In August, FEWS NET cautioned that Famine (IPC Phase 5) would likely occur in northern Gaza in a scenario where food and nutrition assistance – which was delivered to the north in large quantities between May and September – was significantly disrupted or suspended for an extended period of time. Commercial food supply flows to the north have been severely restricted throughout the conflict. In early October, FEWS NET warned this scenario had begun to materialize when the Israeli Defense Force (IDF) ordered the evacuation of over 400,000 people from northern Gaza and launched a siege of North Gaza governorate that blocked humanitarian access and cut off food and nutrition supply flows. As of early November, an estimated 75,000-95,000 people in North Gaza – including civilians who were unable to or were prevented from safely evacuating – have been isolated from food supplies and nutrition services for at least 40 days, and the availability of health services is increasingly dire. 

The intensity of the IDF’s ongoing military operation in North Gaza governorate, especially in Jabaliya, Beit Hanoun, and Beit Lahia, is comparable to that of November 2023, marked by extensive air and ground strikes, shelling, and demolitions, with near-daily counterattacks by Hamas or other Palestinian militias. While over 70,000 people fled from North Gaza to Gaza City, in addition to thousands who reportedly displaced south towards the “humanitarian zone,” tens of thousands were either reportedly deterred by extreme levels of insecurity en route or allegedly prevented from leaving by the IDF and Hamas. The IDF has now reportedly positioned troops along a newly established armed corridor between North Gaza and Gaza City (Figure 1), effectively splitting the north in two and isolating those who remain behind in Jabaliya, Beit Hanoun, and Beit Lahia. After 13 months of war that has widely destroyed basic infrastructure and left civilians heavily dependent on food aid, remaining civilians have already exhausted their capacity to cope and face rapidly worsening starvation and malnourishment.

Humanitarian access to deliver food, nutrition, and health services has been nearly to fully suspended in North Gaza since October 1, and records show commercial food supplies have not reached northern Gaza since September 16. After Israel closed the northern border crossings from October 2-13, the Coordination of Government Activities in the Territories (COGAT) approved fewer than 400 trucks carrying roughly 6,000 metric tons (MT) of humanitarian food for delivery to Gaza City from October 14-31 (compared to roughly 10-15,000 MT monthly in August-September) and just 11 trucks for delivery to North Gaza on November 7, most of which were looted. WFP – which has been the primary food supplier to North Gaza in 2024 – has otherwise suspended operations in North Gaza; all eight hot meal kitchens and two subsidized bakeries have also closed. Food supplies delivered prior to October are now largely depleted; anecdotal reports indicate remaining food is being sourced from the homes of recent evacuees or foraged from rubble, and petty trade consists of food aid sold at exceptionally high prices. In addition, all seven nutrition outpatient therapeutic feeding program sites and the only stabilization center in North Gaza have been forced to close, halting the provision of emergency Lipids-based Nutrition Supplements (LNS) and other nutrition services. 

In the absence of a drastic increase in food supply flows, prolonged food deprivation and a lack of access to therapeutic feeding will undoubtedly lead to Famine (IPC Phase 5) in North Gaza. While the collection of data to monitor whether the Famine (IPC Phase 5) thresholds have been met is no longer feasible due to the siege, extreme caloric deficits are the only logical outcome of the cut-off in the food supply. It is highly likely that levels of acute malnutrition in North Gaza, which ranged between 1.3 and 2.9 percent among children under five (n=2,100) during the last round of nutrition screenings prior to the siege from September 23-October 2, are rising rapidly as a direct consequence of starvation. Furthermore, the operational collapse of North Gaza’s three partially functional hospitals presents a risk of heightened communicable disease prevalence, which will in turn interact with hunger to escalate malnourishment. It is highly likely that hunger-related mortality is ongoing now, on an upward trajectory towards at least 2 deaths per 10,000 people per day.