The Thousandth Cut: Eliminating U.S. Humanitarian Assistance to Gaza

In August 2018, the Trump administration slashed more than half a billion dollars in U.S. assistance to Palestinians. Its first target was the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), the main provider of relief, development, and protection services for Palestinians in need across the region. The administration also ended bilateral humanitarian and development assistance for Palestinians in the West Bank and Gaza. The impact of these cuts will be significant, especially in Gaza, where the population largely relies on the UN for basic services, and humanitarian indicators have been in steep decline for months.

The Trump administration cut aid to the Palestinians in an effort to bring pressure to bear on the Palestinian leadership to re-engage in a faltering peace process with Israel. In doing so, it explicitly broke with decades of bipartisan consensus on an important principle of U.S. foreign policy—that humanitarian aid should be provided on the basis of need, not politics. This principle has been defended by the United States on many occasions, including in the multilateral “Good Humanitarian Donorship Principles” first endorsed by the administration of George W. Bush. To be sure, application of this principle by the United States has been imperfect over time. By so clearly and vocally politicizing relief in this case, President Trump has raised concerns that all U.S. humanitarian assistance is now potentially subject to this kind of political conditionality.

Humanitarian assistance is of course voluntary, but when it is provided, it should adhere to the principles (among others) of impartiality and independence―that is, it must be based on need and must be autonomous from U.S. political objectives with respect to Palestinian political leaders. Rescinding such aid based on political factors does violence to these critical principles. It will also have a dramatic and negative impact on Palestinian civilians.

Some in U.S. policymaking circles argue that the situation in Gaza has been so bad for so long that it cannot get any worse. Tragically, this is not the case. This flawed contention is too often followed by a reassurance that Gazans are so resilient that they will get through anything. But the time has come to face facts. In Gaza, conditions are indeed getting worse. The first section of this report will assess this trend and the potential impact of the U.S aid cuts in key sectors, including food security, health care, education, and livelihoods.

The second section explores key historical factors likely to amplify the pain caused by the reduction in funding. Decades of occupation by Israel have left the Occupied Palestinian Territory (OPT)―Gaza and the West Bank, including East Jerusalem―in need of significant international assistance to maintain public services. In addition, for more than a decade, Gaza has been subject to a socio-economic blockade that has exacerbated humanitarian need and impeded economic development. Although food and some medicines can usually get through, commodities like building materials that qualify as dual use items often are prohibited. Today, some 2 million people are effectively trapped in a space of 140 square miles without reliable access to clean water, sufficient food, adequate medical care―including the ability to leave the territory to receive life-saving treatment not available in Gaza―or the ability to make a living. International humanitarian assistance therefore provides Gazans with a lifeline.

A Palestinian boy carries bottles of oil distributed at UNRWA’s aid distribution center in Rafah in the southern Gaza Strip. (AFP PHOTO / SAID KHATIB)

On a recent field mission in the region, the Refugees International (RI) team was denied permission to enter Gaza but held interviews from Jerusalem with residents and aid providers in the territory. The team repeatedly heard from those who live and work inside Gaza that conditions impacting social and economic well-being―health, education, employment―are the worst they have ever been. In many cases, these conditions are life-threatening, and experts and others interviewed by RI expect them to degrade further. Most alarmingly, there was general agreement that each time Gaza has been hit by a shock in recent years―be it economic, humanitarian or political—its recovery has been slower and less complete. Put simply, Gaza is losing resilience with each crisis. That loss has led to new lows in living conditions and hope for the future.


  • The Trump administration must cease using funding for humanitarian programs to Palestinians as political leverage.
  • The U.S. government must restore its annual contribution to UNRWA, including the funding withheld in 2018, because urgent humanitarian needs remain and are escalating. The contribution should remain at least at the pre-existing level.
  • The U.S. government must restore its bilateral assistance to projects in the OPT, some of which serve critical humanitarian objectives, including the funding withheld in FY2018.
  • U.S. congressional appropriators and the relevant subcommittees must restore all humanitarian and development assistance to the OPT, including earmarking funds for OPT projects in the FY2019 budget.
  • The government of Israel must allow and facilitate the free flow of people and goods in and out of Gaza, subject to reasonable security restrictions. In particular, patients who need life-saving medical assistance outside of Gaza should be expedited for travel. Traders and day laborers must also be able to leave and enter Gaza to pursue their livelihoods.
  • The government of Israel, in conjunction with the Palestinian National Authority (PA), must amend the dual use lists that apply to Gaza so that rebuilding and reconstruction can occur.
  • The Gulf countries—particularly those that have been supportive of addressing humanitarian needs in the OPT—must prioritize the humanitarian response in Gaza in their own foreign assistance policies and practices. They must commit to multiyear financing for UNRWA as well as projects that restore the economy in Gaza and create livelihood opportunities.