The Health Sector Governance and Finance for Early Recovery and Transition Future Workshop at the “Uniting Knowledge, Resource, and Solidarity: Gaza Health Initiative Conference Amsterdam,” hosted by KIT Institute’s Centre for Health Systems in Fragile and Conflict Affected Settings (FCAS), addressed the challenges and opportunities in moving Gaza’s health sector from crisis management to long-term sustainability, and the urgent need for a ceasefire in Gaza.

Speakers from international organisations such as the WHO and the World Bank, alongside the Palestinian Ministry of Health, shared insights with the Institute’ FCAS experts Eelco Jacobs and Mahdi Abdelwahab on integrating governance reform and sustainable financial solutions in a post-conflict setting.

Challenges in Governance and Finance

Dr Ibrahim Bou-Orm of Queen Margaret University discussed the hurdles that fragile and conflict-affected settings like Gaza face in health sector recovery.  “The environment is very fragile,” he affirmed. “In addition to instability… there is the risk of backsliding into violence.” Bou-Orm highlighted weakened state institutions, fragmented service delivery, and unclear leadership as some of the core issues, citing examples from Afghanistan and Cambodia to illustrate how financial fragmentation strains post-conflict healthcare systems. 

Dr Ahmed Shatat, Acting Director of International Cooperation at the Palestinian Ministry of Health, explained that before the war, Gaza’s health system had functional operational plans, a health information system, and effective health indicators such as high vaccination rates. The ongoing conflict has caused an extreme humanitarian crisis, including the destruction of health infrastructure and limited access to essential services. Additionally, the separation between North and South Gaza hampers coordination of health supplies, further fragmenting the recovery response.

Key Solutions: Inclusive Governance and Financial Mechanisms

The session offered strategies to address the complex governance and financing issues in Gaza. Dr Bou-Orm emphasised the importance of adhering to the WHO’s health financing framework, which promotes diversified revenue-raising mechanisms and minimises financial fragmentation. Examples from Afghanistan and Cambodia show the effectiveness of pooling domestic, humanitarian, and donor funds through coordinated mechanisms.

A major theme was the need for inclusive governance. One speaker stressed the importance of collaborating through a unified platform such as the Health Cluster to coordinate efforts among international organisations and local partners. They noted that competition between humanitarian actors often slows progress. A collaborative framework led by the Ministry of Health is crucial to ensure resources are used efficiently, preventing duplication of services. “What we need to mitigate any fragmentation and effectively and efficiently use the minimum resources provided is to have a unified platform.”

Working with the grain of existing health structures and capacities also emerged as a key recommendation. Local structures and health actors are vital to the recovery process and supporting them to make contextually appropriate decisions can address Gaza’s unique needs. Systems for monitoring and evaluation already exist in Gaza, and the challenge lies in strengthening these structures and aligning them with international support.

Financing Early Recovery and Transition

The topic of financing dominated the discussion, with speakers proposing solutions tailored to Gaza’s reality. Dr Ali Ardalan of WHO Regional Office for the Eastern Mediterranean stressed the need to bridge the humanitarian-development nexus in post-conflict settings. He argued that while humanitarian needs will persist after a ceasefire, financing must also support long-term recovery goals.

Dr Ramin Ziwary of the World Bank outlined methods for conducting rapid needs assessments to estimate the cost of damage to Gaza’s health infrastructure. He noted that while infrastructure can be evaluated with tools like satellite data, assessing human resources and long-term injuries is more challenging. Collaborations with local institutions such as the Arab Association of Engineers are already underway to assess infrastructure needs.

One approach to improve access to healthcare in the humanitarian and early recovery phase could be the use of cash and voucher assistance programmes, which have reduced financial barriers to healthcare access in other post-conflict settings. Dr Ardalan highlighted that integrating these programmes into Gaza’s national health strategy and collaborating with international donors will be critical for mobilising the necessary resources.

Lessons from Polio Campaigns

A key speaker shared a success story from Gaza’s recent polio vaccination campaign, through which more than estimated 87% of targeted children were vaccinated in a short period. This achievement was made possible by effective coordination between UNRWA, local health authorities and humanitarian health partners, showing the capacity for swift and organised responses even in challenging conditions when organisations work together. “It is clear, since the start of the war, that we cannot work alone,” said this UNRWA staff member. 

Capacity, Collaboration, and Coordination

The session concluded with a long-term vision for rebuilding Gaza’s health sector, rooted in strategic partnerships, inclusive governance, and sustainable financing mechanisms. Dr Shatat outlined the Ministry of Health’s 2025-2038 master plan for integrated healthcare services. The plan calls for comprehensive assessments to guide recovery, ensuring that interventions are prioritised and resources used efficiently.

The session called for a unified platform to steer recovery efforts, led by local governance bodies and supported by international stakeholders. This approach is essential for ensuring international support and would enhance its contextual relevance and sustainability, ultimately building the resilience of Gaza’s health system.