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In the aftermath of 7 October 2023, Palestinians in the Gaza Strip have been subjected to a near-constant military assault, siege, mass displacement and the systematic destruction of critical civilian infrastructure. These conditions have been widely recognised by legal scholars, human rights organisations and medical experts as genocide.1 2 This genocide has had both direct and indirect health effects, with detrimental ramifications for future generations of Palestinians. To take one illustrative example, a meningitis epidemic during June–August 2025 demonstrated how the systematic destruction of public health infrastructure provides the conditions for epidemic outbreaks. The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reported 484 suspected cases in June 2025, a marked increase as compared with previous years.3 In July 2025, OCHA reported 420 suspected cases of meningitis, with numbers likely higher given the limited diagnostic and surveillance capability in the Gaza Strip.4 In August 2025, there were 119 cases of meningitis reported, bringing the total during May–August 2025 to 1043, with most cases occurring in children below 1 year of age.5 6 The extent of underreporting and aetiological differentiation is unclear, given the resource and personnel limitations, though most of these cases are believed to be viral in origin. For comparison, in 2022, there was a total of 1050 cases of meningitis recorded for the entire year.7 While rates of meningitis vary seasonally, in the context of the current genocide, significant attention has been brought to the structural, social and environmental determinants of health imparted by systematic destruction of Gaza—the denial of basic nutrition, the destruction of healthcare systems leading to the lack of disease surveillance infrastructure, the disruption of immunisation programmes and basic access to medical care. Between 2005 to 2022, reports from the Palestine Ministry of Health demonstrated that the incidence of viral meningitis in the Gaza Strip has never dropped below rates in the West Bank.8 This spans multiple years during which outbreaks were recorded in the Gaza Strip, including in 1997, 2004 and 2013–2014.9 During the 2013–2014 outbreak, incidence rates increased dramatically—reaching 247 per 100 000 in Gaza, nearly 30 times higher than the West Bank.10 Epidemiological studies conducted during these outbreaks found that 80% of meningitis cases in 2014 were viral. Most cases were attributable to enteroviruses, which thrive under conditions of poor sanitation and overcrowding.9 Despite the Gaza Strip’s public health system outperforming the global average childhood vaccination coverage prior to 2023—particularly for Haemophilus influenzae type b and pneumococcal conjugate vaccine coverage—conditions of displacement and crowding, intermittent breakdown in health systems and water, hygiene and sanitation (WASH) failures that facilitate the spread of non-vaccine preventable disease are well described in conflict and war settings.11