West Bank on the Brink: The Alarming Systematic Collapse of the  Vital Sectors in the Occupied West Bank

August 5, 2026
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The occupied West Bank is currently experiencing an unprecedented crisis affecting virtually every essential sector, including healthcare, education, municipal services, water, electricity, fuel, transportation, and the broader economy. The deterioration is no longer limited to isolated sectoral deficiencies or recurring fiscal crises; rather, it reflects a prolonged, cumulative process of institutional weakening that has directly undermined the capacity of Palestinian public institutions to perform their core functions and to ensure Palestinians’ access to the bare minimum of essential services and fundamental rights.  

This deterioration unfolds within the broader context of Israel’s prolonged occupation, which for decades has imposed a system of structural constraints on Palestinian development and fragmented any Palestinian sovereignty. These include severe restrictions on freedom of movement, extensive control over natural resources and border crossings, continued settlement expansion, and the structural economic and fiscal dependence of the Palestinian economy on Israel. Collectively, these policies have significantly reduced the fiscal and administrative space available to Palestinian institutions, leaving them increasingly vulnerable to economic and political shocks. Recently, however, the rate of this decline has risen substantially because of intersecting economic, financial, and political forces. These combined challenges have advanced a state of persistent structural weakness into a crisis that directly risks the preservation of institutions and the realization of economic and social rights for Palestinians.

Control over Public Revenues and the Institutionalization of the Fiscal Crisis

The Palestinian Authority’s (PA) ability to provide essential public services fundamentally depends on clearance revenues collected by Israel pursuant to the 1994 Paris Economic Protocol, under the Oslo frameworks. These revenues, consisting primarily of customs duties, value-added tax (VAT), and import-related taxes and fees, account for approximately 60–70% of the PA’s annual public revenues, making them the primary source of financing for public administration and the provision of essential services.

Since 2024, Israel has continued to withhold substantial portions of these revenues through unilateral deductions and the suspension of their transfer. By early 2025, the total amount of withheld Palestinian clearance revenues had exceeded ILS 10 billion, while monthly deductions during 2024 averaged approximately ILS 500 million. The consequences of this policy have directly affected the ability of the Palestinian government and public institutions to pay public sector salaries, finance hospitals, procure essential medicines, maintain infrastructure, and sustain basic public services. These impacts no longer constitute temporary fiscal constraints; rather, they have become a continuous factor weakening the capacity of institutions responsible for protecting and fulfilling fundamental economic and social rights.

As the withholding of clearance revenues continued, the gap between available government resources and actual public expenditure requirements widened to unprecedented levels. Currently, available monthly government revenues declined to approximately ILS 100 million, while the financing required to cover essential expenditures, public sector salaries, and basic public services was estimated at around ILS 1.5 billion per month. This gap illustrates the scale of the fiscal imbalance confronting the Palestinian public finance system and severely limits institutions’ ability to operate and plan effectively.

The fiscal crisis has also generated a cycle of institutional deterioration. The continued payment of partial salaries has reduced the purchasing power of public-sector employees, thereby affecting domestic consumption and contributing to broader economic contraction. At the same time, municipalities have accumulated increasing operational debts due to difficulties in financing essential services, while public institutions have become increasingly dependent on emergency financing, deferred payments to suppliers, and external assistance to maintain minimum operational capacity. This reliance undermines institutional sustainability and long-term planning.

The fiscal crisis is further exacerbated by a broader system of restrictions imposed on Palestinians, including intensified movement restrictions, escalating settler violence, accelerated settlement expansion, and constraints on economic activity. The interaction between these financial pressures and on-the-ground restrictions has transformed the fiscal crisis from a financial challenge into a broader factor undermining the ability of public institutions to fulfil their obligations, forcing them to rely on short-term emergency measures rather than sustainable institutional planning.

The Palestinian Monetary Authority (PMA) has warned that the continuation of the fiscal crisis threatens economic stability, the banking sector, and the ability to provide essential services. Moreover, any additional restrictions on correspondent banking relationships or the use of the Israeli shekel and cash transactions would further aggravate the crisis, transforming it from a liquidity shortage into a broader process of institutional erosion that threatens the continuity of Palestinian civil administration and its ability to guarantee even the minimum provision of essential services to the Palestinian population.

Collapse of the Health Sector

The Palestinian healthcare system in the West Bank has entered one of the most severe operational crises since the establishment of the PA. Although healthcare institutions have historically operated under the constraints of the Israeli occupation, including movement restrictions, control over resources, and partial dependence on externally controlled supply chains, the unprecedented accumulation of crises since 2023 has significantly undermined the health system’s ability to perform its core functions stably and sustainably.

The continued withholding of Palestinian clearance revenues has been one of the principal factors weakening the Ministry of Health’s capacity to meet its operational obligations, as the fiscal crisis deepened, accumulated debts and arrears within the health sector reached unprecedented levels, amounting to approximately USD 1.1 billion by the end of 2025, severely limiting the Ministry’s ability to ensure a regular supply of essential medical commodities.

By mid-2026, a substantial proportion of essential medicines had reached critically low stock levels. During 2025, approximately 20% of essential medicines and 25% of surgical consumables were reported to be out of stock, while at certain periods shortages exceeded 45% of the national essential medicines list. The shortages affected treatments that require uninterrupted availability, including oncology medications, medicines for chronic diseases, dialysis supplies, and essential materials used in operating theatres and intensive care units. 

The consequences of the crisis extend beyond shortages of medicines to the ability of hospitals to provide timely medical care. Financial constraints and disruptions in procurement processes resulted in the postponement of more than 11,000 non-emergency surgical procedures across the West Bank. Although administratively classified as “non-emergency,” many of these procedures involve conditions that progressively deteriorate if treatment is delayed, leading to increased pain, worsening health outcomes, and the need for more complex medical interventions. As a result, the management of medical resources has shifted from needs-based planning to crisis management driven by scarcity and emergency prioritization. 

The fiscal crisis has also affected healthcare personnel, who have experienced prolonged delays in salary payments or received only partial salaries, undermining workforce stability and the operational capacity of healthcare institutions.

The healthcare system itself has also been subjected to direct Israeli attacks and restrictions affecting its ability to function. Between October 2023 and December 2024, 659 attacks on healthcare were documented across the West Bank, including attacks against ambulances, healthcare workers, and medical facilities, resulting in the killing of 25 individuals and the injury of 120 others. Hospitals and healthcare facilities were also subjected to raids, sieges, movement restrictions, and interference with the work of medical personnel, significantly reducing their ability to provide services, particularly in areas experiencing repeated military operations.

Restrictions on access to healthcare have become one of the defining features of the collapse of the health sector. Intensified military restrictions increased the number of checkpoints and movement obstacles to more than 900 by January 2025, severely disrupting the movement of patients, healthcare workers, and ambulances between cities, villages, and refugee camps. Ambulances have repeatedly experienced delays while transporting emergency cases, increasing the risk of preventable complications and deaths resulting from the inability to access immediate medical care.

The human consequences of these restrictions have been reflected in several documented cases. In one incident, a mother of two died after suffering a heart attack when the ambulance transporting her was delayed at a military checkpoint near Sinjil, north of Ramallah. In Nablus, a pregnant woman lost her fetus during the sixth month of pregnancy after an ambulance carrying her was prevented from passing through a checkpoint, while two other women were forced to give birth at military checkpoints due to delays in reaching hospitals. These incidents are not isolated events but reflect a recurring pattern whereby access to healthcare is made contingent upon military and security measures beyond the control of patients and medical personnel.

Movement restrictions have also affected patients requiring specialized treatment unavailable in their local areas, including referrals to hospitals in East Jerusalem or outside the West Bank. Approval rates for medical referral permits declined significantly, from approximately 80% before October 2023 to less than 60% by the end of 2024, delaying access to essential treatment, particularly for cancer patients and those requiring highly specialized medical interventions. At the same time, persons with disabilities have faced additional barriers due to the destruction of roads and infrastructure in areas affected by military incursions and road demolitions, further limiting their access to healthcare facilities and medical transportation.

Fuel shortages have further increased the fragility of the healthcare system. Hospitals, primary healthcare centres, and ambulance fleets depend on uninterrupted fuel supplies to operate backup generators, refrigeration systems, diagnostic equipment, and pharmaceutical cold chains. Consequently, disruptions in fuel availability affect not only transportation but also threaten the continuous operation of hospitals themselves, particularly operating theatres, intensive care units, dialysis machines, laboratories, and other life-saving medical services.

Collapse of the Education Sector

The education sector has been among the vital public sectors most severely affected by the fiscal crisis, owing to its heavy reliance on regular government funding to cover teachers’ salaries, operate schools, and provide educational resources. The continued withholding of Palestinian clearance revenues and related deductions has significantly weakened the PA’s ability to meet its financial obligations toward public sector employees, including teachers. As a result, teachers have not received their full salaries for several years, with salary payments ranging between 50% and 70% of their original value since 2021. Meanwhile, salaries owed to public employees accumulated to approximately USD 2.85 billion by the end of 2025. In January 2026, the crisis reached an unprecedented level when all public employees, regardless of rank or financial obligations, received a flat payment of only ILS 2,000 following a delay of nearly three months.

The consequences of this crisis have extended well beyond deteriorating teachers’ living conditions to directly affect the continuity of education. Repeated salary delays triggered waves of teachers’ strikes and protests, resulting in interruptions to public education and the postponement of the academic year in certain periods. To cope with the fiscal crisis, the Ministry of Education reduced in-person instruction in public schools to only three days per week, significantly reducing actual teaching hours and widening the gap between curriculum requirements and available instructional time. In practice, public education has failed to operate under a normal and uninterrupted academic schedule for several consecutive years.

The financial crisis has also forced many teachers to rely on bank loans to meet their basic living, educational, and healthcare expenses, increasing their financial vulnerability and tying their economic stability to uncertain future salary payments. This has undermined teachers’ professional stability and their ability to fulfil their educational responsibilities in an environment already characterized by severe economic and social pressures.

The fiscal crisis has coincided with Israel’s intensified movement restrictions, creating additional barriers to access to education. Students and teachers face daily delays caused by military checkpoints, road closures, and prolonged travel times, frequently resulting in late arrivals or complete absence from schools and universities. These restrictions have had a particularly severe impact on educational institutions located in rural communities and Area C, where access is especially fragile due to the proximity of Israeli settlements and areas subject to recurrent military operations.

During the last quarter of 2025, more than 230 education-related violations were documented, affecting over 130 schools and approximately 17,000 students. These incidents included restrictions on access, military incursions, security threats, and disruptions to regular school attendance. Beyond reducing daily attendance, such incidents create an educational environment characterized by instability and fear, particularly for children living in areas repeatedly affected by military operations.

In response to these disruptions, educational institutions have periodically resorted to temporary alternatives, including distance learning. In March 2026, escalating regional tensions forced schools to transition temporarily to fully remote learning. However, this approach does not constitute a sustainable solution within the Palestinian context, given persistent inequalities in internet access, the availability of digital devices, and households’ financial capacity, all of which risk widening existing educational disparities among students.

The consequences of the collapse of the education sector extend far beyond the loss of school days or reduced instructional hours. Prolonged disruption of regular education increases the risks of school dropout, child labour, and early marriage, while undermining students’ future opportunities for higher education and participation in the labour market. It also has profound psychosocial consequences, as children continue to experience persistent uncertainty and anxiety arising from the deteriorating security and economic environment.

Water, Sanitation, and Municipal Services

The deterioration of water, sanitation, and municipal services represents one of the clearest manifestations of the structural crisis affecting the occupied West Bank. Israeli control over natural resources intersects with the Palestinian fiscal crisis and movement restrictions to undermine the ability of local authorities to fulfil their fundamental obligations toward their population. The current crisis reflects an interconnected system of legal, administrative, and military restrictions that limit Palestinians’ ability to manage and develop their natural resources while simultaneously weakening the institutional capacity of local governments to deliver essential public services regularly.

The Palestinian water sector operates within a legal and administrative framework that fundamentally restricts Palestinian sovereignty over water resources. Since 1967, Israeli military orders have transferred effective control over groundwater, well drilling, water infrastructure, and distribution networks to the Israeli authorities. Subsequent arrangements, including the Oslo II Agreement, further entrenched Israeli control over the allocation and management of shared water resources. It is estimated that Israel controls more than 85% of Palestinian water resources, forcing Palestinians to rely increasingly on purchasing water from the Israeli national water company, Mekorot, to meet their basic needs. Approximately 60% of Palestinian domestic water consumption is supplied through purchased water from Mekorot, while dependence is even greater in the southern West Bank, where approximately 90% of Hebron’s domestic water supply and around 63% of Bethlehem’s are purchased from Israeli-controlled sources.

This dependency has become even more critical during the current fiscal crisis, as restrictions on water resources have coincided with repeated reductions in water supplied by Mekorot. In the governorates of Bethlehem and Hebron, water deliveries were reduced by as much as 40% during certain periods, causing widespread supply disruptions. Some communities, including the town of Idhna in Hebron Governorate, remained without running water for more than 100 days. At the same time, the fiscal crisis resulting from the withholding of Palestinian clearance revenues significantly reduced the capacity of municipalities and joint service councils to purchase additional water supplies or maintain distribution networks and water infrastructure, leading to more frequent interruptions and greater reliance on expensive water tankers that many households cannot afford.

Water and sanitation infrastructure has also been subjected to systematic destruction, further increasing the sector’s vulnerability. Since the beginning of 2026, more than 100 demolition or attack incidents carried out by Israeli forces or settlers have damaged or destroyed over 190 water and sanitation facilities across the West Bank, including wells, water reservoirs, transmission pipelines, pumping stations, and distribution networks. In addition, more than 500 rainwater harvesting cisterns were destroyed during 2025, despite their importance as a primary source of water for many Palestinian communities, particularly in rural areas and Area C. This destruction has significantly reduced community resilience while increasing dependence on Israeli-controlled water sources and humanitarian assistance.

At the same time, settler attacks on water infrastructure have emerged as an increasingly significant threat to Palestinian water security. Repeated attacks have targeted wells, pumping stations, and electricity lines supplying water networks. Among the most notable incidents were repeated settler attacks on the Ein Samiya pumping station, which supplies water to approximately 100,000 Palestinians, where pumps and electrical infrastructure were repeatedly vandalized. These attacks not only disrupt water supplies temporarily but also create living conditions that pressure Palestinian communities and undermine their ability to remain on their land, particularly in rural areas facing displacement risks.

The deterioration has also affected the sanitation sector, where attacks on infrastructure and the absence of regular maintenance have heightened environmental and public health risks. In Kafr Aqab, north of Jerusalem, Israeli demolition operations caused extensive damage to water, electricity, and sewage networks, affecting more than 2,600 residents. In addition, human rights and environmental organizations have documented the discharge of untreated wastewater by certain Israeli settlements, including Beitar Illit, into Palestinian agricultural lands, contaminating farmland and natural springs such as Ein Fares, which serves as an important local water source. These practices simultaneously threaten the rights to water and to a healthy environment, while also undermining agriculture and food security.

Palestinian municipalities are simultaneously experiencing a worsening operational crisis due to declining public revenues, reduced fee collection, delayed government transfers, and rising operating costs. The fiscal crisis has weakened the ability of municipalities and electricity and water distribution companies to meet their financial obligations to suppliers, while substantial portions of revenues generated from the energy and water sectors have been redirected to support the general budget and address fiscal deficits rather than financing operational expenses or infrastructure development. Consequently, local authorities have struggled to finance waste collection, wastewater treatment, road maintenance, public sanitation, and routine infrastructure maintenance.

The current fuel crisis has further undermined municipal service delivery. Municipalities depend on regular fuel supplies to operate heavy machinery, waste collection vehicles, water pumps, wastewater treatment facilities, and emergency response equipment. The liquidity crisis and the continued withholding of clearance revenues have resulted in recurring fuel shortages, long queues at fuel stations, and direct disruptions to municipalities’ ability to provide essential services. Simultaneously, the destruction of roads and public infrastructure in governorates such as Jenin, Tulkarm, and Nur Shams Refugee Camp has obstructed the movement of municipal service vehicles and ambulances, delayed maintenance works and emergency responses, and contributed to the further deterioration of urban infrastructure and public services.

The Lawlessness and Decline of Public Security

Alongside the deterioration of essential public services, the West Bank has witnessed a significant decline in the ability of public institutions to enforce the rule of law and maintain public security. This has been reflected in the increase in internal violence, the proliferation of unregulated firearms, and the escalation of armed family disputes across several governorates. These developments illustrate the interaction of multiple structural factors, including the continued Israeli occupation, restrictions on Palestinian security jurisdiction, the fiscal crisis, and the weakening of the justice system, all of which have undermined the capacity of public institutions to uphold the rule of law and protect civilians.

Official data issued by the Palestinian Central Bureau of Statistics (PCBS) indicate that crime rates in the West Bank have remained high, with approximately 1,035.6 recorded crimes per 100,000 inhabitants during 2024. Subsequent developments on the ground further indicate an expansion of armed internal conflicts and growing manifestations of lawlessness in several areas. This deterioration is closely linked to the restrictions imposed on Palestinian security jurisdiction under the Oslo Accords, as well as the continued Israeli military incursions throughout the West Bank, including Area A, and the inability of Palestinian security forces to exercise effective authority in Area C, which constitutes more than 60% of the West Bank, except through prior coordination with the Israeli authorities. Consequently, certain areas have become effectively inaccessible for the execution of arrest warrants or the enforcement of judicial decisions, reinforcing a climate of impunity.

The weakening of the justice system has further aggravated the crisis. Lengthy judicial proceedings, continued interference affecting judicial independence, and the suspension of the Palestinian Legislative Council since 2007 have undermined institutional accountability and oversight. Judicial reports indicate that a significant proportion of cases remain unresolved for years, encouraging some individuals to resort to tribal dispute-resolution mechanisms or acts of self-help and retaliation rather than the formal judicial system, thereby weakening the rule of law and reinforcing parallel systems of private justice.

These dynamics are compounded by deteriorating economic conditions, rising unemployment, and declining public trust in state institutions, all of which contribute to an environment more susceptible to internal violence. The continued political division and the absence of a unified national vision have further reduced the ability of public institutions to contain community disputes, while the ongoing occupation continues to impose restrictions that prevent the PA from fully exercising its security and judicial responsibilities.

Legal Framework and Analysis

The accelerating collapse of essential vital sectors in the West Bank cannot be understood as a series of separate crises or as the result of internal administrative failures. Rather, it must be assessed as the cumulative outcome of interconnected policies and measures that have directly affected the ability of Palestinian institutions and the civilian population to perform their essential functions and enjoy their rights guaranteed under international law. Control over financial resources and public revenues, restrictions on the movement of persons and goods, and constraints affecting essential infrastructure and services have weakened Palestinian institutional capacity and undermined the ability of public institutions to respond to the needs of the population, within a broader context of control exercised by Israel over the Occupied Palestinian Territory. 

Within this framework, the advisory opinion issued by the International Court of Justice on 19 July 2024 concerning the legal consequences arising from Israel’s policies and practices in the Occupied Palestinian Territory constitutes the primary legal reference for assessing this institutional collapse. The Court affirmed that Israel, as the occupying power, remains bound by its obligations under both international humanitarian law and international human rights law throughout the Occupied Palestinian Territory. It further found that the continuation of policies and practices that entrench control over the occupied territory, affect its resources, and impede the Palestinian people’s ability to exercise their right to self-determination raises fundamental legal questions regarding the legality of the continuation of this situation and its consequences for the rights of the Palestinian population.

1. Obligations of the Occupying Power and the Protection of Civilian Life

International humanitarian law imposes positive obligations on the occupying power that extend beyond the maintenance of security and include the preservation of civilian life and the continuation of essential services for the protected population. Article 43 of the 1907 Hague Regulations requires the occupying power to take all measures within its power to restore and ensure public order and civil life. This obligation encompasses maintaining the conditions necessary for the population to exercise their fundamental rights.

Accordingly, policies or measures that continuously undermine the capacity of civilian institutions to function or prevent the population from accessing essential services raise serious legal concerns regarding their compatibility with the obligations of an occupying power. In the context of the West Bank, prolonged restrictions on movement, control over resources, and repeated damage to civilian infrastructure have weakened the ability of essential sectors, including healthcare, education, water services, and municipal services, to respond effectively to the needs of the population.

These obligations carry particular significance given Israel’s extensive control over several vital areas, including border crossings, the movement of goods and persons, and key aspects of Palestinian public revenues. Therefore, the impact of these policies extends beyond institutional relations between Israel and the Palestinian Authority and directly affects the civilian population and its ability to access fundamental rights.

2. Undermining Economic and Social Rights through Financial and Economic Control

Control over Palestinian financial resources constitutes one of the central factors contributing to the weakening of civilian institutions. The withholding of clearance revenues has contributed to a severe fiscal crisis that has directly affected the ability of public institutions to perform essential functions, including paying salaries, financing healthcare and education services, purchasing medicines, and maintaining public infrastructure. The legal concern does not arise solely from the existence of financial measures, but from their use in a manner that disrupts essential services and adversely affects the civilian population. When control over public revenues results in the inability of institutions to provide basic services, it directly affects rights protected under international human rights law, including the rights to health, education, an adequate standard of living, and work.

Similarly, control over natural resources, particularly water resources, raises additional legal concerns in light of the occupying power’s obligation to administer the occupied territory in a manner that preserves the interests and welfare of the protected population and does not deprive them of access to essential resources necessary for the enjoyment of their rights.

3. Restrictions on Freedom of Movement and Their Impact on Fundamental Rights

The system of movement restrictions imposed on Palestinians in the West Bank, including checkpoints, closures, permit regimes, and restrictions on access to cities and essential facilities, has had direct consequences on the population’s ability to access basic services. Freedom of movement is not only a protected right in itself; it is also a prerequisite for the enjoyment of numerous other rights. Restrictions on movement affect access to hospitals and medical care, universities and schools, workplaces, and administrative services. Consequently, the impact of these restrictions extends beyond their stated security justifications and affects the economic, social, and civil rights of the population.

Civilian populations and objects dedicated to civilian purposes enjoy special protection under international humanitarian law. This protection extends to medical facilities, educational institutions, water and sanitation networks, and other infrastructure essential for daily life. The damage affecting civilian infrastructure, whether through demolitions, restrictions on maintenance and development, or obstacles to the entry of necessary equipment and materials, has weakened the capacity of civilian institutions to continue providing essential services. Such actions acquire particular legal significance when they form part of a sustained pattern affecting the ability of the population to meet its basic needs.

4. The Cumulative and Systematic Nature of the Violations

The facts documented in this report demonstrate that the deterioration affecting healthcare, education, water, transportation, and public administration is not the result of a single measure or isolated incidents. Rather, it has emerged from a combination of interconnected policies and practices that reinforce one another. Financial restrictions weaken institutions; movement restrictions obstruct access to services; control over resources limits social and economic development; and administrative and structural constraints contribute to the continuation of this situation.

The documented facts examined in this report, when assessed within their broader legal framework, demonstrate that the deterioration witnessed in the West Bank does not constitute a series of isolated sectoral crises or incidental administrative failures. Rather, it reflects a systematic pattern of institutional weakening resulting from the cumulative interaction of interconnected policies, restrictions, and practices that have undermined the capacity of Palestinian institutions to perform their essential functions. This process has eroded the foundations of civilian governance and impeded the fulfilment of obligations related to safeguarding the fundamental rights of the Palestinian population, constituting a continued violation of rights protected under international humanitarian law and international human rights law.

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