What to Know about How Much the Aid from a US Pier Project Will Help Gaza 

Members of the US Army, US Navy and the Israeli military put in place the Trident Pier, a temporary pier to deliver humanitarian aid, on the Gaza coast, amid the ongoing conflict between Israel and the Palestinian group Hamas, May 16, 2024. (US Central Command/Handout via Reuters)
Members of the US Army, US Navy and the Israeli military put in place the Trident Pier, a temporary pier to deliver humanitarian aid, on the Gaza coast, amid the ongoing conflict between Israel and the Palestinian group Hamas, May 16, 2024. (US Central Command/Handout via Reuters)
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What to Know about How Much the Aid from a US Pier Project Will Help Gaza 

Members of the US Army, US Navy and the Israeli military put in place the Trident Pier, a temporary pier to deliver humanitarian aid, on the Gaza coast, amid the ongoing conflict between Israel and the Palestinian group Hamas, May 16, 2024. (US Central Command/Handout via Reuters)
Members of the US Army, US Navy and the Israeli military put in place the Trident Pier, a temporary pier to deliver humanitarian aid, on the Gaza coast, amid the ongoing conflict between Israel and the Palestinian group Hamas, May 16, 2024. (US Central Command/Handout via Reuters)

A US-built pier is in place to bring humanitarian aid to Gaza by sea, but no one will know if the new route will work until a steady stream of deliveries begins reaching starving Palestinians.

The trucks that will roll off the pier project installed Thursday will face intensified fighting, Hamas threats to target any foreign forces and uncertainty about whether the Israeli military will ensure that aid convoys have access and safety from attack by Israeli forces.

Even if the sea route performs as hoped, US, UN and aid officials caution, it will bring in a fraction of the aid that's needed to the embattled enclave.

Here's a look at what's ahead for aid arriving by sea:

WILL THE SEA ROUTE END THE CRISIS IN GAZA? No, not even if everything with the sea route works perfectly, American and international officials say.

US military officials hope to start with about 90 truckloads of aid a day through the sea route, growing quickly to about 150 trucks a day.

Samantha Power, head of the US Agency for International Development, and other aid officials have consistently said Gaza needs deliveries of more than 500 truckloads a day — the prewar average — to help a population struggling without adequate food or clean water during seven months of war between Israel and Hamas.

Israel has hindered deliveries of food, fuel and other supplies through land crossings since Hamas’ deadly attack on Israel launched the conflict in October. The restrictions on border crossings and fighting have brought on a growing humanitarian catastrophe for civilians.

International experts say all 2.3 million of Gaza's people are experiencing acute levels of food insecurity, 1.1 million of them at “catastrophic” levels. Power and UN World Food Program Director Cindy McCain say north Gaza is in famine.

At that stage, saving the lives of children and others most affected requires steady treatment in clinical settings, making a cease-fire critical, USAID officials say.

At full operation, international officials have said, aid from the sea route is expected to reach a half-million people. That's just over one-fifth of the population.

WHAT ARE THE CHALLENGES FOR THE SEA ROUTE NOW? The US plan is for the UN to take charge of the aid once it's brought in. The UN World Food Program will then turn it over to aid groups for delivery.

UN officials have expressed concern about preserving their neutrality despite the involvement in the sea route by the Israeli military — one of the combatants in the conflict — and say they are negotiating that.

There are still questions on how aid groups will safely operate in Gaza to distribute food to those who need it most, said Sonali Korde, assistant to the administrator for USAID's Bureau for Humanitarian Assistance, which is helping with logistics.

US and international organizations including the US government's USAID and the Oxfam, Save the Children and International Rescue Committee nonprofits say Israeli officials haven't meaningfully improved protections of aid workers since the military's April 1 attack that killed seven aid workers with the World Central Kitchen organization.

Talks with the Israeli military “need to get to a place where humanitarian aid workers feel safe and secure and able to operate safely. And I don’t think we’re there yet," Korde told reporters Thursday.

Meanwhile, fighting is surging in Gaza. It isn’t threatening the new shoreline aid distribution area, Pentagon officials say, but they have made it clear that security conditions could prompt a shutdown of the maritime route, even just temporarily.

A ship is seen off the coast of Gaza near a US-built floating pier that will be used to facilitate aid deliveries, as seen from the central Gaza Strip, Thursday, May 16, 2024. (AP)

The US and Israel have developed a security plan for humanitarian groups coming to a “marshaling yard” next to the pier to pick up the aid, said US Vice Admiral Brad Cooper, deputy commander of the US military’s Central Command. USAID Response Director Dan Dieckhaus said aid groups would follow their own security procedures in distributing the supplies.

Meanwhile, Israeli forces have moved into the border crossing in the southern city of Rafah as part of their offensive, preventing aid from moving through, including fuel.

UN deputy spokesman Farhan Haq said that without fuel, delivery of all aid in Gaza can't happen.

WHAT'S NEEDED? US President Joe Biden's administration, the UN and aid groups have pressed Israel to allow more aid through land crossings, saying that's the only way to ease the suffering of Gaza's civilians. They've also urged Israel's military to actively coordinate with aid groups to stop Israeli attacks on humanitarian workers.

“Getting aid to people in need into and across Gaza cannot and should not depend on a floating dock far from where needs are most acute,” UN deputy spokesman Farhan Haq told reporters Thursday.

“To stave off the horrors of famine, we must use the fastest and most obvious route to reach the people of Gaza — and for that, we need access by land now,” Haq said.

US officials agree that the pier is only a partial solution at best, and say they are pressing Israel for more.

WHAT DOES ISRAEL SAY? Israel says it places no limits on the entry of humanitarian aid and blames the UN for delays in distributing goods entering Gaza. The UN says ongoing fighting, Israeli fire and chaotic security conditions have hindered delivery.

Under pressure from the US, Israel has in recent weeks opened a pair of crossings to deliver aid into hard-hit northern Gaza. It said a series of Hamas attacks on the main crossing, Kerem Shalom, have disrupted the flow of goods.



Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
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Experts: Baby in Gaza Has Strain of Polio Linked to Mistakes in Eradication Campaign

The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed
The mother of Palestinian boy Abdul Rahman Abu Al-Jidyan, who is the first person to contract polio in Gaza in 25 years, gestures as she looks after him in their tent, in Deir Al-Balah, in the central Gaza Strip August 28, 2024. REUTERS/Ramadan Abed

The baby in Gaza who was recently paralyzed by polio was infected with a mutated strain of the virus that vaccinated people shed in their waste, according to scientists who say the case is the result of “an unqualified failure” of public health policy.
The infection, which marked the first detection of polio in the war-torn Palestinian territory in more than 25 years, paralyzed the lower part of one leg in the unvaccinated 10-month-old child. The baby boy was one of hundreds of thousands of children who missed vaccinations because of the fighting between Israel and Hamas.
Scientists who have been monitoring polio outbreaks said the baby's illness showed the failures of a global effort by the World Health Organization and its partners to fix serious problems in their otherwise largely successful eradication campaign, which has nearly wiped out the highly infectious disease. Separately, a draft report by experts deemed the WHO effort a failure and “a severe setback.”
The polio strain in question evolved from a weakened virus that was originally part of an oral vaccine credited with preventing millions of children worldwide from being paralyzed. But that virus was removed from the vaccine in 2016 in hopes of preventing vaccine-derived outbreaks.
Public health authorities knew that decision would leave people unprotected against that particular strain, but they thought they had a plan to ward off and quickly contain any outbreaks. Instead, the move resulted in a surge of thousands of cases, The Associated Press reported.
“It was a really horrible strategy,” said Columbia University virologist Vincent Racaniello, who was not involved with the report or the WHO. “The decision to switch vaccines was based on an incorrect assumption, and the result is now we have more polio and more paralyzed children.”
A draft copy of the report commissioned by the WHO and independent experts said the plan underestimated the amount of the strain in the environment and overestimated how well officials would be able to squash outbreaks.
The plan led to vaccine-linked polio outbreaks in 43 countries that paralyzed more than 3,300 children, the report concluded.
Even before the Gaza case was detected, officials reviewing the initiative to tinker with the vaccine concluded that “the worst-case scenario has materialized,” the report said.
The report has not yet been published, and some changes will likely be made before the final version is released next month, the WHO said.
The strain that infected the baby in Gaza had lingered in the environment and mutated into a version capable of starting outbreaks. It was traced to polio viruses spreading last year in Egypt, according to genetic sequencing, the WHO said.
In 2022, vaccine-linked polio viruses were found to be spreading in Britain, Israel and the US, where an unvaccinated man was paralyzed in upstate New York.
Scientists now worry that the emergence of polio in a war zone with an under-immunized population could fuel further spread.
Racaniello said the failure to track polio carefully and to sufficiently protect children against the strain removed from the vaccine has had devastating consequences.
“Only about 1% of polio cases are symptomatic, so 99% of infections are silently spreading the disease,” he said.
The oral polio vaccine, which contains a weakened live virus, was withdrawn in the US in 2000. Doctors continued to vaccinate children and eventually moved to an injected vaccine, which uses a dead virus and does not come with the risk that polio will be present in human waste. Such waste-borne virus could mutate into a form that triggers outbreaks in unvaccinated people.
The report's authors faulted leaders at the WHO and its partners, saying they were unable or unwilling “to recognize the seriousness of the evolving problem and take corrective action.”
WHO spokesman Oliver Rosenbauer acknowledged that the vaccine strategy “exacerbated” the risk of epidemics linked to the vaccine.
He said in an email that immunization “was not implemented in such a way to rapidly stop outbreaks or to prevent new strains from emerging.” Rosenbauer said not hitting vaccination targets was the biggest risk for allowing vaccine-linked viruses to emerge.
“You need to reach the children with the vaccines ... regardless of which vaccines are used,” he said.
The WHO estimates that 95% of the population needs to be immunized against polio to stop outbreaks. The UN health agency said only about 90% of Gaza’s population was vaccinated earlier this year.
To try to stop polio in Gaza and the wider region, the WHO and its partners plan two rounds of vaccination campaigns later this week and next month, aiming to cover 640,000 children. Authorities will use a newer version of the oral polio vaccine that targets the problematic strain. The weakened live virus in the new vaccine is less likely to cause vaccine-derived outbreaks, but they are still possible.
Racaniello said it was “unethical” that the WHO and its partners were using a vaccine that is unlicensed in rich countries precisely because it can increase the risk of polio in unvaccinated children.
The oral polio vaccine, which has reduced infections globally by more than 99%, is easy to make and distribute. Children require just two drops per dose that can be administered by volunteers. The oral vaccine is better at stopping transmission than the injected version, and it is cheaper and easier to administer.
But as the number of polio cases caused by the wild virus have plummeted in recent years, health officials have been struggling to contain the increasing spread of vaccine-linked cases, which now comprise the majority of polio infections in more than a dozen countries, in addition to Afghanistan and Pakistan, where transmission of the wild virus has never been stopped.
“This is the result of the Faustian bargain we made when we decided to use" the oral polio vaccine, said Dr. Paul Offit, director of the Vaccine Education Center at the University of Philadelphia. “If we really want to eradicate polio, then we need to stop using the vaccine with live (weakened) virus.”