The Lancet: More than 54,600 children under 5 in Gaza suffer from acute malnutrition

While the world celebrates with bated breath the announcement of an agreement for the first phase of the ceasefire in the Gaza Strip, a report just published by the authoritative magazine Lancet recalls how this initiative arrives “cruelly late” and for a population that “is floundering due to hunger”, as Agnès Callamard, general secretary of Amnesty International, recalled when commenting on the news.

More than 54,600 children under 5 years of age in the Gaza Strip are in a condition of acute malnutrition – the study estimates – 12,800 of them in a situation of such serious wasting that it is difficult to resolve without therapeutic food, which is currently practically absent in Gaza, according to complaints from the main NGOs.

It is absolutely urgent to intervene because, «unless there is a lasting cessation of the conflict, combined with unhindered and competent international humanitarian, nutritional, medical, economic and social services, a further deterioration of early childhood nutrition and an increase in mortality are inevitable in the Gaza Strip» wrote Akihiro Seita, Health Director of UNRWA (the United Nations Relief and Works Agency). Palestinian refugees in the Near East) and lead author of the study.

A child is defined as being in a state of acute malnutrition or wasting (wasting in English) when he is too thin for his height, has lost and is losing weight rapidly and is lacking energy due to the lack of nutritious food. In the most serious cases, acute malnutrition can give rise to two typical clinical situations, both found in Gaza: a form of extreme weight loss called marasmus, due to the lack of both calories and proteins, or the typical swelling of the abdomen and cheeks called kwashiorkor, linked above all to the lack of proteins. Children with acute malnutrition are subject to continuous infections and are 12 times more likely to die than their peers with adequate nutrition.

The “diagnosis” of malnutrition is made by measuring the brachial circumference, that is, the measurement of the child’s arm at its widest point. A bracelet similar to a tape measure is used: if the value is less than 12.5 cm the child has moderate acute malnutrition, if it is under 11.5 cm, he instead has severe acute malnutrition.

Between January 2024 and mid-August 2025, UNRWA staff carried out these measurements on 219,783 children aged 6 to 59 months at 16 then-functioning health centers and 78 medical points located in temporary shelters or tent camps, and in 5 governorates in the Gaza Strip, which have a total population of 346,000 children under the age of 5.

The study lasted a total of 20 months, in which the total number of measurements of the children’s arm circumference varied from 722 to 23,651 per month.

Over this period of time, there have been multiple blockades of international aid by the Israeli army, and the authors of the study were able to document the immediate effects of the absence of food on the nutritional status of children. The prevalence of acute malnutrition as of January 2024 was 4.7%; by July of the same year it had risen to 8.9% and by January 2025, after weeks of severe aid restrictions (with a daily average of 42-92 trucks allowed into Gaza per day, compared to 300-600 the day before the war), it had risen to 14.3%.

Earlier this year, a ceasefire had temporarily ensured the entry of more aid, and by March 2025 wasting had fallen to a prevalence of 5.5%. A subsequent 11-week blockade (of food but also medicines, fuel, water and other essential goods) that lasted until May led up to the latest measurements, those of mid-August: acute malnutrition for 15.8% of the children screened, with 3.7% of the total affected by severe wasting.

Comparing these numbers to the total children in Gaza, it is estimated that there are 54,600 children under the age of 5 in urgent need of therapeutic food, including 12,800 with little chance of recovering if they do not have immediate and constant help.

Before the war, the diet of children in Gaza was not varied enough and suffered from nutrient discontinuities, but there was no acute malnutrition thanks to the entry of international aid into the Strip.

Now experts fear the less obvious but more long-lasting effects of wasting away: once the immediate risk of widespread infections has passed (because a body without energy first “turns off” the immune defenses), even decades later there may remain weakening of the bones and problems in the development of organs, structural alterations in the brain, psychological effects and a greater risk of chronic and metabolic diseases.