Media release

From: The Lancet

The Lancet:Tens of thousands of children aged under five suffering acute malnutrition in Gaza, recent estimates suggest

Between Jan 2024 and Aug 2025, peaks in the prevalence of acute malnutrition match periods of severe aid restrictions.

More than 54,600 children in Gaza are estimated to be acutely malnourished, including over 12,800 severely so, with few therapeutic options available to them. With measurements up to the middle of August 2025, the study comprehensively tracks wasting among children during the war, estimates population prevalence, and highlights unprecedented increases in child malnutrition following periods of blockades and severe aid restrictions.

Published in The Lancet, the study was led by the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). Between January 2024 and mid-August 2025, UNRWA staff screened 219,783 children aged 6-59 months, measuring mid-upper arm circumference (MUAC) at 16 functioning health centres and 78 medical points in shelters and tented encampments across five governorates in the Gaza Strip. The researchers then estimated the prevalence of acute malnutrition, based on the total estimated number of children in that age group in the territory (346,000).

Based on evidence of child malnutrition collected from multiple aid agencies, on 15 August 2025 the UN Integrated Food Security Phase Classification (IPC) confirmed famine in the Governate of Gaza City, with the rest of the Gaza Strip facing critical conditions or the prospect of famine. The study reenforces the IPC’s confirmation of famine in Gaza City Governorate, and provides evidence of how child malnutrition has evolved during the war.

Wasting, or acute malnutrition, is defined as a child being too thin for their height, indicating rapid weight loss and severe lack of energy, protein and other nutrients. Wasting can also be assessed by measuring the circumference of a child’s upper arm with a calibrated tape, as done in this study, with a thin arm highly correlating to a thin body. It is a life-threatening condition, and children require regular treatment with therapeutic food over several weeks, or in extreme cases and when possible, hospitalisation.

During the 20-month surveillance period, the number of MUAC screenings varied from 722 to 23,651 per month. Prevalence of wasting in January 2024 was 4.7% (34 out of 722 children), rising to 8.9% (1,281/14,387) in July 2024. The end of 2024 saw severe aid restrictions, with UN sources reporting daily averages of 42 to 92 aid trucks per day crossing into Gaza, compared to 300 to 600 per day pre-war. In January 2025, prevalence of wasting was 14.3% (1,661/11,619).

In early 2025, a six-week ceasefire allowed for increased aid to enter the Gaza Strip, and wasting declined to 5.5% by March 2025 (831 out of 15,165 children). A subsequent 11-week blockade followed, with severe restrictions on the entry of food, water, fuel, medicines and other essentials, was in place until late May 2025.

The latest measurements, taken through mid-August 2025, found that 15.8% (1,213/7,668) of screened children were wasted, 3.7% (280/7,668) severely so. Extrapolated to the estimated total population of the Gaza Strip, this is equivalent to over 54,600 children aged 6-59 months in need of urgent therapeutic nutrition and medical care, including 12,800 severely wasted children with little chance of rehabilitation given the inadequate amounts of food crossing the borders, and the cripped health and nutrition services.

Trends were most extreme in some areas – for instance, in Rafah there was an increase in wasting malnutrition from 7.1% (273/3,855) in April 2024 to 31.5% (63/200) in January 2025, decreasing to 8% in April 2025, in association with the ceasefire, although screening was ceased in this area shortly after. In Gaza City, prevalence rose six-fold from 5.4% (373/6,908) in March 2025, to 28.8% (631/2,194) in mid-August 2025.

Dr Akihiro Seita, the UNRWA Director of Health and a senior author of the paper notes: “Since October 7, 2023, an unprecedented war has unfolded across the Gaza Strip. From the outset, the territory’s infrastructure has been destroyed, the population repeatedly displaced and, with few exceptions, humanitarian aid has been severely restricted. Given the long failure to stop the war and prevent encroaching famine despite a global capacity to do so, unless there is a lasting cessation of the conflict coupled with unimpeded, competent, international humanitarian nutritional, medical, economic and social services, a further deterioration in early childhood nutrition with increased mortality are inevitable in the Gaza Strip.”

Dr Masako Horino, nutrition epidemiologist, UNRWA and lead scientist for the study, adds: “Evidence prior to Oct 2023 indicated that children in Palestine refugee families in the Gaza Strip were food insecure and had poor dietary diversity. Yet, they were only marginally underweight. This paradox was likely explained by these families’ regular access to food aid. Following two years of war and severe restrictions in humanitarian aid, tens of thousands of pre-school aged children in the Gaza Strip are now suffering from preventable acute malnutrition and face an increased risk of mortality.”

The authors note that data collected was limited to available, functioning UNRWA facilities. Two-thirds of screenings were conducted in Khan Younis and Middle areas, due to challenges of operating health centres in other areas. A total of 265,974 screenings were done for 219,783 children, indicating some children were screened more than once over time. Researchers faced considerable challenges including lack of identity information, and unsafe locations making data collection challenging.

In a linked Comment, Zulfiqar A Bhutta (Aga Khan University, Pakistan & Hospital for Sick Children, Canada), Jessica Fanzo (Columbia University, USA) and Paul H Wise (Stanford University School of Medicine, USA), who were not involved in the study, write: “These temporal data strongly suggest that restrictions on food and assistance have resulted in severe malnutrition among children in the Gaza Strip, a reality that will undoubtedly impact their future health and development outcomes for generations... Although immediate attention has been paid to the short-term outcomes of starvation, there should also be serious concern for the well documented long-term effects, such as intergenerational consequences of starvation and food restriction in children, including inordinately high risks of non-communicable diseases and reduced life expectancy.”