The head of the World Health Organization (WHO) on Wednesday warned that halting funding to the U.N. Palestinian refugee agency would entail "catastrophic consequences" for people in war-torn Gaza.

"No other entity has the capacity to deliver the scale and breadth of assistance that 2.2 million people in Gaza urgently need," Tedros Adhanom Ghebreyesus told a press conference.

"We appeal for these announcements to be reconsidered," he added, referring to decisions by several countries to pause funding for the U.N. agency following accusations that some agency staff took part in the Oct. 7 attack by Hamas militants.

Israel's bombardment and land offensive launched in the wake of that attack has displaced most of Gaza's population, left many homes and civilian infrastructure in ruins, and caused acute shortages of food, water and medicine.

Most hospitals in Gaza have already ceased functioning due to bombardments and shortages of fuel and supplies. The Nasser Hospital in Khan Younis in central Gaza is only minimally functional and finds itself surrounded by Israeli military, the United Nations has said.

"Decisions by various countries to pause funds for UNRWA, the largest supplier of humanitarian aid in this crisis, will have catastrophic consequences for the people of Gaza," Tedros said.

Tedros said WHO faced "extreme challenges" in delivering medical supplies in the enclave. It did manage, however, to deliver to supplies to the Nasser hospital on Monday, but mission to deliver fuel and food were denied.

"WHO has faced great difficulty even to reach hospitals in southern Gaza," he said. "Heavy fighting has been reported near hospitals in Khan Younis, severely impeding access to health facilities for patients, health workers, and supplies."

Tedros said WHO workers on the ground were reporting increasing food shortages among patients and health workers in the enclave.

"The risk of famine is high and increasing each day, with persistent hostilities and restricted humanitarian access," he said. "Every person our teams talk to asks for food and water."

UN agencies rally around agency for Palestinian refugees in Gaza as some top donors cut funding

Palestinians carry a a body of a person killed in the Israeli bombardment at a building of an UNRWA vocational training center which displaced people use as a shelter in Khan Younis, southern Gaza Strip,

An array of U.N. organizations have united to warn of “catastrophic consequences for the people of Gaza ” if key donor countries don't resume funding for the U.N. agency for Palestinian refugees, the main lifeline for people in the besieged territory.

The United States and more than a dozen other countries have announced plans to suspend contributions to the agency known as UNRWA after Israel alleged that 12 of its thousands of workers participated in the Oct. 7 attacks in Israel that sparked the war in Gaza.

U.N. officials fired most of the workers and vowed an investigation.

The heads of the World Health Organization, World Food Program, UNICEF, International Organization for Migration and other agencies and partners said the allegations were “horrifying.”

“However, we must not prevent an entire organization from delivering on its mandate to serve people in desperate need,” the joint statement said. “No other entity has the capacity to deliver the scale and breadth of assistance that 2.2 million people in Gaza urgently need.”

U.N. officials have warned that UNRWA will have to halt operations by the end of February if funding is not restored.

U.N. Secretary-General Antonio Guterres appealed to 35 donor nations in a closed-door meeting on Tuesday and sought new support as well.

The allegations against UNRWA staffers are among the most scathing yet to dent the image of the sprawling world body and its affiliates after scandals ranging from breakdowns in peacekeeping to sexual abuse in places like Congo.

Linda Thomas-Greenfield, U.S. ambassador to the United Nations in New York, acknowledged Tuesday that UNRWA plays “a critical role in providing life-saving assistance to Palestinians,” but said “we need to see fundamental changes before we can resume providing funding directly” to the organization.

Martin Griffiths, the U.N. humanitarian aid coordinator, insisted Wednesday that UNRWA was “the beating heart” of all humanitarian aid operations in Gaza, and said its work to reach more than three-quarters of Gazans "should not be jeopardized by the alleged actions of a few individuals.”

Speaking to the Security Council, Griffiths said: “UNRWA is playing an indispensable role in terms of distribution, warehousing, logistics, human resources — 3,000 staff responding to the current crisis ... we would like to see decisions to withhold funds from UNRWA revoked.”

Jan Egeland, former head of the U.N. humanitarian agency and secretary-general of the Norwegian Refugee Council, said it was “telling” that U.N. bodies and nongovernmental organizations agree that defunding UNRWA "means a collapse of humanitarian work among Palestinian women and children in their hour of greatest need — when they’re under this relentless, indiscriminate bombardment and when there is so little capacity for humanitarian relief.”

In an interview, Egeland said “UNRWA did everything right” in response to Israel's allegations about the UNRWA employees' involvement in the “

“They fired these people. On these mere allegations, they've initiated an independent investigation of everything surrounding that potential betrayal of all of our ideals by a small group of employees in the organization,” he said.

Donors seek fast answers to allegations over U.N. agency in Gaza crisis

 Any halt to operations by the U.N. Palestinian agency over Israeli accusations that some of its staff took part in the Oct. 7 Hamas attack could hamstring the entire humanitarian effort in devastated Gaza, aid agencies say.

Donors are demanding a swift investigation before resuming funding, though they have praised the work of the U.N. Relief and Works Agency for Palestine Refugees in Gaza and its response so far to the allegations.

UNRWA believes it has responded rapidly and transparently to Israel's allegations, which came as Israel faced a genocide case at the International Court of Justice over the Gaza war, and after years of it calling for the agency to be disbanded.

Israel's offensive in the Palestinian enclave has caused the world's most acute humanitarian crisis, with 85% of Gaza's 2.3 million inhabitants homeless, large numbers starving and others falling sick.

UNRWA is at the heart of all aid work in Gaza through its 13,000 employees in the enclave, its clinics and schools, many now acting as packed shelters, and its logistics hubs.

"The entire aid system in Gaza will be closer to the point of collapse," said Shaina Low, a spokesperson for the Norwegian Refugee Council, calling UNRWA "vital in coordinating aid and providing shelter".

"No other organisation than UNRWA has the infrastructure to do the work that they do," said the U.N. spokesperson Stephane Dujarric.

Some 15 of the agency's most important donors, including top two the United States and Germany, have suspended funding over Israel's allegations.

About $440 million is at risk, said UNRWA spokesperson Juliette Touma.

"The decision to suspend funding from these countries is tantamount to a death sentence for Palestinians," the charity Action Aid said.

The agency and the wider U.N. now face a race to persuade donors they have responded appropriately to Israel's accusations before money runs out at the end of February.

PROACTIVE

It is not clear how long the investigation by the U.N.'s oversight office may take. It was important for it to be thorough and "unimpeachable", but also swift, U.N. spokesperson Dujarric said.

Israeli government spokesperson Eylon Levy accused UNRWA of acting "as a front for Hamas" and said it was "not bad apples" that were the problem but a systemic failure to address accusations of support for extremism in its ranks.

Responding to those comments, Touma said UNRWA had on Jan. 17 ordered an independent review to establish the truth of longstanding claims about UNRWA and its staff.

Inside the organisation, the accusation that 12 staff members took part in the Hamas attack that killed 1,200 people in Israel had come as a deep shock.

"If these allegations are true, they are a betrayal of U.N. values and a betrayal of the people we serve," Touma said.

The organisation believes it has acted quickly despite Israel only making direct accusations to it about 12 staff while allegations were leaked to media that a larger number of employees have Hamas links.

"UNRWA took a very proactive approach," said Touma the UNRWA spokesperson. Its head Philippe Lazzarini went to the U.N. Secretary General Antonio Guterres and to the U.S. and other top donors after Israel verbally told him on Jan. 18 it had evidence against 12 UNRWA staff, she said.

Lazzarini fired those allegedly involved, an unusual step he is allowed to take "in the best interests of the agency", Touma said.

"UNRWA then went public with the information before anyone else," she added.

Neither Israel nor any other official source has shared with UNRWA a dossier alleging that 190 of the agency's staff members in Gaza are Hamas or Islamic Jihad militants, but learned about it only when reported in the press, Touma said. Reuters viewed and reported on the Israel intelligence dossier on Monday.

UNRWA regularly shares lists of its employees with Israel and with the governments of countries hosting Palestinian refugees. It last did so in May 2023, Touma said. Israel has never provided a response to those lists "let alone an objection", she said.

A spokesperson for Israel's government did not respond to Reuters questions on what information they had shared with UNRWA and the UN and major donors or about how long it had known about Hamas links to UNRWA employees.

LONG-TERM ROLE

Israel has long criticised UNRWA and says its mandate should be given to other U.N. agencies. Its 30,000 staff provide schooling and primary health clinics for Palestinian refugees in several Middle East countries.

The first ever U.N. agency, UNRWA was established by a resolution of the body's General Assembly in 1949 to look after refugees who fled or were pushed from their homes when Israel was created.

Israel has long criticised the curriculum taught in schools UNRWA runs and disputes the agency's count of refugees - an important political issue in any eventual peace talks, with Palestinians demanding a right of return.

"Israel would like there to be an existential threat to UNRWA because they mistakenly think if you get rid of UNRWA then you suddenly get rid of the refugees and their right to return," said former UNRWA spokesperson Chris Gunness.

"Palestinians have been told across U.N. facilities that they are still refugees from a war that took place decades ago, that they possess a right that does not exist," said the Israeli spokesperson Levy.

However, UNRWA's mandate was renewed by the U.N. General Assembly in 2023 until mid 2026 and the agency could only be disbanded by a new General Assembly resolution.

UN chief says UNRWA is 'backbone' of Gaza aid response

United Nations Secretary-General Antonio Guterres speaks in Kampala, Uganda

U.N. Secretary-General Antonio Guterres on Wednesday described the U.N. Palestinian refugee agency (UNRWA) as "the backbone of all humanitarian response in Gaza" and appealed to all countries to "guarantee the continuity of UNRWA's lifesaving work."

The United States is the biggest donor to the U.N. Relief and Works Agency for Palestine Refugees in the Near East and has temporarily paused its funding - along with several other countries - after Israel accused some agency staff of taking part in the Oct. 7 attack by Hamas militants.

"I was personally horrified by these accusations," Guterres told the U.N. Committee on the Exercise of the Inalienable Rights of the Palestinian People. "Yesterday, I met with donors to listen to their concerns and to outline the steps we are taking to address them."

The accusations became public on Friday when UNRWA announced it had fired some staff after Israel provided the agency with information. Guterres said on Sunday that of 12 people implicated nine were fired, one is dead, and the identity of the remaining two was being clarified.

An Israeli intelligence dossier, seen by Reuters on Monday, includes accusations that some UNRWA staff took part in abductions and killings during the Oct. 7 raid that sparked the Gaza war and alleges some 190 UNRWA employees have doubled as Hamas or Islamic Jihad militants.

The Palestinians have accused Israel of falsifying information to tarnish UNRWA. UNRWA employs 13,000 people in Gaza, running schools, its primary healthcare clinics and other social services, and distributing humanitarian aid.

"The humanitarian system in Gaza is collapsing," Guterres said. "I am extremely concerned by the inhumane conditions faced by Gaza's 2.2 million people, as they struggle to survive without any of the basics."

UN warning that aid system could collapse if UNRWA funding is withheld

Medicine is distributed at a UNRWA health centre in Deir Al-Balah, Gaza, earlier this month.

Top UN officials have warned that the withdrawal of funding for its main aid agency in Gaza could lead to the "collapse of the humanitarian system".

They spoke out after the US, UK and other countries halted funding over the alleged role of some UN staff in the 7 October Hamas attacks on Israel.

The UN sacked several of its staff over the allegations.

It said an investigation into its agency for Palestinian refugees, UNRWA, is underway.

Israeli Prime Minister Benjamin Netanyahu has described UNRWA as "perforated with Hamas", saying Israel has "discovered that there were 13 UNRWA workers who actually participated, either directly or indirectly, in the 7 October massacre".

But the US, the biggest donor to the UNWRA, has said it wants to see the aid agency continue its work.

"There is no other humanitarian player in Gaza who can provide food and water and medicine at the scale that UNRWA does," US State Department Spokesman Matthew Miller said.

"We want to see that work continued which is why it is so important that the United Nations take this matter seriously, that they investigate, that there is accountability for anyone who is found to have engaged in wrongdoing."

In the attack on 7 October, Hamas gunmen killed about 1,300 people and took about 250 hostages.

Israel launched an offensive against Hamas in response and more than 26,700 people have been killed in Gaza since then, according to the territory's Hamas-run health ministry.

More than half of Gaza's buildings have been damaged or destroyed during the offensive, new analysis seen by the BBC has revealed.

UN Secretary General António Guterres has said a full independent investigation into UNRWA is under way,

A UNRWA spokesperson has said that if funding is not resumed, the agency will not be able to continue its operations beyond the end of February.

"The allegations of involvement of several UNRWA staff in the heinous attacks on Israel on 7 October are horrifying," a statement by the UN Inter-Agency Standing Committee says.

"As the secretary-general has said, any UN employee involved in acts of terror will be held accountable. However, we must not prevent an entire organisation from delivering on its mandate to serve people in desperate need.

"Withdrawing funds from UNRWA is perilous and would result in the collapse of the humanitarian system in Gaza, with far-reaching humanitarian and human rights consequences in the occupied Palestinian territory and across the region," it adds. "The world cannot abandon the people of Gaza."

Also on Tuesday, the UN's humanitarian coordinator for Gaza said no other organisation can replace UNRWA due to the the agency's "knowledge" of the population in Gaza.

Other countries which have halted funding include Germany, Sweden an Japan.

Mr Guterres met representatives of more than 30 donor states on Tuesday and is reported to have urged those who have withdrawn funding to reconsider.