Why is the New England Journal of Medicine promoting 'health bridges' while Gaza's hospitals burn?
On 27 March 2025, the New England Journal of Medicine (NEJM) - one of the world's most influential medical journals - published an article headlined "Health Care Bridges - Pathways toward Trust in Gaza and Beyond".
It was only the second article in the journal to mention Gaza since Israel escalated its genocide against the Palestinian people in October 2023.
That this is NEJM's leading contribution on Palestine is telling.
There has been no report on the systematic targeting of the Palestinian healthcare system, no call for accountability or justice for the more than 1,200 medical workers killed, and no condemnation of the incarceration and torture of hundreds more. Instead, the journal offers a narrow appeal to build trust through joint health programmes.
This editorial decision is deeply political. It promotes a depoliticised narrative of health as a "bridge to peace" at the expense of an ethical commitment to confront the ongoing destruction of the Palestinian healthcare system, Israel's culpability for these crimes, and the structures of power that enable and sustain such violence.
New MEE newsletter: Jerusalem Dispatch
Sign up to get the latest insights and analysis on Israel-Palestine, alongside Turkey Unpacked and other MEE newsletters
These are not background conditions; they are the central obstruction to any serious effort towards peace.
False equivalence
The article's problematic framing is evident from the outset. It opens with parallel narratives from an Israeli and a Palestinian doctor, each presented as a victim of violence.
While the emotional experiences of both individuals warrant consideration, the structural asymmetry between them is entirely ignored. One works in a fully resourced trauma centre in Israel. The other is violently displaced and left as the sole doctor for 20,000 others in a refugee camp in southern Gaza.
Nowhere do the authors acknowledge that the Palestinian healthcare system has been systematically dismantled, while Israel's remains intact
By presenting these narratives side by side, the article constructs a false equivalence - portraying both as equally harmed and jointly responsible for the breakdown of trust that the authors claim must now be rebuilt.
Nowhere do the authors acknowledge that the Palestinian healthcare system has been systematically dismantled, while Israel's remains intact - and in many cases, actively serves its war effort.
This article reflects a broader pattern within medicine, medical institutions and the editorial cultures of leading journals - one that erases Palestinians, dehumanises their experience, and sidelines their political rights.
As healthcare workers and public health advocates, we have a responsibility to expose and challenge these narratives before they become the basis for further harm. We join others in doing so here.
'Militarised medicine'
While the NEJM authors assert - without evidence or elaboration - that hospitals in Gaza were "militarised" and "weaponised", they cynically ignore entirely the deep and growing militarisation of the Israeli health system.
The Israeli Medical Association has widely supported the assault on Gaza and actively lobbied against international condemnation of the Israeli regime, all while styling itself as a neutral medical body committed to care.
Israeli physicians have been observed carrying weapons inside hospitals. Family physicians helped arm settler civilians. Medical institutions have censored and punished Palestinian healthcare workers who speak out about Israeli military violence in Gaza.
More than 100 Israeli doctors signed an open letter supporting the destruction of hospitals in Gaza. None have faced any legal or professional consequences.
This is not merely silence or complicity. Israeli medical institutions have unabashedly participated in the war. Health workers regularly move between clinical work and military service, often appearing in uniform in hospitals. Some have been directly implicated in the medical neglect and torture of Palestinian detainees.
In Israel, the boundaries between medicine, militarism and impunity are not merely blurred - they are collapsed and normalised within the country's medical establishment.
How can medicine serve as a space of trust when it is so deeply embedded in systems that permit, justify and even celebrate the elimination of Palestinian life?
Cover for oppression
While the NEJM authors briefly note that Gaza's hospitals were bombed and rendered nonfunctional, they offer no analysis of asymmetry, intent or illegality.
Instead, the destruction is framed as an unfortunate byproduct of war, rather than part of a systematic campaign to annihilate an entire people's capacity to live, heal or survive. The result is a sanitised account that obscures state violence behind a veil of shared suffering and shared hope.
Follow Middle East Eye's live coverage of the Israel-Palestine war
This sanitisation masks state violence as a shared tragedy and obscures its intent.
Rather than reckon with the reality of a healthcare system targeted for destruction, the authors retreat into humanitarianised abstractions.
They frame medicine as a neutral practice through which Palestinians and Israelis can build trust and foster mutual understanding - as if such efforts could reasonably exist apart from structures of violence, domination and extermination.
In doing so, they ignore the deep entanglement of the Israeli health system within the machinery of occupation and apartheid - a reality that long predates October 2023.
In the West Bank, Ariel University operates a medical school in the heart of an illegal settlement - a clear example of how medicine is woven into the architecture of settler colonial domination.
In Gaza, a 17-year siege has systematically asphyxiated the health system and denied patients access to life-saving medical care, including exit permits to receive essential medical treatment abroad.
Meanwhile, hospitals were deprived of medical equipment under arbitrary "dual-use" restrictions and regularly suffered shortages of life-saving medicines.
Even inside the 1948 borders, the legacy of colonialism and apartheid is visible in health outcomes. Palestinian citizens of Israel live shorter lives and face poorer health than their Jewish Israeli counterparts.
Echoing propaganda
Worse still, the NEJM authors go beyond omission and recklessly echo Israeli propaganda. They repeat claims that Gaza's hospitals were "militarised" and "weaponised" - language used by the Israeli regime to justify their obliteration.
Yet they avoid entirely the mounting evidence that Israel's attacks on health infrastructure have been systematic, deliberate, and in clear violation of international law.
This rhetorical sleight of hand serves a purpose: to shift focus away from Israel's criminal liability and obscure the destruction of the health system as part of Israel's broader genocidal campaign.
It is now increasingly clear that these allegations were part of a broader strategy to once again exploit international law - invoking the principle of proportionality to justify the targeting of health facilities.
This manipulation of legal frameworks has served to obscure war crimes and legitimise the wholesale destruction of Gaza's health system under the pretense of military necessity.
Such narratives should be unequivocally condemned and certainly have no place in medical journals.
Rebuilding Gaza's healthcare
There can be no recovery in Gaza under conditions of occupation, apartheid, and manufactured dependency on the Israeli regime.
This dependency has been systematically weaponised and intensified throughout the 17-year siege and further escalated in the post-October 2023 phase of Israel's genocide.
Despite this reality, the NEJM authors selectively highlight a handful of small-scale Palestinian-Israeli health partnerships to promote a narrow plan for rebuilding Gaza's health system.
If health is to serve as a bridge, it must not lead to impunity and slow extermination, but to justice and collective liberation
They propose a series of short-, medium-, and long-term actions - none of which address the foundational political structures that harm Palestinians.
Instead, each stage of the plan depends on continued Israeli involvement and the supposed benevolence of the Israeli regime: transferring Palestinian patients to Israeli hospitals, training Palestinian doctors in Israeli institutions, and absorbing Gaza's health sector into Israel's technological ecosystem.
While these actions may offer temporary reprieve to a small number of Palestinians, they ultimately reproduce the very structures of control, vulnerability and violence that have long defined Israel's approach to Palestinian health.
These are not neutral, technical solutions - they are political interventions that preserve Israel's role as gatekeeper over life, death and mobility.
To propose such piecemeal measures now - amid the destruction of Gaza's health system and the intensification of genocide - is deeply cynical. These are not new or innovative proposals; they represent the bare minimum obligations of an occupying power. At best, they offer a fast track back to the violent status quo that existed before October 2023.
Any genuine effort to rebuild Gaza's health system must begin with Israel's full compliance with a ceasefire agreement, followed by the progressive dismantling of occupation, apartheid, and the broader settler colonial project. Only then can Palestinians determine how - and with whom - to rebuild a health system grounded in dignity, political sovereignty, and justice.
Calls for trust, partnership, and collaboration - especially when legitimised by medical professionals and prominent academic journals - function as a potent form of epistemic manipulation.
Medicine is further distorted to serve the broader agenda of the Israeli regime, cloaked in humanitarian language that conceals complicity and obscures the layered violence of genocide, occupation and apartheid.
If health is to serve as a bridge, it must not lead to impunity and slow extermination, but to justice and collective liberation.
The views expressed in this article belong to the authors and do not necessarily reflect the editorial policy of Middle East Eye.
Middle East Eye delivers independent and unrivalled coverage and analysis of the Middle East, North Africa and beyond. To learn more about republishing this content and the associated fees, please fill out this form. More about MEE can be found here.
