...a situation created by Israel.
"Israeli officials are relying on UNRWA to prevent a polio epidemic — while the Knesset advances laws to expel the agency.
By Jonathan Adler October 10, 2024
☝🏿 Palestinians at the site of an Israeli airstrike at a UNRWA school in the Nuseirat camp in the central Gaza Strip, June 6, 2024. (Abed Rahim Khatib/Flash90)
Last month, nearly a year into Israel’s genocidal war, there finally seemed to be a small dose of good news from the Gaza Strip. After the destruction of Gaza’s healthcare and wastewater management infrastructure, a widespread polio epidemic in the besieged territory appeared likely by mid-summer, when the disease was first detected in sewage samples; in early August, a 10-month-old baby contracted the disease and quickly became paralyzed. International media and aid organizations sounded the alarm, yet there seemed to be little chance of conducting a successful mass inoculation campaign in the absence of a ceasefire — an outcome that, after Israel’s assassination of Hamas leader Ismail Haniyeh, grew further out of reach.
Then things started to shift. On Aug. 25, Israel announced that the Coordinator of Government Activities in the Territories (COGAT) — the civilian branch of Israel’s military government in the occupied West Bank and Gaza — had coordinated with the World Health Organization (WHO) and the UN Children’s Fund (UNICEF) to bring 1.2 million doses of the polio vaccine into Gaza. A week later, the Israeli government agreed to pause its military offensive in discrete regions of the Strip to ensure vaccines could be distributed. Prime Minister Benjamin Netanyahu was quick to affirm that these pauses were not a ceasefire, but that Israel was “committed to preventing an outbreak of the disease in the Gaza Strip, as well as in the entire region.”
These Israeli decisions did not arise out of a sudden concern for the welfare of Palestinians. In July, when polio was beginning to spread in Gaza, Israel’s first priority was to administer polio booster shots to its own troops. Yet even vaccinated soldiers could still be a vector for the virus, carrying it from Gaza back into Israel. This posed an immediate threat to Israeli citizens — and, in particular, to the approximately 150,000 children who have not been vaccinated against polio, many from the ultra-Orthodox community.
Over the first two weeks of September, three-day “polio pauses” — first in the Deir al-Balah area, then in and around Khan Younis, and finally in Gaza City and the decimated northern Strip — were largely effective. Aid workers traveled to hundreds of designated vaccination sites, and by Sept. 12, nearly 560,000 Palestinian children under the age of 10 had received a first dose of the oral polio vaccine, reaching 90 percent coverage. To administer the necessary second dose, the WHO is now planning to launch the next phase of vaccinations in mid-October through a similar structure of polio pauses.
Although COGAT didn’t acknowledge as much, a third organization inside Gaza was vital to the success of the vaccination effort: the UN Relief and Works Agency (UNRWA). As the largest humanitarian aid agency in Gaza, with 13,000 employees — most of whom are Palestinian — the agency was uniquely positioned not only to administer the vaccines, but to encourage Palestinian families to participate in the campaign and achieve mass inoculation. In the words of Sam Rose, the Senior Deputy Director of UNRWA Affairs in Gaza, there was “no way the vaccination campaign would have been able to take place without UNRWA.”
Legislate to liquidate UNRWA has coordinated its activities with COGAT for decades. As recently as February, COGAT chief Major General Rasan Elian admitted that “no other organization is equipped to take over the critical role played by UNRWA in distributing humanitarian aid.” But it has become harder for Israeli officials to justify this cooperation, as politicians have ramped up a campaign to abolish the organization amid Israel’s onslaught on the Strip.
In July, the Knesset passed its first reading, by an overwhelming margin, of a bill to brand UNRWA as a terrorist organization and force the government to cut all ties with the agency. Two other bills — one to ban UNRWA from operating on Israeli territory, and another to strip UNRWA personnel of the legal immunities given to UN staff in Israel — were passed as well. As the Knesset entered its end-of-summer recess, the three bills moved on to the parliament’s Foreign Affairs and Defense Committee.
Yet by September, Israel found itself in the awkward position of relying on UNRWA to facilitate a mass vaccination effort in Gaza — primarily to protect its own citizens — while advancing legislation to liquidate the organization.
This contradiction was not lost on MK Yulia Malinovsky, a member of the right- wing opposition party Yisrael Beiteinu, who had sponsored the bill to designate UNRWA as a terrorist entity and demanded that the Foreign Affairs and Defense Committee meet during the recess to address the legislation. “It is unacceptable,” Malinovsky wrote to the committee chair Yuli Edelstein, “that UNRWA will be declared the chief coordinator of the drive.” When the committee convened on Sept. 4, Edelstein agreed to discuss the three bills in order to “introduce clarity into the State of Israel’s attitude towards UNRWA.”
This past Sunday, to mark the anniversary of the Oct. 7 attacks, the committee formally approved two amended bills: the first would sever all ties between UNRWA and Israeli state authorities, while the second would ban UNRWA from operating in Israel. UN Secretary-General António Guterres has called upon Netanyahu to stop the legislation, warning that it may force UNRWA to cease all activity in the occupied territories. Malinovsky, on the other hand, is urging the Knesset to hold a special session to pass the laws before the end of the recess later this month.
Over the coming weeks, then, UNRWA will be racing against the clock to simultaneously administer a second round of desperately needed polio vaccines and secure its very existence in Palestine.
A decades-long crusade Established in the wake of the 1948 Nakba, UNRWA has long been the primary humanitarian aid organization for Palestinian refugees across the Middle East. Since Israel’s occupation of Gaza and the West Bank in 1967, UNRWA has closely coordinated with Israeli authorities — which, in many ways, have come to rely on the agency’s work.
With its educational and vocational training programs, healthcare and social service centers, infrastructure improvement schemes, and emergency response capabilities, UNRWA provides services to the nearly 2.4 million registered refugees across the occupied territories — services for which Israel, as the occupying power, would otherwise be responsible. In a broader sense, Israel and its allies have also profited from UNRWA’s role as what the historian Laura Robson terms an “instrument of containment”: offering some of the structures and resources of a state, but without direct representation, to “keep a lid” on Palestinian political action.
Yet if UNRWA is only a quasi-state, it is a quasi-Palestinian one. Palestinians not only constitute the vast majority of the agency’s employees, but have shaped and transformed it in critical ways — even as senior leadership has largely remained in the hands of Western former diplomats and career UN officials. In its early years, refugees forced UNRWA to abandon a series of resettlement schemes in Arab countries and to redirect its funding toward education instead; UNRWA’s schools, in turn, became key sites for the development and transmission of Palestinian nationalism.
Perhaps most importantly, UNRWA has helped to keep the Palestinian refugee question alive, and serves as a reminder that the international community bears responsibility for its just resolution. It is for this reason that Israel has long sought to dismantle UNRWA — even though doing so would have no bearing on UN Resolution 194, which enshrined the right of return for Palestinian refugees in international law, or the other conventions affirming that right for all refugees worldwide.
The current legislative effort to tarnish and stamp out UNRWA is only the latest and most dangerous stage of this crusade. Israel began targeting UNRWA with the Jan. 26 claim that 12 agency employees had taken part in Hamas’ October 7 attack — an accusation made on the same day that the International Court of Justice (ICJ) ruled Israel’s conduct in Gaza was plausibly a genocide. Over the following weeks, without providing evidence, Israel further alleged that some 1,200 UNRWA employees in Gaza had ties to Hamas, which, in Netanyahu’s words, had “totally infiltrated” the agency.
The reputational and financial damage to UNRWA was swift. Eighteen countries suspended their existing or planned donations to UNRWA, leaving a massive $430 million hole that threatened to debilitate the agency in the middle of a war. Since then, the UN has completed two investigations into the agency’s alleged terrorist infiltration. The first concluded that UNRWA had “a more developed approach to neutrality” than other UN bodies or aid groups, and that Israel provided no evidence to support the charge that UNRWA was overrun by Hamas members; the second found that nine employees “may have been involved” in the Oct 7. attack, yet the evidence was inconclusive.
More recently, as Israel expanded its war into Southern Lebanon, airstrikes killed a former UNRWA teacher who was subsequently revealed to be a Hamas commander — although he had been on administrative leave from the agency since March for violating its ban on “political activities.”
As reported by the New York Times, several donor countries were unconvinced by Israel’s claim that UNRWA was deeply compromised, and many resumed their funding even before the UN investigations had finished. But in the United States — UNRWA’s largest donor, and the last holdout — Congress passed legislation to ban funding to the agency until March 2025. For the rest of the year, UNRWA has raised enough funds from private donors to bridge the gap left by the U.S., but pro-Israel Republican and Democratic lawmakers are seeking to make the ban permanent.
The January allegations largely failed to undermine UNRWA in the short term, but Israel has not relented from its explicit campaign to cripple the organization. The government has frozen UNRWA’s accounts in Israeli banks and blocked all requests from UNRWA employees for residency visas. Israel’s state advertising agency has bought anti-UNRWA ads on Google, redirecting search users to a government website that tries to link UNRWA to Hamas.
In Jerusalem, Deputy Mayor Aryeh King led protests outside UNRWA’s East Jerusalem headquarters for months, culminating in an arson attack on May 9, which King vowed to see repeated. This harrassment has forced UNRWA to temporarily relocate its operations to Amman and Ramallah, and they may not be able to return: the Israel Land Authority has moved to evict UNRWA permanently from East Jerusalem and seize the property for settlement construction.
It is in Gaza, however, where Israel’s assault on UNRWA has been the most destructive. According to the agency’s own tally, there have been over 460 attacks on UNRWA facilities — schools, offices, healthcare clinics — since the start of the war. At least 563 Palestinian civilians have been killed and 1,790 injured while sheltering on UNRWA premises, in addition to the deaths of 226 of UNRWA’s own staff, the highest in any conflict in UN history. The deadliest incident occurred just last month, during the final days of the polio vaccination campaign, when Israeli airstrikes hit a school in Nuseirat refugee camp and killed six UNRWA workers.
In this sense, the legislative offensive to abolish UNRWA from the occupied territories is merely a codification of its existing military practice. The proposed laws may give Israel greater license to target UNRWA infrastructure and personnel, but Israeli troops haven’t waited for any legal permission to do so.
Vaccinate by day, kill by night The ferocity of Israel’s multi-pronged assault on UNRWA makes the successful delivery of polio vaccines all the more striking. Even while helping bring 1.2 million vaccine doses into Gaza, Israel has continued to restrict entry of other humanitarian aid. On Sept. 12, the final day of the vaccine rollout, relief groups projected that 1 million Gazans would go hungry over the course of the month, while Refugees International warned of a “grave risk of famine conditions” reemerging in the Strip.
Palestinians at the site of an Israeli airstrike at a UNRWA school in the Nuseirat camp in the central Gaza Strip, July 15, 2024. (Abed Rahim Khatib/Flash90) Palestinians at the site of an Israeli airstrike at a UNRWA school in the Nuseirat camp in the central Gaza Strip, July 15, 2024. (Abed Rahim Khatib/Flash90) There is something brutal, too, in the very idea of “polio pauses” — a way of conceding that Israel could continue to kill and maim Palestinians, just not in certain places at certain times. During the 10-day inoculation campaign, UNRWA and other aid workers went to great lengths to prevent Palestinian children from becoming irreversibly paralyzed, but they could do nothing to prevent the same children from being maimed and disabled by Israeli bombs — as happened, for instance, to two Palestinian toddlers in Deir al-Balah, just minutes after the pauses ended. “Where is the humanity in giving children a vaccine during the day,” asked Ola al-Masri, a Palestinian mother in Gaza, “and allowing them to be killed at night?”
Academics have long argued that by providing essential services to Palestinian refugees, humanitarian actors like UNRWA create a degree of stability that lowers the cost of Israel’s permanent occupation. Indeed, amid its current existential crisis, UNRWA increasingly invokes the stabilizing effect of its programs to try to shore up international support for the agency. In recent public appearances, UNRWA’s Commissioner-General Philippe Lazzarini has made an effort to show how Israel benefits from its presence; he has framed UNRWA’s educational programs, in particular, as part of the fight against Hamas, by preventing “resentment, revenge, and extremism” in future generations.
This is not to discount the vital importance of UNRWA’s work: if Israel succeeds in banishing the agency from Gaza and the West Bank, Palestinians will only suffer more. But the troubling reality is that UNRWA has now been debilitated to such a degree that it can only deliver lifesaving aid to Palestinians when doing so serves Israel’s interest. In fact, UNRWA’s efforts — the polio vaccination campaign being a prime example — may help Israel continue to pursue its genocidal war.
One of the key arguments by Israeli security officials against the government’s plans to dismantle the agency is that the even worse humanitarian catastrophe that would ensue in UNRWA’s absence would “force Israel to halt its fighting against Hamas.” A polio outbreak, which would threaten Israeli lives and ignite a firestorm of international outrage, could do so, too.
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Inside the siege of northern Gaza, where 'death waits around every corner' At the core of Israel’s anti-UNRWA crusade is the claim that the organization is a front for Hamas, and therefore both must be eliminated. Ironically, if UNRWA manages to survive this assault, it could end up more closely resembling the Palestinian Authority in the West Bank: reduced to a mere subcontractor for Israel, offering Palestinians basic services while ultimately accountable to their occupier.
But with its military escalation in Lebanon and promise of retaliation against Iran, Israel seems intent on destroying many longstanding actors in the region — and there’s no guarantee UNRWA will make it out of the bloodbath alive.
UNRWA Gaza Knesset Palestinian refugees health care humanitarian aid Jonathan Adler Jonathan Adler is an editor at +972 Magazine, based in New York. He was previously a Hurford Fellow at the Carnegie Endowment for International Peace, and his writing has been published in New Lines Magazine, Middle East Eye, and Jadaliyya, among others. Follow him on X @JRAdler4. Our team has been devastated by the horrific events of this latest war. The world is reeling from Israel’s unprecedented onslaught on Gaza, inflicting mass devastation and death upon besieged Palestinians, as well as the atrocious attack and kidnappings by Hamas in Israel on October 7. Our hearts are with all the people and communities facing this violence.
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