Humanitarian Vaccination in War: An Exploration of Médecins Sans Frontières’ Role in Gaza’s Poliomyelitis Epidemic

Abstract

Médecins Sans Frontières (MSF) is an independent and impartial humanitarian organisation that delivers healthcare in areas of crisis, providing medical assistance regardless of race, gender, political stance, or religion. Since 2024, MSF has implemented polio vaccination campaigns in the Gaza Strip to increase population immunity against circulating vaccine-derived poliovirus type 2 (cVDPV2), which has re-emerged amid ongoing violent conflict. This paper examines the public health impact, logistical considerations, and operational challenges associated with these vaccination campaigns. 

This paper highlights three primary operational challenges of vaccine delivery in crisis settings: ensuring the safety of patients and healthcare workers, maintaining the cold chain, and managing limited resources. We also examine key mitigation strategies, including continuous threat surveillance, coordination among humanitarian services, and community engagement, all of which have been shown to improve the effectiveness of vaccination efforts in conflict-affected regions.

Although ongoing turmoil has limited the accuracy of vaccination coverage data, an estimated 603,000 children have been immunised in the Gaza Strip since the onset of hostilities (1). Given polio’s re-emergence approximately 25 years after its initial eradication, sustained vaccination efforts are critical to protecting population health in Palestine (2). 

Effective vaccine delivery in conflict-affected settings requires a flexible logistical framework combined with sensitivity to patient and community factors. Despite significant operational barriers, MSF’s polio vaccination campaign in Gaza demonstrates the feasibility of large-scale immunisation in humanitarian emergencies. Insights from this campaign may help inform future vaccination strategies in conflict and disaster settings.