World Living Beyond Its Means: Warns UN’s Global Water Bankruptcy Report

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Water & Sanitation

Collecting water in Ethiopia. A new report, ‘Global Water Bankruptcy: Living Beyond Our Hydrological Means in the Post Crisis Era’ warns that many of the earth’s water resources have been pushed to a point of permanent failure. Credit: EU/ECHO/Anouk Delafortrie/IPS

Collecting water in Ethiopia. A new report, ‘Global Water Bankruptcy: Living Beyond Our Hydrological Means in the Post Crisis Era’ warns that many of the earth’s water resources have been pushed to a point of permanent failure. Credit: EU/ECHO/Anouk Delafortrie/IPS

UNITED NATIONS & SRINAGAR, India, Jan 20 2026 (IPS) – The world has entered what United Nations researchers now describe as an era of Global Water Bankruptcy, a condition where humanity has irreversibly overspent the planet’s water resources, leaving ecosystems, economies, and communities unable to recover to previous levels.


The new report, released by the United Nations University Institute for Water, Environment and Health, titled Global Water Bankruptcy: Living Beyond Our Hydrological Means in the Post-Crisis Era. The report argues that decades of overextraction, pollution, land degradation, and climate stress have pushed large parts of the global water system into a permanent state of failure.

“The world has entered the era of Global Water Bankruptcy,” the report reads, adding that “in many regions, human water systems are already in a post-crisis state of failure.”

According to the report, the language of “water crisis” is no longer sufficient to explain what is happening. A crisis implies a shock followed by recovery. Water bankruptcy, by contrast, describes a condition where recovery is no longer realistically possible because natural water capital has been permanently damaged.

In an exclusive interview with Inter Press Service, former Deputy Head of Iran’s Department of Environment  Prof. Kaveh Madani, who currently is the Director at United Nations University, Institute for Water, Environment and Health, said that declaring that the planet has entered the era of water bankruptcy must not be interpreted as universal water bankruptcy, as not all basins, aquifers, and systems are water bankrupt.

 Prof. Kaveh Madani, Director at the United Nations University, Institute for Water, Environment and Health, addresses the UN midday press briefing. Credit: IPS

Prof. Kaveh Madani, Director at the United Nations University, Institute for Water, Environment and Health, addresses the UN midday press briefing. Credit: IPS

“But we now have enough critical basins and aquifers in chronic decline and showing clear signs of irreversibility that the global risk landscape is already being reshaped. Scientifically, we know recovery is no longer realistic in many systems when we see persistent overshoot (using more than renewable supply) combined with clear markers of irreversibility—for example aquifer compaction and land subsidence that permanently reduce storage, wetland and lake loss, salinization and pollution that shrink usable water, and glacier retreat that removes a long-term seasonal buffer. When these signals persist over time, the old “bounce back” assumption stops being credible,” Madani said.

According to the report, over decades, societies have drawn down the renewable flow of rivers and rainfall besides long-term reserves stored in aquifers, glaciers, wetlands, and soils. At the same time, pollution and salinization have reduced the share of water that is safe or economically usable.

“Over decades, societies have withdrawn more water than climate and hydrology can reliably provide, drawing down not only the annual income of renewable flows but also the savings stored in aquifers, glaciers, soils, wetlands, and river ecosystems,” the report says.

The scale of the problem, as per the report, is global. Nearly three-quarters of the world’s population now lives in countries classified as water insecure or critically water insecure.

Around 2.2 billion people still lack safely managed drinking water, while 3.5 billion lack safely managed sanitation. About 4 billion people, as per the report findings, experience severe water scarcity for at least one month every year.

Madani said, adding that water bankruptcy is best assessed basin by basin and aquifer by aquifer, not by country.

“Please note that, based on the water security definition used by the UN system, water insecurity and water bankruptcy are not equivalent. Water bankruptcy can drive water insecurity, but water insecurity can also stem from limited financial and institutional capacity to build and operate infrastructure for safe water supply and sanitation, even where physical water is available,” he explained.

Madani added that the regions most consistently closest to irreversible decline cluster in the Middle East and North Africa, Central and South Asia, parts of northern China, the Mediterranean and southern Europe, the southwestern United States and northern Mexico (including the Colorado River system), parts of southern Africa, and parts of Australia.

The Aral Sea, which lies between Kazakhstan and Uzbekistan shows dramatic water loss between 1989 and 2025. Credit: UNU-INWEH

The Aral Sea, which lies between Kazakhstan and Uzbekistan, shows dramatic water loss between 1989 and 2025. Credit: UNU-INWEH

Surface Water Systems Are Shrinking Rapidly

The report shows how more than half of the world’s large lakes have lost water since the early 1990s, affecting nearly one quarter of the global population that depends directly on them. Many major rivers now fail to reach the sea for parts of the year or fall below environmental flow needs.

Massive losses have occurred in wetlands, which serve as natural buffers against floods and droughts. Over the past five decades, the report claims that the world has lost roughly 410 million hectares of natural wetlands, almost the size of the European Union. The economic value of lost ecosystem services from these wetlands exceeds 5.1 trillion US dollars.

Groundwater depletion is one of the clearest signs of water bankruptcy. Groundwater, says the report, now supplies about 50 percent of global domestic water use and over 40 percent of irrigation water. Yet around 70 percent of the world’s major aquifers show long-term declining trends.

“Excessive groundwater extraction has already contributed to significant land subsidence over more than 6 million square kilometers,” the report says, warning that in some locations land is sinking by up to 25 centimeters per year, permanently reducing storage capacity and increasing flood risk.

In coastal areas, overpumping has allowed seawater to intrude into aquifers, rendering groundwater unusable for generations. In inland agricultural regions, falling water tables have triggered sinkholes, soil collapse, and the loss of fertile land.

These satellite images show a dramatic impact of the Aru glacier collapses in western Tibet. First image was taken in 2017 and the second in 2025. Credit: UNU-INWEH

These satellite images show a dramatic impact of the Aru glacier collapses in western Tibet. First image was taken in 2017 and the second in 2025. Credit: UNU-INWEH

The cryosphere, glaciers and snowpacks that act as natural water storage systems are also being rapidly liquidated. The world has already lost more than 30 percent of its glacier mass since 1970. Several low- and mid-latitude mountain ranges could lose functional glaciers within decades.

“The liquidation of this frozen savings account interacts with groundwater depletion and surface water over-allocation to lock many basins into a permanent worsening water deficit state,” says the report.

This loss, as per the report, threatens the long-term water security of hundreds of millions of people who depend on glacier- and snowmelt-fed rivers for drinking water, irrigation, and hydropower, particularly in Asia and the Andes.

Madani said the biggest failure was treating groundwater as an unlimited safety net instead of a strategic reserve.

He says that when surface water tightened, many systems defaulted to “drill deeper” without enforceable caps.

“Authorities often recognize the consequences when it is already late, and meaningful action then faces major political barriers. For example, reducing groundwater use in farming can trigger unemployment, food insecurity, and even instability unless farmers are supported through short-term compensation and a longer-term transition to alternative livelihoods,” he added.

According to Madani, that kind of transition cannot be implemented overnight.

“So, business as usual continues. The result is predictable: groundwater gets “liquidated” to postpone hard choices, and by the time the damage is obvious, recovery is no longer realistic,” he told IPS news.

Agriculture Lies at the Heart of the Crisis

According to the report, farming accounts for approximately 70 percent of global freshwater withdrawals. About 3 billion people and more than half of the world’s food production are located in regions where total water storage is already declining or unstable.

The report states that more than 170 million hectares of irrigated cropland are under high or very high water stress. Land and soil degradation are making matters worse by reducing the ability of soils to retain moisture. The degradation of more than half of the global agricultural land is now moderate or severe.

Drought, once considered a natural hazard, is increasingly driven by human activity. Overallocation, groundwater depletion, deforestation, land degradation, and climate change have turned drought into a chronic condition in many regions.

“Drought-related damages, intensified by land degradation, groundwater depletion and climate change rather than rainfall deficits alone, already amount to about 307 billion US dollars per year worldwide,” the report states.

Water quality degradation further shrinks the usable resource base. Pollution from untreated wastewater, agricultural runoff, industrial effluents, and salinization means that even where water volumes appear stable, much of that water is unsafe or too costly to treat.

The report adds that the planetary freshwater boundary has already been crossed. Both blue water, surface and groundwater, and green water, soil moisture, have been pushed beyond a safe operating space.

Current governance systems, the authors argue, are not fit for this reality. Many legal water rights and development promises far exceed degraded hydrological capacity. Existing global agendas, focused largely on drinking water access, sanitation, and incremental efficiency gains, are inadequate for managing irreversible loss.

“Water bankruptcy must be recognized as a distinct post-crisis state, where accumulated damage and overshoot have undermined the system’s capacity to recover,” the report says.

Water bankruptcy could result in an increase in conflicts. Credit: UNU-INWEH

Water bankruptcy could result in a further increase in conflicts. Credit: UNU-INWEH

It warns that the implications of water bankruptcy are dire.

UN Under-Secretary-General Tshilidzi Marwala, Rector of UNU explains,  “Water bankruptcy is becoming a driver of fragility, displacement, and conflict. Managing it fairly—ensuring that vulnerable communities are protected and that unavoidable losses are shared equitably—is now central to maintaining peace, stability, and social cohesion.”

Policy Implications

Instead of crisis management aimed at restoring the past, the report actually pitches for bankruptcy management. That means acknowledging insolvency, accepting irreversibility, and restructuring water use, rights, and institutions to prevent further damage.

The authors lay stress on the fact that water bankruptcy is also a justice and security issue. The costs of overshoot fall disproportionately on small farmers, rural communities, women, Indigenous peoples, and downstream users, while benefits have often accrued to more powerful actors.

“How societies manage water bankruptcy will shape social cohesion, political stability, and peace,” the report warns.

Furthermore, it urges governments and international institutions to use upcoming UN Water Conferences in 2026 and 2028 as milestones to reset the global water agenda, calling for water to be treated as an upstream sector central to climate action, biodiversity protection, food security, and peace.

“This is about a crisis that might arrive in the future. The world is already living beyond its hydrological means,” reads the report.

When asked why the report frames water bankruptcy as a justice and security issue and how governments can implement painful demand reductions without triggering social unrest or conflict, Madani said the demand reduction becomes dangerous when it is treated as a technical exercise instead of a political economy reform. In many water-bankrupt regions, according to him, water is effectively a jobs policy: it keeps low-productivity farming and local economies afloat.

“If you cut water without an economic transition, you create unemployment, food insecurity, and unrest. So the practical pathway is to decouple livelihoods and growth from water consumption. In many economies, water and other natural resources are used to keep low-efficiency systems alive. In most places, it is possible to produce more strategic food with less water and less land, and with fewer farmers—provided that farmers are supported through a transition and offered alternative livelihoods.”

According to Madani, governments should protect basic needs but target the big reductions where most water is used, especially agriculture and besides that, pair caps with a just transition package for farmers—compensation, insurance, buy-down or retirement of water entitlements where relevant, and real income alternatives.

He further suggests that the governments should invest in diversification, including services, industry, value-added agri-processing, and urban jobs, so communities can earn a living without expanding water withdrawals.

“In short, you avoid conflict by making demand reduction part of a broader economic transition, not a standalone water policy.”

IPS UN Bureau Report

 

Global Survey Finds Citizens back a World Parliament as Trust in International System Erodes

Civil Society, Democracy, Global, Global Governance, Headlines, Human Rights, International Justice, IPS UN: Inside the Glasshouse, TerraViva United Nations

Opinion

A global survey across 101 countries finds global majority support for a citizen-elected world parliament to handle global issues, reflecting widespread concern over an outdated and undemocratic international order. Credit: Democracy Without Borders

BERLIN, Germany, Jan 20 2026 (IPS) – As democracy faces pressure around the world and confidence in international law drops, a new global survey reveals that citizens in a vast majority of countries support the idea of creating a citizen-elected world parliament to deal with global issues.


The survey, commissioned by Democracy Without Borders and conducted across 101 countries representing 90% of the world’s population, finds that 40% of respondents support the proposal, while only 27% are opposed. It is the largest poll ever carried out thus far on this subject.

Support is strongest in countries of the Global South, especially Sub-Saharan Africa, and among groups often underrepresented in national political systems—young people, ethnic minorities, and those with lower income or education levels. In 85 out of 101 countries surveyed, more respondents support the idea than oppose it.

“The message is clear: people around the world are ready to expand democratic representation to the global scale,” said Andreas Bummel, Executive Director of Democracy Without Borders. “This survey shows there is a growing global constituency that wants a voice in decisions affecting humanity as a whole,” he added.

The findings come at a time when the international system is under increasing strain from climate change, war, geopolitical conflicts, authoritarian resurgence, and stalled global cooperation. The results suggest that many citizens—especially in less powerful countries—see a world parliament as a pathway to fairer and more effective global governance.

In countries with limited political freedoms, support for a world parliament is particularly high. According to Democracy Without Borders, this points to a public perception that global democratic institutions could help advance democracy at home as well.

A notable 33% of respondents globally selected a neutral stance, suggesting unfamiliarity with the concept. An analysis of the survey results argues that this indicates a wide-open space for public engagement. If the idea gains visibility, support could grow substantially, it says.

“The international system created in the last century to prevent war and mass violence is built on the United Nations. But many UN member states do not represent their people. They represent oppressive authoritarian elites who have seized power.

The proposed vision of a citizen-elected world parliament could be a vital step in the discussion about building a more democratic global order,” said Oleksandra Matviichuk, head of the Centre for Civil Liberties in Ukraine awarded with the Nobel Peace Prize.

According to the survey, net opposition found in individual countries is most concentrated in high-income democracies. “This is not a rejection of democracy. It is a reminder that privilege may breed complacency, and that those who benefit from existing arrangements may underestimate how urgently they need renewal,” commented George Papandreou, Greek Member of Parliament and former Prime Minister.

Democracy Without Borders, an international civil society organization, advocates for the establishment of a United Nations Parliamentary Assembly as a step toward a democratic world parliament. The organization says the survey results reinforce the urgency for democratic governments to consider this long-standing proposal.

IPS UN Bureau

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Children and Armed Conflict Must be at the Forefront of the Global Agenda

Armed Conflicts, Civil Society, Global, Global Governance, Headlines, Human Rights, International Justice, IPS UN: Inside the Glasshouse, TerraViva United Nations

Opinion

TOKYO, Japan, Jan 19 2026 (IPS) – Thirty years ago, the groundbreaking report by Graça Machel, renowned and widely respected global advocate for women’s and children’s rights, to the United Nations General Assembly laid bare the devastating impact of armed conflict on children and shook the conscience of the world. It led to the historic decision of the General Assembly to create the mandate of the Special Representative of the Secretary-General for Children and Armed Conflict (SRSG-CAAC).


Special Representatives of the Secretary-General are high-level envoys entrusted with carrying out specific responsibilities on behalf of the Secretary-General. Appointed at the rank of Under-Secretary-General, the SRSG-CAAC has since served as the global advocate for raising the awareness about the condition of children affected by armed conflict as well as their comprehensive protection and reintegration in the society.

Children and armed conflict as a peace and security agenda

The children and armed conflict (CAAC) agenda has evolved significantly over the past three decades. As appropriately affirmed in Security Council resolution 1261 (1999), the impact of armed conflict on children constitutes a matter affecting international peace and security. Subsequent resolutions firmly anchored the CAAC agenda within the work of the Security Council and established critical protection mechanisms.

Among the most significant of these is the Monitoring and Reporting Mechanism (MRM), created by Security Council resolution 1612 (2005). The MRM provides verified, credible, and timely information on grave violations committed against children in situations of armed conflict. It has become the backbone of the United Nations’ engagement with parties to conflict to halt such violations.

Credit: UN News

Through this mechanism, parties to conflict are encouraged to commit to ending and preventing grave violations through the development and implementation of time-bound action plans. To date, forty action plans have been concluded with parties to conflict, including non-State armed groups, in eighteen countries, resulting in full compliance by twelve parties.

UNICEF has played a pivotal role on the ground as the United Nations’ lead agency for children, supporting the operation of the MRM and monitoring the implementation of action plans.

Children and armed conflict as a fundamental child rights issue

Beyond peace and security, children and armed conflict is fundamentally a child rights issue. It was the first thematic area addressed as early as 1992 by the United Nations Committee on the Rights of the Child, the treaty body monitoring implementation of the Convention on the Rights of the Child adopted by the United Nations General Assembly in 1989.

That initiative paved the way for the Graça Machel report and the subsequent establishment of the SRSG-CAAC mandate in 1996. It also led to the adoption, in 2000, of the Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict.

In March of this year, the Human Rights Council will dedicate its annual day on the rights of the child to children and armed conflict and is expected to adopt a related resolution, underscoring the continued relevance of this agenda.

Thirty years after the inception of the CAAC mandate

Despite these advances, grave violations against children in armed conflict reached an unprecedented 41,370 cases in 2024 alone. Calls for accountability have understandably grown louder.

The impact of armed conflict on children extends far beyond the six grave violations identified by the Security Council. Today, one in five children worldwide lives in a conflict-affected area, where the full spectrum of their rights is compromised, directly or indirectly.

This stark reality demands renewed urgency, enhanced political will, and more focused action.

Toward child rights-based and child-centred accountability

Children who are victims of armed conflict have too often been excluded from accountability processes.

Some positive developments deserve recognition. In 2023, the Office of the Prosecutor of the International Criminal Court adopted a revised Policy on Children that explicitly embraces a child rights approach. In the same year, the Secretary-General’s Guidance Note on Child Rights Mainstreaming called for the systematic integration of child rights into the mandates of United Nations investigative and accountability mechanisms, including commissions of inquiry and fact-finding missions.

Accountability must be both child rights-based and child-centred. Meaningful child participation is essential. Listening to children and taking their views seriously is fundamental to justice, remedies, and healing. Accountability processes must address children’s immediate and long-term needs, including education, psychosocial support, and family reunification.

Children as peacebuilders

Children want peace. Sustainable peace is the indispensable foundation for the full realization of child rights.

The Convention on the Rights of the Child guarantees the right of children to be heard and to have their views respected in all matters affecting them. Children also have the right to reintegration and to participate in efforts aimed at restoring social cohesion within fractured and traumatized communities.

In many conflict-affected societies, children constitute more than half of the population. Their role as peacebuilders is therefore not optional—it is essential. Recognizing and empowering children as agents of peace will also reinforce both the women, peace and security agenda and the youth, peace and security agenda.

Time for renewed mobilization, in partnership with civil society and children

Graça Machel reminded us that “universal concern for children presents new opportunities to confront the problems that cause their suffering.”

Children and armed conflict goes to the very core of our shared humanity. It demands broader public awareness, stronger political commitment, and sustained global mobilization.

Civil society organizations, working alongside children themselves, have a crucial role to play in advocacy, awareness-raising, and mobilizing support for the CAAC agenda.

The Special Representative of the Secretary-General for Children and Armed Conflict, created by the General Assembly, carries a unique responsibility as the Secretary-General’s envoy to strengthen cooperation and partnerships among United Nations entities, Member States, civil society, and children themselves.

Children and armed conflict must remain at the forefront of the global agenda and be treated as a central priority by the Secretary-General of the United Nations.

Dr. Mikiko Otani, widely recognized as an international human rights lawyer, is currently the President of the Child Rights Connect, a Geneva-based global NGO network promoting child rights. She was the Chair of the United Nations Committee on the Rights of the Child (2021-2023) during her eight-year membership for two terms.

IPS UN Bureau

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Davos: Meaningful Dialogue Requires a Collective Stand Against Military, Economic and Diplomatic Bullying

Civil Society, Development & Aid, Featured, Global, Headlines, Sustainable Development Goals, TerraViva United Nations

Opinion

Agnès Callamard is Amnesty International’s Secretary General

Davos: Meaningful Dialogue Requires a Collective Stand Against Military, Economic and Diplomatic Bullying

Credit: World Economic Forum/Gabriel Lado. Source: Amnesty International

LONDON, Jan 16 2026 (IPS) – “The ‘spirit of dialogue’, the theme for this year’s meeting in Davos, which begins January 19, has been painfully and increasingly absent from international affairs of late. President Trump’s first year back in office has seen the United States withdraw from multilateral bodies, bully other states and relentlessly attack the principles and institutions that underpin the international justice system.


At the same time, the likes of Russia and Israel have continued to make a mockery of the Geneva and Genocide Conventions without facing meaningful accountability.

“A few powerful states are unashamedly working to demolish the rules-based order and reshape the world along self-serving lines. Unilateral interventions and corporate interests are taking precedence over long-term strategic partnerships grounded in universal values and collective solutions.

This was evident in the Trump administration’s military action in Venezuela and its stated intent to ‘run’ the country, which the president himself admitted was at least partially driven by the interests of US oil corporations. Make no mistake: the only certain consequence of vandalizing international law and multilateral institutions will be extensive suffering and destruction the world over.

“When faced with diplomatic, economic and military bullying and attacks, many states and corporations have opted for appeasement instead of taking a principled and united stand. Humanity needs world leaders, business executives and civil society to collectively resist or even disrupt these destructive trends. It requires denouncing the bullying and the attacks, and strong legal, economic, and diplomatic responses.

What should not happen is silence, complicity and inaction. It also demands engaging in a transformative quest for common solutions to the many shared and existential problems we face.

“We need UN Security Council reform to address abuse of veto powers, robust regulation to protect us against harmful new technologies; more inclusive and transparent decision-making on climate solutions; and international treaties on tax and debt to deliver a more equitable, rights-based global economy. But this will only be achievable through cooperation and steadfast will to resist those who seek to strongarm and divide us.”

-Israel’s ongoing genocide against the Palestinians in Gaza

-The USA’s military action in Venezuela, Russia’s war of aggression against Ukraine, and the conflicts in Sudan, DRC and Myanmar

-The importance of revindicating and revitalizing multilateralism

-The need for global tax and debt reform and universal social protection

-The urgent need for a full, fast, fair and funded fossil fuel phase-out

-The need to massively scale up climate finance, including to address loss and damage

-Big Tech, corporate accountability and the risks of deregulation

-How to limit the harmful impact of artificial intelligence on human rights, including the right to a healthy environment

IPS UN Bureau

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The Iranian Military Is the Only Institution Capable of Catalyzing the Downfall of the Regime

Armed Conflicts, Civil Society, Featured, Global Governance, Headlines, Human Rights, International Justice, IPS UN: Inside the Glasshouse, Middle East & North Africa, TerraViva United Nations

The Iranian Military Is the Only Institution Capable of Catalyzing the Downfall of the Regime

UN Secretary-General Antonio Guterres, “shocked by reports of violence and excessive use of force by Iranian authorities against protesters”, is urging restraint and immediate restoration of communications, as unrest enters its third week. 11 January 2026. Credit: United Nations

NEW YORK, Jan 15 2026 (IPS) – Unlike ever before, Iran’s Islamic regime is facing a revolt led by a generation that has lost its fear. Young and old, men and women, students and workers, are flooding the streets across the country.


Iran’s future may well hinge on whether its military chooses to act and save the country, driven by economic collapse, corruption, and decades of repression. Women and girls are at the forefront, protesting without headscarves, defying the clergy that once controlled every aspect of their lives. They don’t want reform; they are demanding freedom, economic relief, and the end of authoritarianism.

Shutting down the internet, arresting nearly 17,000 protesters, killing at least 3,000, including children, and Trump’s threat to use force to stop the Iranian regime have not prevented the mullahs from continuing their onslaught. The regime’s ruthless crackdown has been a calamitous wave of repression, taking thousands of lives in a brutal attempt to crush dissent. Yet even in the face of such peril, the public remains undeterred, determined to continue their fight.

Now, however, they need the support of the most powerful domestic—not foreign—power to come to their aid. The Iranian military is the most pivotal institution in the country, capable of catalyzing the downfall of the regime. The military is the key player, with significant internal influence and the capability to drive the necessary change from within, ultimately leading to regime change.

Every officer in the military should stop and think, how do I want to serve my country.

Do I want to continue to prop up a bunch of reactionaries, self-obsessed old men who have long since lost their relevance, wearing the false robe of piety to appear sanctimonious while subjugating the people to hardship and hopelessness?

Should I not support the younger generation who are yearning for a better life, for opportunity, for a future that gives meaning to their existence?

Should I not participate in sparking the revival of this magnificent nation from the doldrums of the past 47 years that have consumed it from within?

Should I continue to prepare for war against Israel, or extend a peaceful hand and invest in building my country with such immense natural and human riches and be in the forefront of all other modern democratic and progressive nations, and restore the glory of ancient Persia?

Do I truly want to continue to wear blinders and let my country be destroyed from within, or should I become part of a newly reborn nation and take personal pride in helping to revive it?

The answer to these questions should be clear to every officer. The military should establish a transitional government and pave the way for a legitimate, freely elected government, and restore the Iranian people’s dignity and their right to be free.

The idea that the Shah’s son, Reza Pahlavi, could return and restore a monarchy is just the opposite of what the Iranian people need. Instead of another form of corruption or an old kingdom, they deserve a democracy and genuine freedom.

In the final analysis, Iran’s destiny may rest on a single profound choice—whether its military steps forward to reshape the nation’s destiny.

Dr. Alon Ben-Meir is a retired professor of international relations, most recently at the Center for Global Affairs at NYU. He taught courses on international negotiation and Middle Eastern studies.

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Gaza: Physicians Call For Unimpeded Aid To Restore Reproductive Healthcare

Aid, Armed Conflicts, Civil Society, Development & Aid, Editors’ Choice, Featured, Gender, Headlines, Health, Human Rights, Humanitarian Emergencies, Middle East & North Africa, Population, Sustainable Development Goals, TerraViva United Nations, Women’s Health

Armed Conflicts

Cardiologist Dr. Marwan Sultan, then Director of the Indonesian Hospital in north Gaza, in February 2025 showing damage to hospital equipment following an Israeli attack on the facility a few months prior. In July 2025, Dr. Sultan was killed in an Israeli strike on the apartment where he was sheltering with his family. Credit: PHR/GHRC

Cardiologist Dr. Marwan Sultan, then Director of the Indonesian Hospital in north Gaza, in February 2025 showing damage to hospital equipment following an Israeli attack on the facility a few months prior. In July 2025, Dr. Sultan was killed in an Israeli strike on the apartment where he was sheltering with his family. Credit: PHR/GHRC

BRATISLAVA, Jan 14 2026 (IPS) – Israel must lift all restrictions on medicine, food and aid coming into Gaza, rights groups have demanded, as two reports released today (Jan 14) document how maternal and reproductive healthcare have been all but destroyed in the country.


In two separate reports released jointly, Physicians for Human Rights (with the Global Human Rights Clinic at the University of Chicago Law School) and Physicians for Human Rights–Israel (PHR-I) show how the war in Gaza has led to rising maternal and neonatal mortality, births under dangerous conditions, and the systematic destruction of health services for women in Gaza.

The reports from the two groups, which are independent organizations, provide both detailed clinical analysis of the collapse of Gaza’s health system and its medical consequences as well as firsthand testimonies from clinicians and pregnant and breastfeeding women in Gaza forced to live and care for their newborns in extreme conditions.

And the organizations say that with conditions improving only marginally for many women despite the current ceasefire, Israel must roll back restrictions placed on aid and immediately help ensure people in Gaza get access to the healthcare they need.

Israel’s destruction of Gaza’s health infrastructure, combined with untreated malnutrition resulting from restrictions on food and medical supplies, including baby formula, has created an environment in which the fundamental biological processes of reproduction and survival have been systematically destroyed, resulting in known and foreseeable harm, pain, suffering, and death,” Sam Zarifi, Physicians for Human Rights (PHR) Executive Director, said.

“Israel must immediately allow food and essential medical material to enter Gaza with a proper medical plan for helping the besieged population,” he added.

Israeli military operations following Hamas’s attack on Israel on October 7, 2023, have left massive destruction across Gaza, including to healthcare facilities. According to UNICEF, 94 percent of hospitals have been damaged or destroyed.

1.Destroyed incubators and equipment at the Kamal Adwan Hospital Neonatal Intensive Care Unit in north Gaza, following the targeting and raid of the facility by the Israeli forces in December 2024. Credit: PHR/GHRC

Destroyed incubators and equipment at the Kamal Adwan Hospital Neonatal Intensive Care Unit in north Gaza, following the targeting and raid of the facility by the Israeli forces in December 2024. Credit: PHR/GHRC

Maternal and reproductive healthcare has suffered. Before the war, Gaza had eight neonatal intensive care units with 178 incubators. Today, the number of incubators has dropped by 70 percent. In the north, there were 105 incubators across three NICUs, now there are barely any functional units remaining, UNICEF told IPS.

It says that the numbers of low birth weight babies have nearly tripled compared to pre-war levels and the number of first-day deaths of babies increased by 75 percent.

The PHR and PHR-I reports paint a similar picture.

The PHR report, which focuses on the period between January 2025 and October 2025 when a ceasefire was agreed, details how between May and June last year, the Palestinian Ministry of Health reported a 41 percent decrease in the birth rate in Gaza compared to the same time period in 2022; there was a significant increase in miscarriages that affected more than 2,600 women, and 220 pregnancy-related deaths that occurred before delivery.

The ministry also reported a sharp increase in premature births and low birth weight cases; over 1,460 babies were reported to be born prematurely, while more than 2,500 were admitted to neonatal intensive care. Newborn deaths also increased, with at least 21 babies reported to have died on their first day of life.

Meanwhile, the PHR-I report includes personal testimonies illustrating the severe problems pregnant women and women with newborns have faced in Gaza during the war, from lacking safe routes to care and being forced to give birth in unsanitary, dangerous conditions to battling hunger and severe food shortages as they try to breastfeed their children.

One woman, Samah Muhammad Abu Mustafa, a 30-year-old mother of two from Khuza’a, Khan Youni, described how when her contractions began in the middle of the night, because there were no vehicles and very few ambulances, which are reserved for shelling or other critical emergencies, she had to walk a long distance through rain. When she eventually reached the hospital, she said it was “horrifying.”

“I swear, one woman gave birth in the corridor, and her baby died. It was very crowded, and the doctors worked nonstop. I felt as though I could give birth at any moment. After giving birth to my eldest daughter, I was told I should not deliver naturally again because my pelvis was too narrow. Despite this, the doctors said I would have to deliver naturally because a cesarean section required anesthesia, and there was not enough available. I stood for three hours until it was finally my turn, without sitting even for a moment,” she said.

But despite the October 2025 ceasefire, massive problems remain with women’s access to and the provision of, maternal and reproductive healthcare in Gaza.

“Maternal health units in Gaza are largely non-functional and face critical shortages of essential medicines, consumables, and equipment,” Lama Bakri, project coordinator in the Occupied Territories Department at PHR-I, told IPS.

“Neonatal and diagnostic equipment remains scarce or blocked, including portable incubators for premature and low-birth-weight newborns. Although some aid has entered since the ceasefire, these gaps are not being addressed at the scale required, and meaningful improvement in the immediate future remains unlikely.”

Malnutrition also remains a serious problem.

“The ceasefire has allowed us to significantly scale up our nutrition response, but we are still treating pregnant and breastfeeding women for acute malnutrition in alarmingly high numbers,” Ricardo Pires, Communication Manager, Division of Global Communications & Advocacy at UNICEF, told IPS.

He said that between July and September 2025 about 38 percent of pregnant women screened were diagnosed with acute malnutrition.

“In October alone, we admitted 8,300 pregnant and breastfeeding women for treatment, about 270 a day, in a place where there was no discernible malnutrition among this group before October 2023,” he added.

UNICEF has documented almost 6,800 children admitted for acute malnutrition treatment in November 2025 compared to 4,700 cases in November 2024. So far, the number of admitted cases more than doubled in 2025 compared to 2024: almost 89,000 admissions of children to date in 2025, compared to 40,000 cases in 2024, and almost none before 2023.

“What we’re seeing is that no child meets minimum dietary diversity standards, and two-thirds of children are surviving on just two food groups or less. Around 90 percent of caregivers reported their children had been sick in the previous two weeks, which compounds the malnutrition crisis,” Pires said.

And there are fears for the longer-term demographic future of Gaza given the damage to maternal and reproductive healthcare.

“For Gaza’s demographic future, the implications are serious. Even with reconstruction, we will be dealing with a generation of children who were scarred before they took their first breath, children who may face lifelong health complications, developmental challenges, and the effects of stunting. The rebuilding must start now, but we should be clear-eyed: the damage to maternal and newborn health will echo for years, potentially decades,” said Pires.

But others say that with cooperation between international actors and the right political will, the situation need not remain so dire.

“To rehabilitate the population after everything that has happened is going to be a real issue, [but] now there is a Board of Peace, the needs of pregnant women and maternal and reproductive healthcare can be prioritized,” Zarifi told IPS.

“The capacity and the will exist among Gazans and Gazan healthcare workers to rebuild the healthcare system, including maternal and reproductive health services,” added Bakri. “The primary obstacle is not technical or professional but political: Israel’s control over Gaza’s borders and the restrictions on the entry of essential equipment, medical supplies, and reconstruction materials. With unrestricted access to what is needed to rehabilitate hospitals, rebuild destroyed units, and restock essential medicines, recovery is entirely feasible. Whether maternal and reproductive healthcare can return to pre-war levels depends on sustained international pressure to allow that access.”

Although some aid has entered since the ceasefire, these gaps are not being addressed at the scale required, and meaningful improvement in the immediate future remains unlikely.

However, while both NGOs like PHR and PHR-I and others, alongside international bodies like the UN, stress that any recovery and reconstruction in Gaza requires the ceasefire to hold and consolidate, repeated violations underline its fragility, and the effect that has on women.

Meanwhile, PHR and PHR-I point out that extreme weather and ongoing Israeli restrictions on medicine and food getting to Gaza to this day continue to severely affect pregnant women, new mothers, and babies. On top of this, Israel has also announced it will bar 37 international aid groups from working in Gaza, potentially compounding the problems.

Bakri said such measures were jeopardizing what small gains had been made since the ceasefire and “raise serious concerns about whether the situation can improve.”

“Even after the ceasefire, while bombardment has decreased, the reality these women face remains catastrophic – not only for their bodies and well-being but for the survival of the entire society,” said Bakri.

Zarifi added, “We are worried that the restrictions placed by Israel on some of the major actors in the humanitarian response will hamper access to assistance for those that need it. We have raised questions with the Israeli government as to why specific medicines are not allowed to be brought into Gaza and they say that they are not stopping them from being brought in but they can be brought in by commercial means. That is hard for people who can barely put any money together. These medicines should definitely be coming in through humanitarian channels.”

He also highlighted how important the issue of accountability is in ensuring any progress is made in rebuilding healthcare in Gaza and also limiting the probability of similar devastation in the future.

Both reports concluded that the harms caused by Israeli attacks are not isolated incidents but part of an ongoing pattern of systematic damage to the health of women and their children in Gaza, amounting to reproductive violence.

Israel has denied this and said that attacks on hospitals in Gaza have been because the medical facilities are being used by Hamas, and it has maintained that its forces adhere to international law.

While under international law healthcare facilities have special protection even in war, and attacks on them are prohibited, that protection is lost if they are deemed to fulfill criteria to be considered military objectives, such as housing militaries and arms.

However, any attack on them must still comply with the fundamental principles of distinction, proportionality and precautions in attack and failure to respect any of these principles constitutes a breach of international humanitarian law, according to the UN.

“These attacks are part of a deliberate policy designed to create a domino effect of suffering. From starvation and militarized aid distribution by the GHF, to lack of access to clean water, repeated displacement orders, living in shelters under continuous bombardment, and exposure to infections, disease, and harsh weather, the attacks on maternal and reproductive healthcare are another piece of this puzzle. Together, these conditions were created to systematically destroy the fabric of life in Gaza and reduce the population’s ability to survive,” said Bakri.

“The Israeli government has justified attacks on healthcare facilities by saying this was a problem caused by Hamas. We haven’t had an indication of this but it might be true. But in any case there has to be an investigation of these incidents and we hope the Israeli government will carry out such an investigation,” said Zarifi.

“But what is really alarming to us is that the norms prohibiting attacks on healthcare have been repeatedly violated, and there are also laws governing the protection of women and children that appear to have been violated. The only thing that makes these norms work is accountability. There has to be accountability for what happened, as it is the only way we can ensure that what has happened won’t happen in other conflicts. Impunity is watched by other actors around the world,” he added.

IPS UN Bureau Report

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