Gaza: Open letter to EU heads of state

The war in Gaza has been allowed to become one of the most egregious, deadly, and ruthless wars waged on a people. Gaza’s homes, hospitals, markets, water networks, roads, and power grids have all been demolished by Israeli forces, not by disregard but by design. What we are witnessing is the calculated evisceration of the very systems that sustain life. It is ethnic cleansing, wrapped in the rhetoric of security defense, but executed with complete disregard for international humanitarian and human rights laws. 

Daily atrocities in Gaza are not unfolding in the shadows. They are occurring before our eyes. They are brazen in their brutality.

For more than 20 months, Israeli authorities and forces have inflicted a punishing campaign against Palestinians in Gaza. On a daily basis, Doctors Without Borders/Médecins Sans Frontières (MSF) teams witness patterns consistent with genocide through deliberate actions by Israeli forces—including mass killings, the destruction of vital civilian infrastructure, and blockades choking off access to food, water, medicines, and other essential humanitarian supplies. Israel is systematically destroying the conditions necessary for Palestinian life.

A recent retrospective mortality survey run by MSF and our epidemiological arm Epicentre showed that nearly 2 percent of our staff in Gaza and those in their households have died since October 7, 2023. Three-quarters of them died because of war-related injuries. This ratio is consistent with figures of the Ministry of Health in Gaza, which reports that 55,000 people have been killed across the Strip up until June 4 this year. In the MSF survey, 40 percent of the people who died of injuries were aged below 10 years. This disregard for civilian life shows that this war run by Israel in Gaza is against Palestinians as a whole.

On June 11, the MSF-supported Al-Mawasi clinic received 32 casualties, including three people dead on arrival. They had been shot on their way to a food distribution site, run by the Gaza Humanitarian Foundation (GHF). 

This was not an isolated incident.

Three days earlier, teams at Nasser Hospital received 40 patients, most of them with gunshot wounds. This is the main referral hospital for thousands of patients in southern Gaza and it is barely able to continue working due to repeated evacuation orders and movement restrictions on staff and patients. Humanitarian organizations have set up makeshift hospitals to fill the gap, but that can in no way replace regular hospitals. In recent weeks, MSF teams have admitted over 500 patients requiring medical care to Nasser Hospital and supported the hospital’s medical staff to respond to repeated mass casualty influxes from constant bombings and attacks. 

The GHF launched its activities on May 27 as part of the US-Israeli plan that instrumentalizes aid. Since then, hundreds of Palestinians have been treated in hospitals and scores have been killed after being shot at these aid distribution sites while waiting to receive basic necessities for survival. One of our colleagues in Gaza observed that some people returned from the distribution sites with a bag of flour; others with a shroud.

Humanitarian aid is being weaponized. It is being used as leverage to forcibly displace people, to meet military objectives, or blocked entirely. Aid is not a bargaining chip. It is a lifeline. Denying it is collective punishment—a war crime. 

Since October 2023, health care has been consistently under attack, and MSF staff and patients have been forced to leave at least 18 different health structures and have endured 50 violent incidents, which include airstrikes against hospitals, tank shells being fired at deconflicted shelters, ground offensives into medical centers, and convoys fired upon. Eleven of our colleagues have been killed. We are not unique in these experiences; these attacks have occurred across the humanitarian spectrum. They are part of a systematic disregard for International Humanitarian Law (IHL), including the UNSC resolution 2286 on the protection of the medical mission.

MSF, like many other organizations, has repeatedly called for an immediate and unconditional ceasefire, unfettered humanitarian access, and respect for IHL—including medical facilities and personnel—by all parties, including Hamas. But this military onslaught, against a besieged people, rages on and is growing more brutal by the day. 

The European Union and European governments have the political, economic, and diplomatic means capable of exerting real pressure on Israel to stop this assault and open Gaza’s border crossings to unhindered humanitarian aid. These are not theoretical instruments; they can be effectively mobilized in defense of international law and to protect civilians.

The European Union and many of its leaders have recently chosen to rebuke Israel; yet these words ring hollow, as they fail to take the substantive action needed to stop the slaughter and hypocritically continue to provide weapons to Israel that kill, burn, or permanently disable the people who end up in our hospitals. This must stop. 

There was never a time for hesitation and inhumane double standards. Your words and actions are a test of your credibility and leadership. Now is a moment that will define your legacy and determine whether laws meant to protect civilians in war retain any meaning at all. It requires political courage, legal responsibility, and moral commitment. The scale of suffering in Gaza demands more than your empty rhetoric. 

Every delay, every equivocation, and every policy that permits the machinery of devastation to roll forward with impunity is an act of complicity.

We urge the European Union and its 27 Member States to act decisively and finally use the leverage they have on Israel in order to:

LIFT THE SIEGE

Blocking lifesaving assistance is not a legitimate security measure—it is a war crime. Claims of aid diversion cannot begin to justify withholding aid from over 2 million people. This is collective punishment. Every delay is costing lives. 

DEFEND HUMANITARIAN ACTION

Reject any mechanism that instrumentalizes aid or uses humanitarian relief as a bargaining chip. Aid must be based on needs. Policies that subordinate aid to military strategy are not only cynical; they are deadly. 

ACTIONS NOT WORDS

Many European governments have spoken about the appalling atrocities we see Israel perpetuate in Gaza, yet they continue sending the weapons that kill our patients and colleagues. Governments must end their complicity in this campaign of ethnic cleansing. 

BOOST MEDICAL EVACUATIONS

Today, around 13,000 people, including more than 4,500 children, remain in urgent need of medical evacuation , with the right to return. Nevertheless, despite these needs and the proven capacity of the European Union, only a few hundred patients have been welcomed by European Member States. Member States must do more to show that solidarity isn’t just words. You can and must act now. 

Sincerely, 

Dr. Christos Christou, MSF International President

Christopher Lockyear, Secretary General, MSF International