The Al Basma fertility clinic in Gaza City after an Israeli missile strike. December 2023. Credit: Mohammad Ajjour.

By Dawn Clancy
UNITED NATIONS, Mar 12 2025 (IPS)

With enough steel and concrete, the hospitals that have been smashed to bits in Gaza can be rebuilt. But a construction plan paired with an army of bulldozers will not be enough to reconstruct the entirety of Gaza’s health care system, which, after many months of war, has been decimated by the Israeli military forces.

From the full-scale destruction of Gaza’s roads, polluted water systems and sewage infrastructure. To the long-standing networks of doctors, nurses, pharmacists and medical professionals with specialized knowledge who have been killed or left the Strip. The restriction of medications and critical vaccinations destroyed telecommunication and electricity networks, and data systems that monitor health at the community level and manage the medical history of thousands of patients and families across Gaza have all “disappeared,” says Karl Blanchet. He is the director of the Geneva Center of Humanitarian Studies at the University of Geneva in Switzerland. Blanchet told IPS that to rebuild the system, you would need to “start from scratch,” which would be expensive.

A recent needs assessment report published by the World Bank, the European Union and the United Nations estimates that “the total recovery and reconstruction needs [in Gaza] are estimated at USD 53.2 billion.” The report adds that Gaza’s healthcare sector alone—including the reconstruction of hospitals, private and public health facilities, pharmacies, dental practices, and maternity clinics, in addition to the short-term restoration of essential services such as mental health assistance, rehabilitation, nutrition, and non-communicable disease treatments—will cost over USD 1.7 billion.

According to the latest data collected by the UN Office of the Coordination of Humanitarian Affairs (OCHA), 1,060 health workers have been killed in the Strip since October 7, 2023, and only 18 out of 35 hospitals, or 50 percent, are “partially functional.” Additionally, Health Care Workers Watch—an initiative that monitors attacks on healthcare facilities and workers in Palestine—estimates that Israeli forces have unlawfully detained 339 health workers in Gaza, including nurses, pharmacists, administrative staff, technicians, physicians and paramedics.

However, Dr. Mona Jebril, a research associate at the University of Cambridge’s Center for Business Research, told IPS that even before October 7, Gaza’s healthcare sector struggled under the oppressive weight of the Israeli occupation and political jockeying between Hamas, Fatah and the Palestinian Authority. The historical legacies of sanctions imposed on the Strip by the international community after Hamas came to power in 2007, limited funding, the complete siege of Gaza by the Israeli government and the cycle of destruction brought on by repeated wars kept the sector functioning, but barely.

“The health system has always been attacked,” said Jebril. “Maybe sometimes a little damage to a clinic and an ambulance here or there. But after the seventh of October, we noticed a different pattern, where actually the hospital itself has been burned, targeted, and destroyed.”

Similar observations have been outlined in a recent report published by the UN Human Rights Office of the High Commissioner (OHCHR), which concluded that “Israeli Defense Forces (IDF) operations on, within and around hospitals generally followed a pattern with often catastrophic impacts” on the facilities, the people reliant on their services, and those who were sheltering inside. The report found that IDF operations against hospitals started with airstrikes, followed by a complete siege of the facilities by ground troops, followed by raids, the detention of medical staff and patients, followed by forced evacuation and finally, the withdrawal of IDF troops. The report added that the severe damage and destruction left behind effectively rendered the hospitals “non-functional.”

Notably, Annie Sparrow, a practicing clinician in conflict zones and an associate professor at the Icahn School of Medicine at Mount Sinai in New York, who volunteered in Syria during the civil war, credits Russian President Vladimir Putin with “understanding so effectively that people won’t stay where there’s no doctor.”

“Putin created five million refugees in six weeks, which is a world record,” said Sparrow. “He started bombing hospitals and clinics on the first day of the war in Ukraine, and Israel has learned these lessons from Russia and perfected it.” She added, “Attacking hospitals was once exceptional and now for Putin it is military doctrine.”

The mass destruction of Gaza, including the bombing of hospitals and the killing of civilians, technically ceased on January 19, 2025, when Hamas and Israel agreed to a shaky three-phased ceasefire deal that requires ongoing negotiations. Although the first phase of the agreement is currently underway—each phase lasts for 42 days and includes the return of all Israeli hostages—the reconstruction of Gaza won’t begin until the deal’s third phase, when Israeli troops withdraw completely from the Gaza Strip and the war is declared over.

But, given the current political climate, including President Donald Trump’s controversial plan to forcibly and illegally displace Palestinians from Gaza to Egypt and Jordan to build the “Riviera of the Middle East” and Israeli Prime Minister Benjamin Netanyahu’s flat-out rejection of a Palestinian state, Jen Gavito, a non-resident senior fellow at the Atlantic Council—an American think tank based in Washington D.C.—told IPS that she is skeptical the deal will reach phase three.

“With all things related to reconstruction right now, it’s hard to do it with a straight face,” said Gavito. “Having worked on peace negotiations, the statement we always made was that until there is a permanent solution that allows Palestinian self-determination, all of this is moot.”

To counter Trump’s Gaza proposal, Arab leaders met in Riyadh, Saudi Arabia, on Friday, February 21, to hammer out an alternative reconstruction plan that would allow Palestinians to remain in Gaza. Although the details have yet to be released, some reports suggest there was little agreement on who would govern the enclave and fund its reconstruction.

Arab mediators and the United States are currently trying to resolve differences between Hamas and Israel over a January 19 ceasefire agreement after Israel blocked aid to the region.

Regardless of how the final plan for the reconstruction of Gaza’s healthcare system shakes out, Dr. Omar Lattouf, a heart surgeon and one of the founders of the Gaza Health Initiative—a global coalition of healthcare and humanitarian workers organizing to assist in the rebuild of Gaza—told IPS that he is optimistic about the reconstruction of the healthcare sector even if it has to be rebuilt “brick by brick.”

“We don’t know what’s going to happen. It’s impossible to predict, but one thing we know for sure is that there will always be people there: sick people, injured, hungry people, orphans, widows, and people who need help,” said Lattouf.

“As harsh as this is going to sound, irrespective of politics and how many people will be killed—and that’s a painful statement to make—there will be people who are injured and need to be treated,” he said. “There’s no way everybody’s going to vanish.”

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Sigrid Kaag, Senior Humanitarian and Reconstruction Coordinator for Gaza, briefs the Security Council meeting on the situation in the Middle East, including the Palestinian question. Credit: UN Photo

By Dawn Clancy
UNITED NATIONS, Jan 31 2025 (IPS)

Before the three-phased ceasefire deal—proposed by President Joe Biden and dragged over the finish line by the then-incoming Donald Trump administration—silenced the bombs and drones over Gaza and allowed for humanitarian aid to flow into the strip, there was United Nations Security Council Resolution 2720.

Adopted on December 22, 2023, and tabled by the United Arab Emirates, the resolution was created to streamline and accelerate the delivery and distribution of much-needed humanitarian aid to civilians in Gaza. However, critics of the resolution say that a lack of political will and cooperation from the Israeli government and COGAT, the aid coordination arm of Israel’s military—identified by UN bodies and aid organizations on the ground in Gaza as the primary obstruction to aid delivery and distribution—paralyzed the implementation of the resolution’s mandate, unnecessarily prolonging the suffering of Palestinian civilians in the battered and bloodied enclave.

COGAT did not respond to a request for comment.

The resolution also tasked Secretary-General António Guterres to appoint a senior humanitarian and reconstruction coordinator to expedite the mandate and to “establish a UN mechanism for accelerating the provision of humanitarian relief.” For that role, he chose Sigrid Kaag of the Netherlands. She officially started the job on January 8, 2024.

“There are thousands of trucks [with humanitarian aid] trying and failing” to enter Gaza, said Lana Nusseibeh, the UAE’s ambassador to the UN, in her remarks to the Council before the vote in December 2023. “Unless we take drastic action, there will be famine in Gaza.” The situation for Palestinians, she added, is “desperate” and “unbearable.”

In the name of self-defense and security, Israeli Deputy Permanent Representative to the UN, Jonathan Miller, told Council members after resolution 2720 was adopted that Israel “will not change” its approach to the delivery and distribution of aid. In stark contrast to Nusseibeh’s warning of a looming famine in the strip, Miller said, “Hundreds of truckloads of aid enter Gaza every day… the only roadblock for aid entry is the UN’s ability to accept them.”

But Kaag chipped away at Miller’s claim in her first public briefing to the Security Council on April 24, 2024—her first official briefing was a closed session with Security Council members on January 30, 2024—which followed an Israeli airstrike on a World Central Kitchen (WCK) aid convoy in Gaza that killed seven aid workers on April 1.

Notably, before the WCK strike, leadership at the highest levels of the UN recognized the dire humanitarian situation in Gaza. Secretary-General Guterres described the humanitarian situation as “appalling.” And Martin Griffiths, the former UN relief chief, told the Security Council that “providing humanitarian assistance across Gaza is almost impossible.”

Jeremy Konyndyk, the president of Refugees International, in a televised interview, called out Israel for “actively blocking humanitarian groups” from getting into northern and southern Gaza. “What we need to see is the opening of border crossings,” said Konyndyk. “We need to see Israel doing much more to facilitate humanitarian action.”

Meanwhile, the “tragic” and unintentional WCK military strike—as Israeli Prime Minister Benjamin Netanyahu described it in a video statement—drew heaps of condemnation and criticism from the international community, prompting Netanyahu, after a call with Biden, to make commitments to improve Israel’s approach to humanitarian aid in Gaza, which Kaag noted in her remarks on April 24. Some of these steps included an increase in the volume of aid crossing into Gaza, the temporary opening of the Erez crossing and the opening of Ashdod port for humanitarian goods.

“There’s still a lot of work to be done,” Kaag told reporters after the council meeting. She added that her mandate “requires the full cooperation of the Israeli authorities.”

However, three months after the WCK military strike, on July 29, 2024, while briefing reporters at UN headquarters in New York from Amman, Jordan, Kaag, who had just returned from a trip to Gaza, described the situation as “absolutely catastrophic” and the level of destruction as “almost incomprehensible.” When Kaag returned to New York to brief the Council on September 16, her assessment grew darker.

“Effective humanitarian operations require the right quality, quantity and a broad range of goods to meet the daily needs of civilians in Gaza. That goal is not being met.” She added that the breakdown of law and order and looting of supplies “are additional significant impediments to the UN operations in Gaza. “The operating conditions for humanitarian workers include denials, delays, a lack of safety and security and poor logistical infrastructure. This continues to hamper relief operations,” she said.

Contrary to Kaag’s briefing, Danny Danon, Israeli Ambassador to the UN, in his remarks to the council, described Israel’s humanitarian efforts as “unparalleled” for a country that was forced to go to war.

“We have gone above and beyond our obligations, aiming to improve the well-being of a civilian population embedded within the enemy,” he said. Less than a month later, on October 6, 2024, the Israeli military laid siege to north Gaza, complicating Resolution 2720’s mandate by prohibiting aid deliveries, including food and other essential supplies and trapping upwards of 65,000 Palestinians.

“We have been collectively killing ourselves to establish systems, negotiate, to get dual-use items in, to assist children that are deaf, to get their hearing aids… we’ve established the systems, the teams, the mechanism, the database, we’ve organized the suppliers,” Kaag told reporters in New York on December 10, 2024. “But there’s no substitute for political will. You can’t “ask humanitarians to do more.”

On January 17, 2025, the UN’s press office announced the temporary appointment of Kaag as special coordinator for the Middle East peace process. According to the statement, her new role “will be concurrent” with her present mandate as Gaza’s senior humanitarian and reconstruction coordinator.

Notably, as Kaag worked to implement her mandate to increase and streamline aid into the Gaza Strip, the International Court of Justice (ICJ)—the judicial body of the United Nations—ordered Israel on January 26, 2024, to take steps to prevent genocide in Gaza, including taking all measures within its power to provide adequate access to food, water, fuel, shelter and medical supplies to civilians in Gaza. The Integrated Food Security Phase Classification (IPC) issued reports of imminent famine in Gaza. Human Rights Watch (HRW) issued a report that detailed how Israeli authorities have “deliberately obstructed Palestinians’ access to the adequate amount of water required for survival.”

Amnesty International published a report on December 5, 2024, concluding that Israel is committing genocide in Gaza by “failing to facilitate meaningful access within Gaza so others, particularly humanitarian organizations, could deliver essential services and life-saving supplies.” And on November 21, 2024, the International Criminal Court (ICC) issued arrest warrants for Israeli Prime Minister Netanyahu and his former Defense Minister Yoav Gallant for crimes against humanity and the “war crime of starvation as a method of warfare.”

Additionally, a recent ProPublica investigation revealed that two humanitarian agencies within the US government had concluded last spring that “Israel had deliberately blocked deliveries of food and medicine into Gaza.” The investigation claims that former US Secretary of State Antony Blinken rejected the agency’s findings.

Despite multiple attempts by IPS to interview a variety of humanitarian aid organizations on the implementation of resolution 2720 and its impact on the ground in Gaza—including whether Kaag has effectively executed her ongoing mandate and whether Israel played a primarily obstructive role in the process—some, due to the issue’s sensitivity, declined to speak on the record.

A spokesperson for Islamic Relief did, however, provide IPS with an email statement.

“UN resolution 2720 did not deliver on its mandate to get more humanitarian aid to people in Gaza. It should have led to a massive surge in aid, but instead the amount of aid getting into Gaza decreased even further. Israel has continued to use starvation and denial of aid as a weapon of war, violating international law and UN resolutions with complete impunity.”

A series of humanitarian access snapshot reports published by a group of international humanitarian organizations operating in Gaza also provides insight into the challenges aid workers face despite what Security Council Resolution 2020 has tried to accomplish. These include, according to available snapshots, denials and delays in the delivery of food, medical and building supplies, forced displacement of humanitarian staff and multiple incidents of the Israeli military targeting areas close to aid distribution sites.

After 15 months of war, President Biden, alongside the Trump administration, announced a three-phased ceasefire deal between Israel and Hamas, the armed group that attacked Israel on October 7, 2023. The deal’s first phase, which began on January 19, called for a surge in humanitarian aid to Gaza.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) has reported that through “interactions with the Israeli authorities and the guarantors for the ceasefire deal,” 915 aid trucks crossed into the Gaza Strip on Monday, January 20, and 897 entered on Tuesday. OCHA estimates that a daily average of 76 trucks carrying humanitarian aid entered Gaza in December 2024. Currently, the flow of aid into Gaza and other critical supplies continues as the ceasefire appears to be holding. It updates humanitarian aid daily.

Still, the uptick in trucks entering Gaza, notably more than the 600 a day stipulated in the ceasefire agreement, has some wondering why aid has been so severely obstructed for the last 15 months.

“You can make the argument that it was more difficult to deliver supplies during Israel’s military campaign than it is during a ceasefire,” said Mouin Rabbani, a nonresident fellow at the Center for Conflict and Humanitarian Studies. However, he added that the sudden surge in aid “shows that there was a decision, a policy to starve the Gaza Strip.”

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Seedlings from the Seeds of Resilience initiative amid destruction in north Gaza. Credit: Bisan Okasha

By Dawn Clancy
UNITED NATIONS, Oct 29 2024 (IPS)

It was two weeks before October 7—when Hamas attacked Israel—that Prime Minister Benjamin Netanyahu stood behind the rostrum in the United Nations General Assembly hall clutching a crude map of what he called the “new Middle East,” a visual that erased the land of Palestine.

A year later, Israel’s retaliatory war in Gaza has accelerated, including the destruction of Palestine’s agricultural lands, tipping Netanyahu’s vision of a Middle East without Palestine closer to reality.

According to a recent report by the Food and Agricultural Organization of the United Nations (FAO), “as of September 1st, 2024, 67.6 percent of Gaza’s cropland has been damaged,” and much of its agricultural infrastructure, including “greenhouses, agricultural wells and solar panels,” has been destroyed.

“There is no agricultural sector anymore,” said Hani Al Ramlawi, director of operations for the Palestinian Agricultural Development Association (PARC). Ramlawi is from Gaza City but relocated to Egypt six months after the conflict began.

Ramwali told IPS that over the past year, no agricultural supplies have made it into the Strip. Ongoing water and electricity shortages have made fuel, used to power generators and solar panels, too expensive and caused the cost of produce in local markets to soar. In the north of Gaza, Ramlawi said one kilo of potatoes, roughly two pounds, costs $80, a kilo of tomatoes around $90 and one kilo of garlic is $200, and the prices fluctuate daily. Less than 10 percent of farmers have access to their land, and the soil is “diseased” due to ongoing military activities.

Everyone in Gaza is “food insecure,” Ramlawi said. Additionally, the International Labor Organization (ILO), a UN agency, estimates that after a year of war, Gaza’s unemployment rate has skyrocketed to 80 percent.

Seedlings waiting to be distributed to home gardens in displacement camps in north Gaza. Credit: Bisan Okasha

A new Integrated Food Security Phase Classification (IPC) report has found that between Sept. and Oct. 2024, 1.84 million or 90 percent of people across the Gaza Strip are experiencing crisis levels of food insecurity. “The risk of famine persists across the whole Gaza Strip,” the report added. “Given the recent surge in hostilities, there are growing concerns that this worst-case scenario may materialize.”

Starvation in Gaza, in the context of conflict, is not unique—a group of UN experts published a statement on Oct. 17 warning that “97 percent of Sudan’s IDPs” are facing severe levels of hunger due to “starvation tactics” implemented by the warring parties—but what is different about Gaza, said Michael Fakhri, the UN’s special rapporteur on the right to food, is the “speed” and the “intensity” at which starvation has spread across the Strip.

“This is the fastest instance of starvation we’ve ever seen in modern history,” said Fakhri. “How is Israel able to starve 2.3 million people so quickly and so completely? It’s almost like they pushed a button or flipped a switch.”

What is happening in Gaza, according to Fakhri, is not entirely a humanitarian crisis brought on by prolonged armed conflict but rather a byproduct of decades of illegal land grabs, forced displacement, punitive economic policies and the physical destruction of Palestinian croplands—whether by bulldozers or ever-widening military buffer zones—by the Israeli government. Practices that began in the late nineteenth century, when the first wave of European Jews emigrated to Palestine, long before the State of Israel was established in 1948.

“There’s a consistent through line” that predates the horrors of October 7, said Fakhri. “What is happening today is not new,” he added, or limited to the Gaza Strip.

Relatedly, in response to Fakhri’s latest report examining food and starvation in Palestine, Israeli Ambassador to the UN Danny Danon sent a letter of complaint to Secretary-General António Guterres on October 17, calling on him to retract Fakhri’s “disgraceful” and antisemitic report.

Meanwhile in the West Bank, according to Ubai Al-Aboudi, executive director of the Bisan Center for Research and Development—a Palestinian think tank based in Ramallah—the destruction of crop lands and the targeting of farmers, primarily by Israeli settlers, is “systematic.”

“Now is olive season,” Al-Aboudi told IPS. “And we have this tradition; almost all Palestinian families in the West Bank have their olive trees that they go to in the olive picking season.” But with increased settler attacks, villagers now coordinate, Al-Aboudi said, and harvest collectively to protect their lands, their farmers and one another.

According to estimates from the UN Office for the Coordination of Humanitarian Affairs (OCHA), as of Oct. 7, 2023, over 40,000 Palestinians in Gaza have been killed, close to 100,000 injured and 1.9 million have been displaced. (OCHA relies on Gaza’s Ministry of Health for casualty figures.) However, a recent report from The Lancet, a weekly medical journal, suggests that the number of dead in Gaza is likely much higher.

While an official tally of the number of farmers killed in the Strip is not available, members of the Union of Agricultural Work Committees (UAWC), a Palestinian NGO in Gaza, estimate that since Oct. 7, no fewer than 500 farmers out of roughly 30,000 have been killed.

“You know, the farmers and their families are experiencing the same as what we are witnessing for all the population,” said Mahmoud Alsaqqa in a phone interview with IPS. Alsaqqa is Oxfam’s food security and livelihood lead. He is based in Deir Al-Balah.

But, for the remaining farmers, accessing their lands, most of which are located on the eastern edge of the Strip next to the Israeli border, means risking death or sustaining life-altering injuries. “They become an easy target for the military,” said Alsaqqa. And when farmers are killed, their decade’s worth of agricultural knowledge and know-how dies with them.

“There is significant concern about the challenge of rebuilding the knowledge base in Gaza,” UAWC told IPS. “Many universities have been destroyed, and this creates a major fear regarding the re-establishment of academic and agricultural expertise in the region.”

Still, despite ongoing hostilities and sharp decreases in the availability of humanitarian aid, since Oct. 7, Alsaqqa with Oxfam said that more Palestinians are relying on urban or home gardening to feed their families and others in need.

Before the war, Bisan Okasha’s home garden in the Jabalia camp in northern Gaza was bursting with olive, palm and banana trees, citrus fruits, grapes and mint and basil seedlings. However, after Oct. 7, when her home and garden were destroyed and the threat of famine loomed large, Okasha’s father, determined to rebuild, cleared their land of debris and planted 70 eggplant seedlings on a mound of soil that covered the rubbled chunks of their home.

The effort was “successful,” said Okasha in a series of texts with IPS. The experience left her feeling inspired, and soon after, Okasha, despite being displaced three times, created Seeds of Resilience, a collaborative, community-driven initiative designed to revive and establish home gardens in the north by providing and planting seedlings and seeds for free. So far, Okasha and her team—all volunteers—have planted eggplant, cauliflower, chili, and peppers in multiple home gardens.

“My dad’s personal effort to change the reality we were living in is what gave me the belief that I can create change in my entire community and take a real, practical step to prepare the people in Northern Gaza for any future crisis that may threaten their lives,” said Okasha.

“Wars and disasters in this world show no mercy to souls,” she added.

According to the FAO report, out of the five governorates in Gaza, North Gaza, where the Jabalia camp is located, has the highest proportion of damaged cropland at 78 percent. Khan Younis has the largest amount of damaged agricultural infrastructure—animal shelters, home barns, agricultural houses, and cattle farms—while the Gaza governorate has the largest number of damaged wells, reducing access to water. Relatedly, OCHA estimates that over 70,000 housing units have been destroyed across Gaza.

The Israeli mission to the UN, based in New York, declined to comment on the FAO report, and the Israeli Defense Forces (IDF) did not respond.

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A wide view of the General Assembly Hall during the opening of the Summit of the Future. Credit: UN Photo

By Dawn Clancy
UNITED NATIONS, Sep 30 2024 (IPS)

While most world leaders who attended the United Nations inaugural Summit of the Future—a two-day high-level event at UN headquarters in New York meant to address the most pressing global challenges of the 21st century—agree that the world’s aging multilateral system needs modernizing, not all agree on how to get there.

“We will not succeed in overcoming our existential challenges if we are not prepared to change the global governance structures that are rooted in the outcome of World War II and have become unsuited to today’s world,” said Mia Mottley, the prime minister of Barbados, at the summit on September 22. “What the world needs now is a reset.”

For the countries that make up the global South—while not a monolith—the path to reform begins with overhauling the current international financial architecture that has trapped developing countries in an untenable cycle of debt. Still, there is doubt that the blueprint for reform presented in the summit’s non-binding outcome document, the Pact for the Future, goes far enough to rally the political will needed for change.

Despite months of fraught negotiations and a last-minute amendment tabled by Russia that was rejected, the pact was adopted by consensus on the first day of the summit.

“The Pact for the Future designed an excellent building, but it didn’t leave that many instructions for the construction of the building,” said Tim Hirschel-Burns, policy liaison for the Boston University Global Development Policy Center.

With its 56 action items, the pact, a 42-page document, addresses five areas of global concern: sustainable development and financing, international peace and security, digital cooperation, youth and future generations, and global governance. It also includes two separate annexes, a Global Digital Compact and a Declaration on Future Generations.

But while Hirschel-Burns describes the language in the pact as “weak” and “fairly vague,” he told IPS there is still room for some optimism considering that “the pact is signed from leaders [and] heads of states representing the peoples of the world,” and so “you have a really high mandate” for action, he added. Notably, no leaders from the P5 countries—the United States, United Kingdom, France, China and Russia—spoke at the summit.

One promising action item in the pact calls on signees to close the Sustainable Development Goals (SDG) financing gap—estimated at 4.2 trillion annually—in developing countries. Established in 2015, the SDGs act as a blueprint to eliminate a wide range of global challenges, including poverty, hunger and inequality, by 2030.

However, progress on the SDGs has fluctuated for countries drowning in debt and who are without sustainable options for affordable financing. The most recent SDG report estimates that “only 17 percent of the SDG targets are on track,” in some cases, progress has stalled or even regressed.

Still, Hirschel-Burns told IPS, “Even if the Pact for the Future doesn’t have a clear roadmap for addressing unsustainable debt, the bigger outcomes pledged in the pact [including SDG funding] won’t happen unless there is meaningful action on debt relief.”

When accessing financing, global South countries are traditionally met with much higher interest rates than their neighbors in the West. According to the latest UN Conference on Trade and Development (UNCTAD) report, “developing regions—in Asia, Latin America, the Caribbean and Africa—borrow at rates that are 2 to 4 times higher than those of the United States and 6 to 12 times higher than those of Germany.”

This dynamic has led to developing nations racking up USD 365 billion in external debt—money owed to foreign investors, governments and multilateral institutions in 2022.” The report found that 3.3 billion people “live in countries that spend more on interest payments than education or health.” That is nearly 40 percent of the total global population of 8 million.

A separate 2023 report published by Debt Justice, an organization based in London that aims to end unjust debt practices, found that “lower-income country debt payments in 2023 hit their highest level since 1998.” And external debt payments “for 91 countries will average at least 16.3 percent of government revenue in 2023, rising to 16.7 percent in 2024, an increase of over 150 percent since 2011.”

In addition to high interest rates and lack of political will, however, there are additional structural causes for developing countries’ high debt levels, said Iolanda Fresnillo, policy and advocacy manager for the European Network on Debt and Development (EURODAD), such as unfair trade relations, technology dependence on China and the global North, along with the impact of exogenous shocks such as major climate events, pandemics and war.

When countries already drowning in debt do not have the tools to deal with the consequences of a hurricane, an earthquake or a change in oil or other commodity prices, they have to borrow more, Fresnillo told IPS. So, to repay their growing debt, countries cut health and education expenditures and investments in climate adaptation and mitigation, leaving them unprepared for the next major climate event. “We call it the debt and climate vicious cycle,” she said.

Notably, it is the countries of the global North that emit an excess of the emissions that drive climate change, but it is the underdeveloped nations of the global South that suffer consequences that compound the debt cycle.

“The international community [must take] much more ambitious action to address this climate crisis,” said Ralph Gonsalves, prime minister of Saint Vincent and the Grenadines, at the Summit of the Future on Sept. 22. “Otherwise, all of us here—we are going to go to hell in a handbasket. You know it, and I know it.”

Meanwhile, Fresnillo told IPS that before any multilateral system or blueprint for the future can tackle the issue of debt reform, a “common framework” must be established. “So when we say that the debt architecture needs a reform, what we mean is that we need a debt architecture,” as there are no rules when developing countries face a crisis and need to restructure their debt.

“It’s crazy,” Fresnillo said. “When a company goes bankrupt, there are rules that the company has to follow in order to address that bankruptcy,” but that doesn’t exist for countries. “It’s terribly unfair because then who bears the burden is the people in the country.”

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