© 2025 Palestine Center for Public Policy
The United States now faces direct legal and moral risk for continuing unconditional support to Israel. In January 2024, the International Court of Justice (ICJ) found that Israel’s actions in Gaza present a plausible risk of genocide under the Genocide Convention, to which the United States is a party. Verified investigations confirm systematic destruction of hospitals, schools, and civilian infrastructure. U.S.-made weapons have been directly tied to strikes killing civilians, including children. The United Nations Children’s Fund (UNICEF) reports that nearly every child in Gaza now requires urgent mental health care. Continuing aid without conditions places the United States in breach of its binding laws designed to prevent complicity in atrocities.
The precedent for recovery is proven. After the Bosnian conflict, international partners rebuilt mental health care through community-based services tied to primary care. This restored functioning even when infrastructure lay in ruins. Gaza’s urgent needs intersect directly with U.S. policy, given Washington’s role as Israel’s largest donor. Redirecting 38 million dollars, about one percent of annual U.S. military assistance to Israel, could cover the full projected cost of UNICEF’s mental health and psychosocial programs in Gaza. This level of support would significantly expand access for nearly one million children in urgent need. Such an investment would not only protect a generation but also demonstrate fiscal responsibility, strategic leadership, and commitment to American values of law and accountability. Failing to act undermines U.S. legal credibility, increases regional instability, fuels recruitment by armed groups, and creates long-term security risks for American interests.
Bosnia offers an instructive precedent. European governments and institutions played a direct role in rebuilding its health system after the war. Large psychiatric institutions were replaced with community-based services tied to primary care. Municipal centers, staffed by multidisciplinary teams and trained nonspecialists, expanded access and restored basic functioning even with damaged infrastructure. The key to success was sustained outside funding combined with strong local ownership, which made the model durable and adaptable in fragile post-war conditions.
Gaza’s trajectory is the reverse. Since October 2023, the United Nations and the World Health Organization (WHO) have verified repeated attacks on medical facilities, transport, and personnel. By July 2025, United Nations–compiled data recorded 686 separate attacks on health care, leaving only 18 of 36 hospitals partially functional and 1,580 health workers killed. Nearly 89 percent of schools now require complete reconstruction or major rehabilitation. More than 16,300 students and 721 teachers have been killed, and over 1 million children need urgent mental health and psychosocial support. These figures come directly from incident reports by humanitarian agencies operating on the ground.
The fiscal contrast is striking. United States operations in Iraq cost more than 1.7 trillion dollars over two decades. By comparison, the United Nations Children’s Fund appeal to cover all humanitarian needs for Gaza in 2025 is 716.5 million dollars, less than one twentieth of one percent of what America spent in Iraq. Redirecting 38 million dollars, equal to one percent of annual United States aid to Israel, would fully fund every mental health and psychosocial support program for Gaza’s one million children. That is about the cost of a single F-35 engine.
United States law and binding international obligations converge on a simple principle: when foreign assistance is tied to grave violations of human rights, it must be suspended and redirected to lawful recovery. Gaza’s devastated mental health system, and especially the psychological trauma borne by its children, falls squarely within this framework.
Treaty Duties and Prevention of Atrocities
The Genocide Convention, to which the United States is a party, obliges every state to take “all measures reasonably available” to prevent genocide once a serious risk is identified. The ICJ in Bosnia and Herzegovina v. Serbia and Montenegro (2007) confirmed that this is a duty of conduct, not of result. It applies wherever a state has influence. As Israel’s largest donor and weapons supplier, the United States cannot disclaim responsibility. Preventive measures are not limited to halting transfers; they include positive steps to address widespread trauma and enable civilian survival. Mental health services for children, who make up half of Gaza’s population, are precisely such preventive measures.
International humanitarian law reinforces this baseline. Common Article 1 of the four Geneva Conventions requires states “to respect and ensure respect” for the rules of war. This duty is active, not passive. It requires states to prevent violations and to facilitate humanitarian relief. Attacks on hospitals, schools, and ambulances directly implicate these obligations. Conditioning aid on rehabilitation, and funding community-based mental health services, is a concrete way to “ensure respect” while remaining within the letter of the Conventions.
Children’s Rights as Binding Law
General obligations must be read alongside child-specific frameworks. The Convention on the Rights of the Child (CRC), the most widely ratified treaty in history, obliges states to secure children’s survival and development (Article 6), to ensure the highest attainable standard of health (Article 24), and to promote psychological recovery and reintegration of child victims of armed conflict (Article 39). While the United States has signed but not ratified the CRC, its provisions have achieved the status of customary law through universal acceptance and consistent state practice. Ignoring them weakens U.S. credibility in every other context where Washington seeks to hold adversaries accountable.
The United States has also ratified the Optional Protocol on the Involvement of Children in Armed Conflict, which binds Washington to protect children from the effects of war. Its provisions align with the duty to provide mental health support to children traumatized by hostilities.
Additional treaties reinforce this duty. The International Covenant on Economic, Social and Cultural Rights (ICESCR), ratified by allies and cited in U.N. reporting, defines mental health as integral to the right to health and elaborated in General Comment 14 of the Committee on Economic, Social and Cultural Rights. The Convention on the Rights of Persons with Disabilities (CRPD), ratified by 191 states, requires habilitation and rehabilitation for those with psychosocial disabilities. Children in Gaza suffering trauma meet this threshold, obligating international partners to provide community-based support.
U.S. Statutes and Policy Commitments
Domestic law points in the same direction. The Leahy Laws bar assistance to foreign security units credibly implicated in gross violations of human rights, including torture, extrajudicial killings, enforced disappearances, and rape. Section 502B of the Foreign Assistance Act prohibits aid to governments engaged in a consistent pattern of abuses. These laws close the door to enabling transfers but do not block lawful humanitarian aid.
Congress has already created that channel. Section 491 of the Foreign Assistance Act authorizes international disaster relief and rehabilitation, expressly directing U.S. assistance to those most in need after man-made catastrophes. Section 620I bars aid to any country that obstructs U.S. humanitarian assistance, a provision directly triggered by Israel’s blockade of Gaza convoys. Mental health and psychosocial services for children fit squarely within this mandate.
The Arms Export Control Act (AECA) likewise requires that U.S. weapons be used only for legitimate self-defense and internal security. Strikes on hospitals and schools with U.S.-origin bombs violate these statutory limits. Continuing transfers under these conditions exposes the United States to legal risk for breach of its own arms export laws.
Additional criminal statutes underscore the point. The War Crimes Act (18 U.S.C. § 2441) criminalizes grave breaches of the Geneva Conventions by U.S. nationals or members of the armed forces. The Genocide Statute (18 U.S.C. § 1091) establishes U.S. jurisdiction over genocide committed abroad by U.S. nationals or persons present in the United States. Both statutes heighten the legal risk of complicity when U.S. arms or financing facilitate foreseeable violations.
Other statutes and policies confirm the point. The Global Fragility Act of 2019 requires the United States to address drivers of conflict, including trauma, through integrated civilian responses. The National Strategy on Children in Adversity (2019–2029), adopted by the U.S. government, commits agencies to provide early childhood development and trauma-informed interventions in crisis settings. Both frameworks recognize that unresolved trauma drives cycles of violence, displacement, and instability. Addressing child mental health is therefore not only a humanitarian duty but also a security imperative. Together these provisions demonstrate that redirecting a fraction of security assistance to child mental health is not discretionary. It is consistent with enacted U.S. policy.
The Department of Defense Law of War Manual further reinforces these obligations by emphasizing the special protection afforded to children, hospitals, and schools during armed conflict. Conditioning aid on compliance with these baseline protections would align U.S. foreign assistance with its own military doctrine.
Customary Law and Responsibility for Wrongful Acts
Customary international law bars complicity in grave breaches. Article 16 of the International Law Commission’s Articles on State Responsibility prohibits aiding another state’s internationally wrongful acts with knowledge of the circumstances. Article 41 requires all states to cooperate to end serious breaches and forbids assistance in maintaining them. Redirecting aid away from enabling transfers toward rehabilitation is therefore not optional. It is the corrective measure required under customary law.
The ICJ’s Bosnia v. Serbia judgment (2007) confirmed that states may be responsible for complicity even if they do not share genocidal intent, so long as their aid substantially contributes to violations. This precedent makes the U.S. duty of prevention unavoidable in the present case.
Rebuilding Gaza’s mental health system demands lawful conditionality, targeted financing, and proven delivery models. Each step below draws from documented precedent and measurable results in other post-war recoveries, making them specific, enforceable, and evidence based.
1. Suspend unlawful security assistance. Assistance must be conditioned on compliance, not granted despite violations. The State and Defense Departments should pause transfers until independent investigations confirm adherence to humanitarian law. During suspension, funds should be redirected under rehabilitation authority to lawful civilian programs, prioritizing mental health and education. Resumption of security aid must require corrective action plans, transparent oversight, and ongoing verification by independent monitors. Critics may argue conditioning aid undermines Israel’s security or exceeds U.S. authority. Yet Congress has imposed similar conditions on Egypt, Nigeria, and Guatemala. Some claim U.S. non-ratification of the CRC weakens its force. Near-universal state practice confirms its provisions as customary law. Others argue Hamas misuse of facilities negates protections. The Geneva Conventions, reaffirmed by the ICJ and ICRC, forbid indiscriminate or disproportionate attacks regardless of such claims.
2. Redirect assistance through lawful rehabilitation authority. Dedicate at least $38 million of the $3.8 billion provided annually to recovery. Channel funds through WHO, UNICEF, and vetted humanitarian partners with proven access. Prioritize child protection, education, and mental health, then expand as systems scale. Ensure all services are culturally and linguistically appropriate and meet international humanitarian and human rights standards. Pair this reallocation with sustained multi-year investment to rebuild Gaza’s mental health system.
3. Implement a community-based mental health model. After Bosnia, donor funding trained non-specialist teachers, nurses, and social workers to provide structured psychosocial interventions under psychiatric supervision. Gaza can replicate this model. Finance training for teachers, nurses, and social workers to deliver care under monthly supervision with referral pathways for complex cases. Establish community hubs linked to mobile teams reaching shelters and temporary learning sites. Add Arabic-language teleconsultation for trauma, maternal mental health, and medication needs. This approach fulfills the Genocide Convention’s duty to take all measures reasonably available while meeting U.S. obligations to replace enabling assistance with corrective measures that protect civilian life.
4. Secure binding protection of medical and education sites. Require explicit, written commitments from all authorities to respect hospitals, ambulances, and schools at all times under the Geneva Conventions and customary norms. Embed humanitarian access clauses, deconfliction protocols, and site registries into all aid and security agreements. Establish independent monitoring to verify compliance, investigate misuse, and order immediate remedial measures. Allegations of misuse, including human shield claims, must undergo independent verification and cannot justify indiscriminate or disproportionate attacks on protected facilities. This framework satisfies the Genocide Convention’s duty to prevent harm and ensures U.S. compliance with domestic laws that bar assistance where gross violations occur.
5. Condition all assistance on humanitarian access and transparency. Establish and fund an independent civilian harm assessment unit with authority to document incidents, support impartial investigations, and recommend immediate adjustments to targeting practices under international humanitarian law. Require regular public reports to Congress detailing compliance with access and protection obligations, verified civilian impact of operations, and measurable outcomes for health and education programs.
6. Guarantee durability through precedent. Bosnia shows recovery lasts with multi-year funding and local ownership. The President’s Emergency Plan for AIDS Relief (PEPFAR) proves bipartisan oversight, clear metrics, and vetted partners sustain programs across political shifts. Humanitarian funding for Gaza should be secured by statutory earmarks and cross-party oversight. Delivery partners must have proven access, capacity, and compliance with international law. Contingency plans should maintain continuity of mental health and education services through rapid deployment and remote delivery if access is restricted. Durability can be secured through annual certification and statutory earmarks, as Congress already requires under the Arms Export Control Act and PEPFAR reauthorizations.
These measures are not optional. They fulfill binding legal obligations, safeguard civilians, and lay the foundation for lasting recovery. They also reflect fiscal discipline and strategic prudence. Inaction risks complicity, erodes rule-of-law credibility, and inflates long-term costs. It also fuels instability that undermines U.S. security interests. Redirecting a fraction of existing aid toward lawful rehabilitation is not charity. It is a required and pragmatic course that meets legal duties, protects taxpayer resources, and strengthens the stability on which future peace depends.
Selected References
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