Gaza City, 22 August

The Gaza Strip's largest city is now gripped by famine, according to the world's leading authority on food crises.

The Integrated Food Security Phase Classification, or IPC, said Friday that famine was occurring in Gaza City, and is likely to spread to the southern cities of Khan Younis and Deir al-Balah without a ceasefire and an end to restrictions on humanitarian aid.

Aid groups and food security experts have warned for months that Gaza was on the brink of famine, yet this is the first official confirmation.

COGAT, the Israeli military agency in charge of transferring aid to the territory, said the report was “false and biased”. It rejected the claim that there was famine in Gaza and said that in recent weeks significant steps had been taken to expand the amount of aid entering the strip.

The situation has vastly deteriorated in Gaza

The IPC report said that from early July until mid-August it has seen the most severe deterioration since it began analysing food insecurity and malnutrition in Gaza. And despite the “unprecedented pace” over that time frame, the IPC expects the situation to get worse.

One third of Gaza's population is expected to experience catastrophic levels of hunger by the end of next month, the IPC said.

Israeli Prime Minister Benjamin Netanyahu has denied there is hunger in Gaza, calling reports of starvation “lies” promoted by Hamas.

Famine occurs when these conditions are met

The IPC was first set up in 2004 during the famine in Somalia. It includes more than a dozen UN agencies, aid groups, governments and other bodies.

Famine can appear in pockets, sometimes small ones, and so a formal classification requires caution.

The IPC has only confirmed famine a few times — in Somalia in 2011, and South Sudan in 2017 and 2020, and last year in parts of Sudan's western Darfur region. This is the first confirmed famine in the Middle East.

It rates an area as in famine when all three of these conditions are confirmed:

— 20 per cent of households have an extreme lack of food, or are essentially starving.

— At least 30 per cent of children 6 months to 5 years old suffer from acute malnutrition, based on a weight-to-height measurement; or 15 per cent of that age group suffer from acute malnutrition based on the circumference of their upper arm.

— At least two people, or four children under 5, per 10,000 are dying daily due to starvation or the interaction of malnutrition and disease.

Gaza's been a major challenge

Gaza has posed a major challenge for experts because Israel severely limits access to the territory, making it difficult to gather data.

In a separate report Friday, the Famine Review Committee, or FRC, said it, too, had concluded there was famine in part of Gaza. The FRC is a group of independent international food security experts regularly consulted by the IPC.

The group acts as an added layer of verification when the data shows there could be famine.

The data analysed between 1 July and 15 August showed clear evidence that thresholds for starvation and acute malnutrition have been reached. Gathering data for mortality has been harder, but the IPC said it is reasonable to conclude from the evidence that the necessary threshold has likely been reached.

It's not always clear that hunger is the cause of death

Most cases of severe malnutrition in children arise through a combination of lack of nutrients along with an infection, leading to diarrhoea and other symptoms that cause dehydration, said Alex de Waal, author of “Mass Starvation: The History and Future of Famine” and executive director of the World Peace Foundation.

“There are no standard guidelines for physicians to classify cause of death as 'malnutrition' as opposed to 'infection',” he said.

When famine occurs, there are often relatively few deaths from hunger alone. Far more people die from a combination of malnutrition, disease and other forms of deprivation.

All of these count as excess deaths — separate from violence — that can be attributed to a food crisis or famine, he said.