A full-blown humanitarian emergency in Gaza is no longer looming. It is here, and it is catastrophic.

It’s been more than two months since Israel cut off all humanitarian aid and commercial supplies into Gaza. The World Food Program delivered its last stores of food on April 25. Two million Palestinians in Gaza, nearly half of them children, are now surviving on a single meal every two or three days.

At makeshift clinics run by my relief organization, American Near East Refugee Aid, signs of prolonged starvation are becoming more frequent and alarming. In the past 10 days, our lab technicians began detecting ketones, an indicator of starvation, in one-third of urine samples tested, the first time we have seen such cases in significant numbers since we began testing in October 2024. Food, fuel and medicine are exhausted or close to it.

Every hour is a race against time — but without the access and political will needed to deliver aid, save lives and end the unimaginable suffering, our hands are tied.

This is the longest continuous total siege Gaza has endured in the war. Israel is now openly exploiting aid as a tool of war; senior Israeli officials have declared what effectively is the intent to use starvation as a tactic to pressure Hamas to release the remaining hostages — a clear violation of international law. Many Palestinians fear it is also part of a plan to expel them from Gaza, and aid groups warn that Palestinians could end up in “de facto internment conditions.”

Israel’s blockade — and the deliberate delays, denials and excessive security procedures that surround it — is not just a failure of logistics. It is an engineered system of deprivation. The short-lived cease-fire in January proved inadequate to meet humanitarian needs. Aid increased beginning on Jan. 19, but was again cut off entirely by March. The intent to use hunger as leverage is explicit, and it is unconscionable.