The Israeli Medical Association (IMA) has sent a letter to Prime Minister Benjamin Netanyahu warning of significant damage to the healthcare system in the West Bank caused by Israel’s withholding of customs revenues from the Palestinian Authority. The letter, issued last week, urged the government to reconsider the policy in order to alleviate what it described as an escalating humanitarian and public health crisis.

According to IMA president Prof. Zion Hagay, the Palestinian Health Ministry has struggled for several years to pay full salaries to government medical employees and has accumulated large debts to private hospitals and pharmaceutical suppliers. This financial strain has led public clinics and hospitals in the West Bank to reduce operating hours and scale back services. Hagay cited reports indicating that all elective and semi-urgent medical procedures have been suspended for over a year, resulting in some patients suffering complications and others dying while awaiting treatment.

Hagay also expressed concern about the future of the West Bank’s medical workforce, noting a decline in the number of physicians as many potential trainees are unable to begin or continue their medical education. The shortage of medicines is critical, with most supplies already depleted and remaining stocks close to exhaustion. He warned that the collapse of the Palestinian health system poses risks beyond humanitarian distress, potentially contributing to the spread of disease and regional instability.

While the IMA highlighted these problems, it clarified that it was not taking a stance on the political rationale behind the government’s decision to withhold funds. In his letter, Hagay called on Netanyahu to find a way to transfer the funds ensuring they are used solely for the Palestinian health sector.

Separately, international controversy has surrounded the IMA’s role amid ongoing violence in Gaza. A recent report from the medical journal The Lancet detailed a petition signed by over 1,150 health professionals and organizations, including the Dutch Doctors for Gaza and the Jewish Voice for Peace Health Advisory Council, calling for an international boycott of the IMA and its suspension from the World Medical Association (WMA). The petition accuses the IMA of failing to speak out against what it terms the "genocide of Palestinians in Gaza" and the destruction of medical infrastructure.

Critics like Leslie London, emeritus professor of public health at the University of Cape Town and a member of the People’s Health Movement—which spearheaded the petition—assert that the IMA has been complicit in the mistreatment of Palestinians, citing the association’s alleged refusal to acknowledge evidence of targeted attacks on healthcare facilities and workers in Gaza.

The IMA has denied these allegations, describing them as false or highly contested and argued that such calls to expel the association conflate the actions of a government with those of a medical professional organization. The IMA also highlighted Hamas’s use of medical facilities for military purposes as a factor in the conflict’s impact on healthcare infrastructure.

The World Medical Association responded by affirming its opposition to the exclusion of members based on their governments' policies and noted the IMA’s involvement in joint statements on Gaza, emphasizing its engagement and shared concerns within the medical community.

Within Israel, the NGO Physicians for Human Rights-Israel welcomed the IMA’s appeal to Netanyahu but criticized its limited focus on healthcare, arguing that Israel’s withholding of Palestinian Authority funds also harms broader social determinants of health such as infrastructure, welfare, food security, and education.

Hagay indicated that his letter to Netanyahu was sent before he became aware of the international petition and The Lancet report, suggesting the timing was coincidental. The situation underscores the complex challenges facing healthcare provision in the West Bank amid ongoing political and humanitarian tensions.