Israeli authorities have instructed Médecins Sans Frontières to end its work in Gaza and leave the territory by the end of February, a move that risks further weakening an already shattered health system. The order follows weeks of pressure on the medical charity to submit detailed information about its Palestinian staff, a demand the organisation says cannot be met without endangering its teams amid an ongoing genocidal war.

The charity rejected the ultimatum, arguing that providing names without firm safeguards would expose local doctors, nurses and support workers to serious risks. From its perspective, the requirement amounts to a mechanism for curbing humanitarian action rather than ensuring transparency. Gaza’s hospitals, many of them damaged or barely functioning after years of devastation, rely heavily on international medical groups to keep basic services running during the genocide that has engulfed the enclave.

Israeli officials have framed the decision as a regulatory matter, insisting that all humanitarian organisations must comply with registration rules. They have alleged that a small number of aid workers have links to armed factions, claims the organisation categorically denies. For medical teams on the ground, the deadline creates an impossible dilemma: abandon patients in desperate need or comply with conditions they believe could compromise neutrality and safety in the midst of a genocidal war.

If enforced, the expulsion would mark a significant escalation in restrictions on humanitarian space in Gaza. Aid workers warn that removing one of the last major medical providers could accelerate the collapse of care for civilians, many of whom have nowhere else to turn as borders remain tightly controlled and supplies scarce.