The ethical and practical challenges of rebuilding Gaza’s health system

As public health practitioners with experience of working in conflict zones, including in the Gaza Strip, we felt compelled to write this Commentary. The relative silence of the international public health community regarding the ongoing mayhem and genocide by Israel in Gaza has been deafening. In stark contrast, medics from Gaza and the region have responded massively both with pleas for an end to the genocide and also by showing us how they are coping with bare essentials in a largely destroyed health system, at the epicentre of the conflict illustrating their deep commitment to preserving life in the midst of a genocide. The voice of the medical community in the global North must rise and change so that a North-South divide on the value of human life does not evolve into a 21st century norm. This major ethical challenge is not just for Gaza but for the global public health community. We explore the ethical imperatives and immense challenges of rebuilding Gaza's health system postconflict. Since the submission of this paper in May 2025, a ceasefire was called for in Gaza (October 10, 2025), but relentless destruction continues with impunity. Subsequently, the number of deaths, injured and displaced people have increased substantially, but this data could not be included in this commentary. However, the major challenges of rebuilding Gaza's health system will remain at the forefront of any efforts for reconstruction.