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To: Rt Hon Sir Keir Starmer and Rt Hon Mr David Lammy MP

Dear Prime Minister and Foreign Secretary,

As Director of the ������app of Hygiene & Tropical Medicine (LSHTM) I feel it is my duty to write to you about the public health catastrophe unfolding in Gaza.

As a university dedicated to improving public health, LSHTM researchers study the health of populations around the world, including in conflict zones such as Gaza. Their work has shed new light on this devastating conflict, estimating in January this year that there were 64,260 traumatic injury deaths in Gaza between 7 October 2023 and 30 June 2024 (compared to the 37,877 reported by the Palestinian Ministry of Health). More than half (59%) of these deaths were women, children, and the elderly.

The total death toll due to the war is almost certain to be higher as this analysis does not account for non-trauma related deaths caused by disruption to healthcare, food insecurity, inadequate water and sanitation, and disease outbreaks.

While our community holds a wide range of personal and political views, including relating to this conflict, as public health professionals we’re united in our commitment to basic humanitarian principles. These include protecting civilian lives and the lives of health workers under international law. These are protections that should apply universally and without exception, and yet we have seen civilians targeted, health infrastructure systematically destroyed, and many health workers killed, including Palestinian orthopaedic surgeon Dr Adnan al-Bursh who died in an Israeli prison. These are red lines that should never be crossed.

Since March 2025, humanitarian aid, including food, has been deliberately withheld from the population of Gaza. This blockade, ordered by the Israeli government has, , left three quarters of Gaza’s population at “Emergency” or “Catastrophic” food deprivation levels, on the brink of starvation, and highly vulnerable to outbreaks of infectious disease. As an  from more than 800 UK lawyers stated, “genocide is being perpetrated in Gaza or, at a minimum, there is a serious risk of genocide occurring”.

I am sure you will have been profoundly affected by the suffering in Gaza and have taken diplomatic steps to signal to Israel that its violations of international law are unacceptable. But we have reached a critical moment when action must be taken to prevent an even greater public health disaster. I, along with many of our concerned staff and students, am urging you and the UK Government to go further by:

• Increasing the UK’s diplomatic efforts to secure an immediate, unconditional and permanent ceasefire in Gaza and the release of all hostages;
• Calling on Israel to fulfil its obligations under international law and ensure the urgent, unconditional and unimpeded resumption of aid, at scale, to the population of Gaza;
• Suspending all arms sales to Israel. The legal basis for such a suspension was presented in detail in a previous open letter from UK lawyers (link );
• Committing to playing a major role in supporting efforts to reconstruct the health care and public health infrastructure in Gaza, including the training and education of the health workforce as well as securing the release of health workers from prisons.

I fully recognise and deplore the horrific Hamas attack of 7 October 2023 that killed well over 1,000 people with hundreds more taken hostage. But this does not alter the urgent need to take action to end the devastating public health and humanitarian impact of Israeli military action on the civilian population of Gaza. This is a call to recognise, protect and be guided by common humanitarian values that transcend all divisions and borders. It’s these values that see health professionals go wherever they are needed to save lives, whether it’s in conflict zones or disease outbreaks, in the belief that we all have a duty to do everything we can to protect our shared health.

We cannot change what has already happened in this war, but the humanitarian crisis in Gaza continues to unfold right now as the world watches. Urgent action is needed to end this appalling situation.

We may one day look back at this catastrophe as a pivotal moment, while key elements of the UN-led humanitarian response architecture were impeded and bypassed, and while apparent war crimes occurred in plain sight. This could encourage others around the world to undertake a similar path to pursue their war aims. We need to do what we can to avert such a precedent.

Yours sincerely,

Liam Smeeth