recover.
Recovery from a wound, infections etcetera takes way more time.
All of those things are related to the, I would say to the, to the almost generalised malnourished state of so many people in Gaza.
And I think it's, you see that in IPC report, rightly so.
There's always a focus on under 5, under five children because they are the vulnerable group small children.
But IPC report and we've pointed this out as well many times also points out they are deeply concerned about let's say the older children, adolescents and the elderly, not just trauma related, let's say injuries that people recall, recover, the recovery time takes way longer or it doesn't happen, but also elderly and other people suffering from non common cold diseases etcetera.
So if you are in a better, we all go into the better physical state and at least well nourished etcetera, the whole even your medication etcetera makes a much better impact.
So yeah, it's a huge impact on every health related condition.
Thank you very much, Rick, and thanks to Jean Martin.
I'll go now to Gabriela Sotomayor, our correspondent of Processor.
So this is a famine that has been predicted for a long time.
Why are you announcing it now?
And the second question regarding accountability.
Know, I like to ask you, it's obvious that Mister Netanyahu is responsible, but so are the complicit governments that have supported him.
You, more than anyone are witnessed of what is happening.
So can you induct, indict Mr Netanyahu in an international?
Do you recommend a court like others established in the past like International Criminal Court of Rhonda for example?
So I'll ask maybe Jamerton to answer your first question.
I think he did actually explain, but maybe you want to reiterate this for our journalists and German will take your second question, Jamerton.
What I'd like to emphasise here is that there have been many warnings of a risk of famine in Gaza from the IPC and the Famine Review Committee.
Those warnings began in late 2023 and the last time we were here together to discuss the IPC process for Gaza it was on July 29th when there was an alert issue.
So there have been many, many warnings along the way.
I need to emphasise that the IPC is a 21 agency partnership, but it includes intergovernmental organisations, UN agencies, NGOs.
It's a very robust process that has been ringing the alarm.
So the question is why now?
Well, as the last time we spoke in in July 29th was was the, the, the moment when in Gaza City we saw indicators breach famine thresholds.
That has been the case for for food consumption.
It's been the case for malnutrition.
And what's happened since is that the experts have worked on the the that data for the entire Gaza Strip.
They've looked at updated information also in the case of mortality.
And that allowed a famine determination to be made and confirmed by the Famine Review Committee.
So this is a process that's very meticulous, it's very precise.
And that reached its conclusion just a few days ago.
And This is why we're coming out today with this confirmation of a famine in Gaza City.
2, There are two, I guess, two ways, two parts to this question.
First and first of all, first and foremost, as the High Commissioner said, it is Israel's responsibility to open the borders and to ensure aid flows in at massive levels immediately.
As he says, it's a war crime to use starvation as a method of warfare, and the resulting deaths may amount to the war crime of wilful killing.
I'd also like to to point out on with respect to third parties, because I think you raise an interesting point and it goes to what other journalists raised earlier and what when we talk about international humanitarian law, which is, and specifically the Geneva Conventions, which are the cornerstone of international humanitarian law.
And they it states, Article One of the Geneva Convention states that all contracting parties must undertake to respect and ensure respect for the Convention in all circumstances.
All states have an obligation to prevent a violation that may be committed.
The greater the degree of influence, the more measures a state is obligated to take.
It is quite clear and also referred to the statement of the Secretary General.
Oh, I see you have a follow up then I'll go to ARDNFA.
So the the cruelty of this punishment.
I am not a doctor, but how long a person has to suffer for from hunger to die?
I mean, how many days the the cruelty is is it's really.
I don't know how to describe in English, but it's beyond measure.
Can you say something about this process of a person to die without food and water?
Yeah, maybe I will ask Rick to to take this one.
Yeah, I find it's a difficult question and, and, and, and also, you know, maybe I don't want to go into this discussion of cruelty and everything cruelty and everything related to that.
It should just simply not happen.
And I think as has been mentioned, we're talking about a a man made malnutrition crisis.
And I think so men can also fix this.
I also want to stress it's very difficult because and I, I think I, we, we, I just referred to that earlier that malnutrition can be a direct cause of death or contributing factor.
And it's, it often directly, of course, weakens the immune system and, and it makes the body more, more vulnerable to infections and other diseases.
We we see this incredible yeah, we see this incredible poor water sanitation conditions all over Gaza and already from the start of the crisis and vastly deteriorating which which all which are all cofactors.
So it's it's sometimes difficult to also say is this malnutrition the primary cause or is it definitely a cofactor.
So we in in short term, in days or weeks, we see weight loss and and and and muscle wasting, fatigue, weakened immunity, etcetera.
When it takes a little longer, you just talk about micronutrient deficiencies which cause anaemia, poor wound healing, which I already refer to, which is every time you go to this, to this trauma, warts, etcetera.
The doctors there and nurses, etcetera tell me that something like how incredibly long term.
And then with all the risks of this multiple and, and and these multi drug resistance, of course, which is increasing as well and higher risk of infection for anything.
And that is, I think we, we even even don't, if you don't think about enough that when you, when you talk about long term stunting and for children, you talk about, you can talk about organ damage and, and, and delayed development.
And, and of course in, in severe cases also death for young children can happen very quickly, as we know in a few days without and, and, and weeks without adequate feeding because they have a high nutrient needs etcetera.
And also especially elderly etcetera.
The visible science can take longer, but I think it's not for nothing that also the IPC book report points out, hey, this is so generalised and and then yeah, we focus on children under fives as a special vulnerable groups, but please, please also take care of the older children and the elderly.
And I see by the way, also around me and, and, and, and even among my own teams and staff, etcetera in, in, in general, there's much more of a almost a lethargy.
People not only are exhausted, etcetera, but hardly anyone gets proper diverse food.
And that is even for the, once, you know, humanitarian workers we, we work with.
So let me leave it here over to you.
Thank you very much, Rick.
Let me go to ARD Tobias Haller.
I am asking the question.
I'm also from the ARD, German TV and radio.
I'm asking the question for Mr Haller.
I have a question also for the WFP or The Who, which we've heard it before that there are certain factors that led to the declaration and we heard that there was some mortality was one of the factors.
Could you please elaborate again, maybe or emphasise, emphasise on which factors you kind of base this declaration and what made it phase five?
What were the essential factors?
And also what will be the direct consequences of this declaration?
What will be the consequences for Israel?
What will have to be done and also whether this Phase 5 is set for all of Gaza, so like 100% of the population or how much percent of the population is affected?
I think Jean Marta had spoken about that, but I'll give him the floor again, maybe to just underline these few points.
And Rick if you want to add something afterwards.
OK, well look, what this new IPC analysis tells us is that there is a famine in Gaza City, but IPC 5 conditions also cover other errors and there's a distinction between famine and IPC five.
The IPC is a 5 point scale.
Phase 1 is a normal, 2 is stressed, 3 is emergency.
Well, three is crisis, 4 is emergency, and five is a catastrophe.
When we've got enough people in phase five and there's a review by the FRC, then that can be confirmed as a famine.
So phase five and famine are two, 2, two things that are related but not exactly the same.
So what we say in this in this release that came out just recently is that there is a famine that's confirmed in Gaza City, but the phase five conditions are now affecting a half million people and up to 630,000 in between now and the end of September.
Now, in terms of mortality, what would the report says is that and and this was looked at by the FRC who include experts in the areas of food security and nutrition and and, and the study of mortality.
They tell us that mortality is usually under reported in Gaza, especially for non trauma deaths.
And that's because of the breakdown of the information systems in in in place.
So the, the health systems is now experiencing a surge in, in illness and things like multi drug resistant infections that makes treatable injuries increasingly fatal.
Newborns face elevated mortality risks as well because there's been a collapse in neonatal intensive care and there's a convergence of widespread malnutrition, illness and collapsing health systems, deteriorating WASH conditions, water and sanitation is, is, is very problematic and increase in child diseases in addition to a a, a, a very worrying increase in acute malnutrition.
All that led to the consideration that Gaza Governor of Gaza City reached a famine level mortality.
Rick, you want to add something?
I think Jean Martin I think raised all and I think it's and you can find this by the way, in the IPC report.
So I mean for classifying famine, it, it means that the most that's the most extreme category and it's triggered when three critical thresholds are met.
So extreme food deprivation, acute malnutrition and starvation related deaths.
And they have been breached.
And the latest analysis now affirmed from the basis of reasonable ethicists that these criteria have been met.
I mean like for the for the Gaza governorate and, and maybe to, to, to ask there because you ask a bit.
So you talked about half a million people facing catastrophic conditions characterised by starvation, destitution and death.
But another one, another over 1,000,000 people.
Yeah, 54% of the entire population are facing emergency IPC phase four and close to 400,000 people, 20% are in crisis what is called IPC 3.
And, and, and maybe to say one more thing, if, if, if, if nothing would be done now, if nothing would be done.
And the report also is clear on that, then it's projected not just if you look at cute malnutrition of, of children, which is that really exponentially increasing, but it's also over the longer term.
If if very little happens that it's projected that through June 26th auditory report, at least one of the 32,000 children under the age of five are at risk of death from acute, yeah, from acute malnutrition according to this IPC analysis.
And also this number has doubled compared to the IPC estimates reported in May 25.
And this figure are really appalling.
And so let me go to the last questions from Isabel Sacco, the Spanish News Agency.
I there is already a reaction by Israel to the report and I would like to read to the representative of of IPC what Israel says denying all the main result of the of the report about famine.
So Israel says the IPC twisted its own rules and ignore its own criteria just to produce false accusations against Israel.
The IPC changed its own global standard, cutting to 30% search hold to 15 for this report only and totally ignoring its second criteria of death rate.
So so Lily to serve Hamas fake campaign.
Thank you for your response.
Maybe Jamarta, I think you had spoken about some of the criterias.
Maybe you want to answer our journalist.
So what I'd like to say is that again, the IPC is the gold standard for food security analysis worldwide.
The indicators we used in Gaza that the IPC use, and I'm not the IPC representative, I'm the WFP director of Food Security analysis, but the indicators that the IPC used for this analysis have been used in other countries.
I told you earlier on that there have been famine determinations in the past in Somalia, South Sudan, Sudan.
We use the nutrition measure used in Gaza in the past as well.
I think what what I've heard as an objection is that we used the mid upper arm circumference as a measure for malnutrition instead of weight for height.
That's something that is allowed for in the IPC protocol and has been allowed for by the IPC manual since 2019.
And this measure that we used in Gaza for the determination was also used in past time and declarations in South Sudan and in Sudan.
So the protocols have been applied in the case of Gaza.
And I remind you that the IPC also has a strong governor governance mechanism that includes A famine review committee with the foremost experts in food security and nutrition and mortality that looked at the data.
And we can take this finding as seriously because this is the gold standard in food security analysis worldwide.
Thank you very much, Martin.
I see Rick wants to add something.
It's difficult to add something.
Sham Return has been very clear, not just the gold standard, but it's also a very well established global system.
So I think it should be taken seriously, Very, very seriously.
I also want to remind us everyone who's working here on the ground.
And anyone for FWHOI heard it from my UNICEF colleagues and and and many other NGOs and and colleagues etcetera.
We see this happening on the grounds and we have been warning constantly on this.
And, and this is so I mean like overwhelming when you, when you see this not just in the hospitals, etcetera, within the communities, etcetera.
I also want to make the point that we have had previous debates on mortality rates and, and, and, and the number of people killed and injured etcetera.
And, and like we have raised before, I think every one of us tries to be as factual analytical as possible.
And I'm afraid we're talking about underestimation in many of these topics.
So maybe that's all what I want to add to this.
Yeah, I'd just like to add one thing, well a couple of things actually with respect to this and just take on what my colleagues saying there.
The 1st is we have, we are witnessing people starving to death already beyond what this report is saying.
The second thing is this, we have been talking about flagging warning about this nightmare scenario which is going to present itself through, through the, through the declaration of famine now.
So now we're at the stage where this nightmare scenario is reality.
It's horrible, cruel, unforgivable reality.
What's happening on the ground as stated in the in the declaration.
And the other thing is I just reflect on the fact we've talked about our office on, on the stain of a stain on humanity when it comes to events that have been unfolding in Gaza.
Maybe today we need to reflect on the fact that inhumanity, our collective inhumanity.
And maybe Alexandra, can I maybe add one thing?
You know, also the IPC over the years, etcetera.
What I understand it is definitely not the IPC experts.
I'm not speaking, but it's not just the UN, it's 21 organisation, including respected NGOs with long experience in dealing with hunger, malnutrition and its effects.
And it's kind of questioning and arguing about the reports.
It makes me incredibly sad.
I mean, like we got to do something about that, you know, please, can we please do something about this?
Can we please, I mean, like make sure that this is reversed and this never happens again.
Can we please work on that?
I think these petty discussions about about arguments about, about data, etcetera, there's a massive disaster going on.
Can we please help solve this?
This is indeed a a humanitarian catastrophe of epic proportion.
And as we've been seeing the whole morning, I mean, must be stopped at all costs.
And this is a race against time and to end this, this terrible situation with an immediate ceasefire and humanitarian response at a very large scale and impeded, that will save a life.
Christian, because she's not ask any question.
Then if we have time, we'll I'll go back to you, Christian.
Erik is our correspondent of the German News Agency.
And I'm sorry, Rick, I totally agree with you.
But because this information is out there, we, we do have to follow it and and verify what the facts are.
We report all the time that there's this 30% threshold on.
Let me just read it properly on children that suffer from malnutrition and the Israelis are saying in this particular report it's only 15%.
I haven't found that immediately, but to refute that claim, it would be good to to have a confirmation that no the three criteria, 20% of households, 30% of children and so many people dying per 10,000.
It would be great to have a information that all three, including the 30% of children with malnutrition, could be confirmed.
Thank you Christian, I'd like to help with that.
There are different ways of measuring malnutrition.
One of them is weight for height and that's when if measured by weight for height.
So that's measure how tall that the child is in the way the child when you get 30% above the the malnutrition as assessed by weight for height, that's where you're in famine territory.
And now the IPC manual also provides for using MUAPP which is mid upper arm circumference.
You measure the upper arm of the child with a tape.
Both are acceptable measures, but they're very different measures.
And you the equivalent to 30% in weight for height is 15% by MUAPP.
That's been established again by the nutrition community, by the experts were part of the IPC and even outside the IPC, what happened in Gaza City is that the threshold of 50% NUAC mid upper arm circumference has been exceeded.
The incidence of acute malnutrition by the NUAC in Gaza City has tripled between May and July.
The use of the NUAC as a measure for the IPC has been accepted for years now and has been used in past famine confirmations as well.
So I, I hope that reassures you all that information, it's very technical, is available online if you want to double check as well.
We're also happy to take further questions if we want to get into the details of that.
And yeah, as one of our colleagues here saying, I mean, we, we, that would be a simple solution to verify all this, Christian, that would be to let international media in to verify and to see by themselves.
But I think Jean Mata has been giving you the scientific answer.
And I thank you very much for this.
Rick, I see your hand moving.
Is that you want to add something?
It's hard to see from here.
Alessandra, my question is, was oxycodone a drug found in flower bags distributed by Israel in eight centres?
And if it's true, because I was on vacation, I don't know if you already talked about this, but I I understand that oxycodone drug, it's, it's, it's a serious thing.
I don't know what are the main effects of this drug.
If you have any evidence on that, thank you so much.
I think we heard the rumours.
We there's no confirmation of that at all.
So that's all what I can say.
So I'd like to thank all the the colleagues have been speaking this morning on this.
Let me remind you a couple of things.
First of all that you have the information on the the complete information on the IPC website.
We also have several agencies that have spoken this morning and others, so FAO, UNICEF, of course, Wolford Programme and WHO, who have published a joint press release that you find on any of their websites where they say, in addition, of course, as we start to confirm the famine for the first time in Gaza, they reiterate the call for immediate ceasefire and unhindered humanitarian access to curb deaths from anger and malnutrition.
So you have this also on these websites.
You have also the statement from the Secretary General in your beatbox and by the Commissioner General Ladzarini on his social media.
And I see in the chat and in my message on WhatsApp that you're all asking for the notes of Tom Fletcher from this morning.
But you can already see the video on the UNOG multimedia room.
And it may be that in the meantime.
Yeah, it's, I think it's arrived.
So you have now also the the remarks on Gaza that Tom Fletcher gave this morning at the press briefing.
And I'd like to thank really everyone, Rick, please stay safe in Gaza.
And we we're really happy that you connect connected this morning.
Good luck with your very important work.
Thank you very much to Jean Martin.
But we're to connect from Rome.
That was really insightful And thanks to Jeremy for the human rights approach.
I have just one last state information for you that comes from the Committee on the Rights of Persons with Disabilities, which is concluding this morning the review of the report of Finland.
The next week, they will complete their meeting by issuing the observation on the four countries that they have reviewed, which are in addition to Finland, also the PRK, Kiribati and the Maldives.
So if there are no other questions, I'd like to thank you very much for having followed this along but extremely important briefing.
Thanks again to all our speakers and I wish you a very good weekend.
