The aid delivery, which ended in blood this week, showed the extent of the desperation of the people of Gaza: dozens were killed after many thousands gathered in a rare convoy of aid trucks. As aid flows into Gaza have plummeted and Palestinians struggle to find food, humanitarian workers and United Nations officials are warning that famine is looming in the enclave.
For aid organizations and the UN, officially declaring a famine is a technical process. It requires analysis by experts, and only government agencies and senior UN officials can make such a statement.
What is a famine?
Food insecurity experts working on the Integrated Food Security Phase Classification (IPC), an initiative controlled by UN bodies and major aid agencies, identify famine in an area based on three conditions:
At least 20 percent of households suffer from extreme food shortages.
At least 30 percent of children suffer from acute malnutrition.
At least two adults or four children per 10,000 people die every day from hunger or diseases related to malnutrition.
Since the IPC was developed in 2004, it has identified only two famines: in Somalia in 2011 and in South Sudan in 2017. In Somalia, more than 100,000 people died before the famine was officially declared.
IPC analysts expressed grave concern about food insecurity in Yemen and Ethiopia in the context of the civil wars in those countries, but said there was not enough information available from governments to make a formal assessment.
The declaration of famine in Somalia and South Sudan sparked global action and large donations. Aid workers and hunger experts point out that the hunger crisis in Gaza is already dire, whether there is a famine or not, and that rapid relief is needed.
“For me it's important to basically say, look, technically we haven't met the conditions of famine, and frankly we don't want to meet those conditions,” said Arif Husain, the World Food Program's chief economist. “So please help, now.”
What is the situation in Gaza?
Palestinians, particularly in the north, are battling famine and regularly crowd the relatively few aid trucks that enter the area. Aid groups say people are so hungry that they are resorting to leaves, donkey food and leftover food.
The first IPC report on Gaza, released in December, found that the enclave's entire population suffered from crisis or worse food insecurity. Although the group said Gaza had not yet crossed the famine threshold, it warned that the risk of famine after famine would increase if the war did not stop.
A second analysis of food security is currently underway, the IPC group said.
What are the complications?
IPC's December analysis relied on publicly available data from international and local aid organizations in Gaza, which the group said met its methodological standards. However, IPC analysts said they lacked current data on the prevalence of acute malnutrition. Obtaining this data is very difficult in a war zone and places a burden on already overstretched health workers, the group added.
The organization's criteria were originally designed to combat weather-related famines, not crises like the one in Gaza, Husain said. But most severe hunger crises in recent history have been due to conflict rather than climate, he noted.
And while IPC experts conduct the analysis that can classify a famine, it is up to government authorities and the United Nations to officially declare a famine.
In some cases, countries have been reluctant to do so. In 2022, the Somali president expressed reluctance to declare a famine during a severe hunger crisis triggered by a drought. And in 2021, Ethiopia blocked the declaration of famine in the Tigray region through strong lobbying, according to a senior U.N. official.
It is unclear exactly which authority could declare a famine in Gaza. The IPC group said the process typically involves a country's government and its top U.N. official. Determining who that authority in Gaza would be was outside the organization's jurisdiction, it said.
Stephanie Nolen contributed reporting.