Where Does The U.S. Go From Here— Gaza: The Human Toll

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This transcript is from a CSIS event hosted on May 23, 2024. Watch the full video here.

Stephen Morrison: Good morning, good afternoon, good evening. I’m J. Stephen Morrison, senior vice president here at the Center for Strategic and International Studies, CSIS, in Washington, D.C. This is the 12th episode of our broadcast series Gaza: The Human Toll. It’s a production of the CSIS Bipartisan Alliance for Global Health Security. And it’s a partnership that’s done in collaboration with the CSIS Middle East Program and the CSIS Humanitarian Agenda. Today’s focus is U.S. policy on the health and humanitarian crisis in Gaza. What are the options looking ahead?

We’re delighted to have with us today David Satterfield and Nick Schifrin as our featured guests.

David is a retired senior career diplomat, very distinguished record, who served extensively in the Middle East. President Biden appointed him in October as a special envoy for humanitarian issues in Gaza. He stepped down from that position recently and is now a senior adviser on Middle East issues. His day job is as director of Rice University’s James A. Baker III Institute for Public Policy. David, thank you for being with us. It’s great to have you with us here today.

Nick Schifrin is PBS NewsHour’s foreign affairs and defense correspondent. Coverage under his watch on the Gaza since the October 7th Hamas massacre and the subsequent war has been absolutely sterling. Earlier in his career, while working for Al Jazeera, he covered the Gaza war in 2014. Nick, thanks so much for being with us.

And I’m delighted to be joined again by my colleagues Michelle Strucke, director of the CSIS Humanitarian Agenda and our Human Rights Initiative; and Jon Alterman

, senior vice president, and director of our Middle East Program. Special thanks to Sophia Hirshfield for pulling this together; and our – and our terrific production team, Eric Ruditskiy and Dwayne Gladden.

Today there’s, frankly, not much good news to report on the war and peace issues, humanitarian and health crises. It’s difficult to imagine a more bleak and discouraging place to be, eight months into the war. And options for the future remain somewhat unclear and few in number. It seems we’ve entered a phase of escalating violence and kinetic military action born of the IDF’s eviction orders two weeks ago, the enduring Rafah military – ensuing Rafah military operation, and renewed fighting in the north. Hamas continuously shelled the Kerem Shalom gate May 6th to 16th, and there’s continued Hamas embedment in civilian institutions, including schools and medical facilities, and use of civilians as human shields.

In just two weeks, the Rafah military campaign and renewed fighting in the north has triggered mass movement of over 1 million civilians, displaced into utterly horrific conditions. And in the meantime, it’s become exceptionally dangerous for humanitarians to work inside Gaza. There’s still no effective deconfliction mechanisms in place and the flow of goods has ground to a halt, except for modest private sector flows. Gates are closed and then opened only minimally. And there are acute and mounting shortages of food, fuel, water, medicines. As we knew before this began, starvation is happening in the north and the prediction now is that we’re going to see famine across Gaza.

Egypt has entered this conflict, in closing the Kerem Shalom gate in retaliation against IDF actions to control the southern corridor on the Egyptian border. The DOD pier announced in the president’s State of the Union address arrived last week and began its operations on Friday, at a cost of 320 million (dollars). It still remains to be seen whether that can bring relief at scale to those who need it, and whether or not the efforts at bringing into force some kind of deconfliction mechanism can work. We’ll be talking today about the fact that the big end game remains elusive in terms of trying to achieve a ceasefire, release of hostages, humanitarian access, and plans for day-after governance and realignment within the region of new alliances.

We’re focused here on what U.S. policy options are, looking ahead, to address the humanitarian health crisis. Obviously, that requires us to talk about many other things.

I just want to make one note that U.S. policy has remarkably attracted criticism from all directions, and it has become embedded in our own presidential elections. It has divided the Democratic Party. It has triggered responses in various places, including the Trump administration and Republican leaders in Congress. That’s rather – that is rather remarkable.

We also will talk I’m sure here today about the decision by the ICC to request warrants – arrest warrants for Prime Minister Netanyahu, Defense Minister Gallant, and three Hamas military and political leaders. We’ll hear more about that.

I want to ask our speakers today to kick off this discussion around what are the options here. That, of course, encompasses its conditionality, which we’ve debated out over the last months. Is that – is it too late to consider conditionality in new forms? Do we simply have to wait for the – for the Rafah operation to be completed, or are we at some breaking point where perhaps other more radical steps have to be considered? Many of the routine matters about opening gates, about deconfliction – all of those issues still remain.

So we’re going to hear from our speakers in quick succession, and then we’re going to have a conversation flow from that. David, I’d like to ask you to kick things off, please. Thank you for your service.

Ambassador David Satterfield: Thank you very much, and I’m happy to be here.

The title for this series of events has been human tolls, so I’ll start with that, but there is another critical dimension which does impact the human toll. We had seen a progressive improvement in the ability to deliver, through land corridors, which are always the most efficient and effective way to get assistance into Gaza, increasing quantities in an increasingly consistent, sustainable fashion of humanitarian assistance, not just into the center itself where the bulk of the population – pre-Rafah operation – were living, but also into the north, which for so long had been denied the ability to be supplied or even to have credible, comprehensive assessments made of the situation there – the humanitarian situation.

That progressive improvement, which the opening of the JLOTS maritime corridor, was seen as an adjunct to – not a substitute for, but an adjunct to – was certainly reversed with the initiation of the Rafah operation. It is, as you have noted, extremely difficult for the international humanitarian actors – NGOs, the U.N. in all of its dimensions – to consistently move, at scale, assistance into the center itself. This is not just a question – I don’t even think it’s primarily a question of physical danger or classical deconfliction. It is congestion, it is the introduction of very significant quantities of commercial goods, which are moving on only – now – a very limited number of roads. It makes it very difficult to do two critical things: first, to move the kind of specialized feeding assistance that’s needed to deal with malnutrition, with wasting, with infant and young child mortality and morbidity to all the places where that is needed. It has interfered with the ability of the humanitarian community to make accurate assessments.

If you ask me, so is there starvation, is there famine in center and south Gaza, or in the north, that’s a very difficult question to answer. We can certainly acknowledge the extraordinary risk, and it’s a risk that has increased dramatically since the 6th of May and the initiation of the operation. But the precise details of what’s going on, and thus the means needed to specifically address them, are very hard to come by, and that is all a product of the kinetic operation and the displacements that have taken place.

But I want to not pivot from but to add to that discussion, with humanitarian dimension, the real question, which is strategic – strategic for the U.S., strategic for the fate of Palestinians in Gaza and the West Bank, and the region as a whole, which is the day after, the madha baed (ph), the what after, as it would be referred to in Arabic.

What is the day after? Now when I’m asked the question, in my previous role, I said, well, you know, my job is to make sure there is a day before that permits a day after to be contemplated. But the real issue here is can there be a security, a political, administrative reset in Gaza that does not allow Hamas passively or actively to remain, to resume, being the effective governing authority.

Because if that’s the case then all of this – all of the sacrifices, all of the humanitarian crisis, the Israeli dead – all of this will not have produced a positive strategic outcome not just for Israel but for all of us and for the region as a whole.

Hamas is deeply embedded in Gaza far more than any of us assumed when this campaign began. Its military strength, not a terrorist gang but a terrorist army 30,000 strong in tunnels hundreds of kilometers long at depth, this was beyond what was anticipated.

And I’ll just make a final comment, because we can talk about all of this during the dialogue, is nobody has fought a campaign like this. We haven’t. Israel hasn’t. No modern army has done this.

It’s a campaign above ground and below ground. It’s a campaign against a deeply entrenched, very well equipped, very coherent military – it’s a terrorist military but it’s a military more than a gang – and it’s done in a compacted compressed space where the terrorist force has had 16, 17 years to deliberately embed itself in, under, around not just civilian infrastructure but humanitarian infrastructure as well.

That was a deliberate strategic act on the part of Hamas, the consequences of which are the very grave, very serious humanitarian consequences images that we’ve all seen over these seven months.

This is really hard but the outcome matters. It matters to the U.S. It matters to every state in the Middle East. It matters to Israel and Israelis and it matters to Palestinians.

Dr. Morrison: Thank you, David.


Nick Schifrin: Well, I just want to say thank you, Stephen, and thank you for asking me to join this panel and, frankly, I’d be more interested in asking all you questions.

And as Ambassador Satterfield just very, very well pointed out how difficult both the human toll and the strategic questions are and so I don’t intend to quibble at all with what Ambassador Satterfield raised and so, perhaps, I can add just a couple of extra points on top of what he said. As someone who as a policymaker once put me down saying, well, I peddle in anecdotes, so perhaps I’ll peddle a few anecdotes and see if they’re helpful.

The first thing is I’ll start where Ambassador Satterfield left off which is the idea of Hamas in Gaza and why this is so difficult. It is not just that Hamas has strategically made a decision to embed itself inside Gaza. Hamas has become part of Gaza and Gaza has become part of Hamas, and what I mean by that is, you know, I spent not only seven weeks in Gaza in 2014 during wartime but many weeks before that during peacetime – relative peacetime – and then since then multiple trips ’16, ’18, and ’20 during wars and before wars is that you don’t meet a family who is anti-Hamas or pro-Hamas.

Hamas is just within the family, whether it’s because there’s a member of the family who works for the government, right, whose salaries are paid for by the Palestinian Authority, and we can talk about Israel and Bibi’s own history with that, or is a fighter or is a militant, right, who has a particular opinion about Israel and, therefore, wants to fight and the idea of separating Hamas from the population of Gaza is just never going to happen and I think Israeli officials, certainly military officials I’ve talked to over the years, would agree with that.

But the challenge that they are faced by October the 7th by the nature of the attack is such that the Israelis have had to fight. The closest thing we’ve done to that is in Mosul and Fallujah. And so what Netanyahu has argued and with specific numbers more recently is the ratio is one to one. We have killed as many militants as we have civilians.

The problem with that is twofold. One, that means you’ve killed 14(,000) or 15,000 civilians as the world watches, right. This is not even Mosul and Fallujah where, frankly, there wasn’t daily coverage. Whether it was because of ABC News or Al Jazeera, just the nature of the fight didn’t allow daily coverage or the editors didn’t invite it.

This is daily, nightly, coverage both on social media and on primetime television in America and we need to acknowledge the impact that’s having. So that’s the first problem.

The second half – and the chair and the ranking member of the Senate Intelligence Committee just made this intelligence public and, you know, Ambassador Satterfield knows more about this than we do, but if the ratio is 1:1, that means Israel has killed half or less than half of Hamas. And the chairman and the vice chairman of the Senate Intelligence Committee made public that they have taken out less than half the tunnels. So here we are, however many months later, with the toll immense and the challenge is so large that even the IDF could only achieve that. And so that leads to the question, all right – the phrase is Yiddish is oubriete (ph) – now what, right? Now what, smart guy? And that leads to the question of OK, well, how are you going to defeat Hamas and what is the political solution? And there are actually options on the table for Bibi, for the region, for the international community, and I’m sure we’ll talk about that.

One last point about famine and about opinions. Ambassador Satterfield, again, laid out better than I can or anybody can how difficult it is for the humanitarians to work and therefore how difficult it is for them to really know what’s happening. But we have a looming deadline or a looming prediction that the umbrella organizations that declare famine have said within days, by the end of the month, there could be famine in northern Gaza. Man-made famines are rare, right, and they’re incredibly unpopular – (laughs) – I mean, that’s almost like a stupid thing to say, but, you know, the national security adviser has pointed this out to Netanyahu and his team, and I’m sure other U.S. officials have pointed out multiple times, the creation of famine in Gaza is very bad for the Palestinians, very bad for Israel, very bad for Israel’s allies and partners, and that could be coming very, very soon. Cindy McCain, executive director of the World Food Programme, basically gave her opinion recently and said there is full-blown famine, but the umbrella organization that could declare that could do so soon. And on top of the diplomatic pressure on Israel, that would just be an extraordinary thing to say that in the 21st century a war has created famine among, you know, hundreds of thousands of people and that is really – could be looming.

Dr. Morrison: Thank you. Thank you very much.


Michelle Strucke: Thank you for having me today. You know, picking up on that point on the man-made famine issue, Samantha Power, the USAID administrator, has said there is famine. Cindy McCain has said there is famine. The IPC indicators cross the threshold that would allow the U.N. to declare a famine.

Mr. Schifrin: IPC is that umbrella organization that I was talking about, yeah.

Ms. Strucke: Yeah. So but – well, the United Nations. So the United Nations – there’s the independent and impartial committee that does the kind of fact checking but they never declare a famine; it’s not their role. The U.N. can declare it, the State Department can make a determination. Those things haven’t happened, but that doesn’t mean that there isn’t very concerning evidence. I think no one is disputing, except the Israeli government who says there’s no famine and there’s no humanitarian crisis – are not disputing it. And I think that point is significant because, to me, as a person who worked in humanitarian organizations, that worked in humanitarian assistance with the U.S. government, the kind of humanitarian, almost diplomatic gaslighting that is happening, where humanitarian organizations, professional, impartial, independent organizations that are not only receiving U.S. taxpayer money to put their lives at risk to go and deliver aid in Gaza are then also being told by authorities that there’s not really a problem here. I take issue with that. I think that’s an important thing to put on the table because they have staff that are, again, putting their lives in harm’s way and they’re encountering incredible problems on the ground in distribution of aid, in deconfliction, because, as much as – with respect to Ambassador Satterfield, you’re saying it’s not physical safety. I think that the lives of more than 190 U.N. staff being taken in this conflict, a historic number of journalists and aid workers that, frankly, don’t feel safe is indicating that there is an issue with physical safety that continues, as they’re trying to navigate the operational obstacles of having to deliver aid under these circumstances.

And I will say, too, that the interesting part – you know, the fact that the DOD-created pier was made to augment other aid delivery mechanisms, and you said that quite well, that is a really important point, but I think it kind of hides a contradiction that we should look at, which is that $320 million of U.S. taxpayer money spent on this pier is a significant number. The U.S. DOD budget for humanitarian assistance, the OHDACA account, usually every year is about 130 million (dollars). And that’s for global support to humanitarian response, and disasters, and demining efforts. So to take 320 million (dollars) – and I don’t know if all the funds are coming from that. I imagine that it’s from other parts of DOD as well. But that is a significant sum.

And that – $320 million – so almost – so more than doubling the amount that the U.S. usually spends per year on U.S. military support to humanitarian assistance, the fact that that is happening demonstrates, I think, not only the political will by the U.S. government to try to get humanitarian aid in themselves, but it also demonstrates proof that aid – not enough aid is flowing into Gaza, which is causing the U.S. government to have to take what are essentially extraordinary measures to provide an augmented channel which, as we’ve seen in the last few days, is simply not effective because of issues on the ground, like deconfliction, like distribution efforts that are – that are hindered.

So it’s contradictory, on the one hand, to say that there – you know, there is no humanitarian crisis, that there is no famine happening – which is, again, what the Israeli authorities and War Cabinet members continue to say – while still saying that they’re attempting to get aid inside and opening up every channel they can. And for the U.S. government, you know, I think what we’ve seen on the – your question on what do we do going forward? What are the policy solutions? The U.S. has demonstrated that when they’ve taken more decisive action on the security cooperation side to us that, use its leverage in private – in private negotiations, but then also increasingly in public view, that has spurred decisive humanitarian action by the Israeli government.

They’ve opened more border crossings. They’ve looked at different options. They’ve tried to start to do things like pave roads to allow aid to get in, or themselves pursue actions. It’s really important that the U.S. continues, as they did in NSM-20, the national security memorandum we discussed before, to look at using the tools in their toolkit, including limiting particularly offensive weapons going to the IDF, as a means to pressure them, this very important ally, to allow humanitarian assistance to come in. And to – and to face the facts, to admit the facts.

So I’ll stop there, but I think it’s a very important discussion of what is the suite of tools that should be used by the U.S. government to push for more concessions, especially as we have escalation in Rafah which, as you mentioned is a catastrophic escalation, on the table.

Dr. Morrison: Thanks, Michelle.


Dr. Alterman: Yeah, I agree with a lot of things that have been said very articulately. But I think the other element, and David knows is much better than I do, is working through differences with Democratic partners who have the public support of their population, is a different kind of problem than what we’d like to do in other places. Oftentimes, democratic partners, we’re all aligned. The G-7, we’re all aligned. We see the world a lot the same way. Sometimes we don’t. The British thought we were crazy about the Iraq War. They made their own decision and were criticized for supporting us in the Iraq War.

But I think that the challenge that we have is Prime Minister Netanyahu is not a right-wing crazy, in Israeli political terms. And I think people actually overestimate the extent to which he’s being trapped by his right-wing allies. I think he has a remarkable sense for where the center of Israeli politics is. Israelis remain deeply traumatized by the events of October 7th, as we were traumatized for years by the events of September 11th. The Israeli – the Hebrew language press in Israel has almost no coverage of any kind on the humanitarian consequences in Gaza. And there is no Israeli public demand to meet the humanitarian needs in Gaza.

Instead, it’s talking about our martyrs, talking about our heroes, talking about the need to uproot Hamas decisively, permanently, notwithstanding what Nick has said about the fact that that’s not really doable. But that’s where the public is. I think Netanyahu appeals to that notion, to that logic. The last poll I’ve seen said that about 48 percent of Israelis agree with Gallant’s idea there has to be a plan. About 34 percent agree with Netanyahu’s argument that first we win and then we talk about the plan. But when you actually move from the idea of a plan to a specific plan, it seems to me that those even out. And then Netanyahu, who is the longest-serving prime minister in Israeli history, a very shrewd and skillful political actor, I think Netanyahu is dealing with this politically. I think trying to pressure him diplomatically without addressing the political context and his ability to feed on his domestic political context, I think, is going to be an exercise in frustration.

To an extent, this is what Yahya Sinwar and Hamas wanted to do, right? They wanted to divide Israel not only from Arab countries that were increasingly willing to engage with Israel; they want to divide Israel from the Global South, where Israel had been making increasing leaps, including with China and other countries; they are delighted to divide Israel from Europe; they’re delighted to have support for Israel become much more of a political issue in the United States – and by the way, I think the Russians were also delighted by this.

So it seems to me that what might be the obvious thing of, well, we give Israel billions of dollars a year, we’ll just turn the screws and they’ll do what we want, I’m not sure in this circumstance that gets you where you want to go. And I’m not sure, if you’re not going to address the issues of a democratic public in a state that’s a partner and ally, I’m not sure you can be very effective working through closed diplomatic channels. Certainly, after World Central Kitchen we got some very important things done. But I think there are real limits to what you can do as long as Israeli public opinion is where it is.

Dr. Morrison: Jon – and maybe David can comment on this as well – what’s the consequence of Benny Gantz coming forward and saying we’re laying down an ultimatum of three weeks out, early June, wants to see a plan, and Defense Minister Gallant voicing his objections to the – to the Netanyahu unwillingness to talk about the day after?

Amb. Satterfield: You want to start, Jon?

Dr. Morrison: What does that mean? And now you have the ICC request for warrants.

Dr. Alterman: Yeah. So when I first met David decades ago, he was the deputy assistant secretary of state responsible for Israel. He understands Israeli politics – (laughs) – better than I ever will.

My sense is that Gantz made a fundamental mistake because he didn’t create an alliance behind his ultimatum. And he doesn’t bring down the government by leaving; he isolates himself. Netanyahu has continually bested Gantz politically. And while I understand the polling suggests that Gantz is above Netanyahu as the next prime minister, Netanyahu is rising and Gantz is falling. I wouldn’t put my money on Benny Gantz’s ultimatum changing anything. There are no circumstances – none – under which I can imagine Netanyahu will meet Gantz’s ultimatum.

Gallant is an interesting issue. But again, if your plan is a plan, that’s lovely; but to actually introduce a plan and to stress test it and to get people onboard and implement it, that’s a different task. I hope Israel goes that direction. I think it’s necessary for Israel to go in that direction. But does that change Israeli politics? I don’t know. It seems to me that the issue that I’ve been hearing from people in the U.S. government is the hostage families feel they’re getting more from the U.S. government than they’re getting from the Israeli government. And if your theory of the case is the way this ends is you get the hostages back and you get a ceasefire, that the folks who are working to make that happen are on the side of the angels and the folks who are blocking it are the problem, and the perception of a growing number of Israelis – still not a majority, but a growing number of Israelis – is Netanyahu is becoming part of the problem not part of the solution, I don’t know how that plays out over the next several months, but it seems to me that’s the issue. That’s where some of the ICC things come in as well.

Dr. Morrison: David?

Amb. Satterfield: Let’s talk again about where this all goes, the tell me how this ends. And I have to remind folks here this didn’t start because of an Israeli calculation to malevolently attack Palestinians in Gaza; there was a massacre of historic post-Holocaust proportions. Jews were killed, brutally, bestially, in Israel as a calculated act of terror intended – it mercifully failed because of Sinwar’s miscalculation from the tunnels – to elicit a full-blown Iranian, Hezbollah, and Arab street uprising attack on Israel. Let’s not ever lose sight of how this began.

There is no justification for such a massacre. Can’t be, A. B, any state in this world with the capacity to respond would have had, as the president said on October 18th and 19th, an obligation, not just a right, to take every possible action to prevent it from happening, as Yahya Sinwar and his officials have said, again and again and again.

So let’s not ever lose sight of what the not just initial problem was – the October 7th massacre – but what the challenge is. This is a brutal terrorist force which cheerfully will sacrifice Palestinian civilians.

Now, we counseled Israel strongly privately and publicly for a very long period of time – no secret here; Jake, Secretary Blinken, the president has made reference to this – against a Rafah operation of the character that – we thought full-blown ground maneuver campaign would do two things. It would produce a far more significant movement/displacement of persons out of Rafah than Israel calculated on. When they speak of precise operations, our experience with Khan Younis in particular but also with the north Gaza operations is doesn’t come out that way. And indeed, what was to have been a precise operation for maybe a hundred (thousand), 110,000 in eastern Rafah has now moved to estimates of 800,000-plus, not because they had been ordered to evacuate by Israel but because they’re voting with their feet.

Dr. Morrison: They’re panicked. Yeah.

Amb. Satterfield: They’re moving out of harm’s way. Getting out of Dodge.

So the first concern was the displacement and how you met humanitarian needs of those displaced. We did not see a credible plan. We had a serious plan presented to us, but we didn’t believe the timelines or the substantive assumptions in the plan would work. That was the first concern.

The second concern was the kinetic operation in and of itself would interfere with the ability to move humanitarian assistance through Khan Younis – I’m sorry, through Kerem Shalom and through Rafah and, indeed, that has been, sadly, validated in spades.

It is very hard physically to move assistance in through Kerem Shalom. The Egyptian decision to use denial of movement of any humanitarian assistance or fuel from Egypt, the massive quantity of aid stacked up in north Sinai, to withhold that as a deliberate pressure tactic to bring about a halt to the operation and a reopening of Rafah that was another dimension which, very frankly, took us all and the international community by surprise and we have urged Egypt to move forward with Israel in restoring the flow of humanitarian assistance into Gaza.

It’s there. It would be complex to move it because of the kinetic actions inside Gaza. But taking that out of the picture and trying to supplant it with commercial assistance coming out of Israel, coming out of the West Bank, it doesn’t work. You need the humanitarian actors on the ground there.

But I want to go to what Jon said about consequences. When Benny Gantz, when Yoav Gallant, speak to the need for a plan they are speaking to – and I’ll put the politics aside – they’re speaking to exactly what we are right now.

There must be a cogent security/political resolution plan for all of this that is strategic in its dimension. It has a regional character to it, and it’s not just the Saudi normalization deal – that’s part of it but not all of it – and it must include a vision, a pathway, to a two-state resolution.

That’s very distant, Jon. I know that. I’ve seen the polls. I’ve talked with Israelis from across the spectrum. It’s really hard to contemplate.

But if you don’t hold that horizon out there then you will never compete with Hamas’ very well established, Nick, as you said, integrated into Gazan life. You’re never going to be able to counter that.

You’ve got to have that as part and parcel of all of this. If you take that away, if you have no ability or only limited ability from a military standpoint to eliminate or even significantly degrade Hamas, you’re left in a very difficult situation. And the “you” here is not just Israel; it’s us, it’s Palestinian Authority, Palestinians, and it is the entire region.

And I’ll make one anecdotal point here. What’s the greatest fear on the part of every regional government, really? It is that in the face of the images coming out every day of Gaza, and their impact on their street, the rising popularity everywhere – but in Gaza, where it’s dropped – of Hamas, that Israel will not be able to do the job. They, at the end of all of this, will not be able to diminish and degrade Hamas. That’s the single greatest fear. And Sinwar – my own view is, yeah, Sinwar is perfectly happy, if it comes to that, to be a martyr because his legacy, leader if the resistance throughout the region, will go on.

I don’t think he thinks that’s what’s going to happen, any more than Vladimir Putin thinks he’s going to lose in Ukraine. They will wait it out. They are, as Hafez al-Assad used to say, “tawil min altanafus,” long of breath. We’re strategically impatient – for political, for other reasons – “we,” the world. They are endlessly patient. They will wait it out. And they will be the victors in all of this. That would be a terrible outcome, terrible strategically for all of us.

Dr. Morrison: I want to bring the conversation back to the sort of reality that we’ve got a million people displaced into absolutely inhumane conditions. We have a humanitarian community to that saying it has become so dangerous during this – during this current military operation that it’s very, very difficult to operate. We have gates closed. We have no deconfliction mechanisms in place. We have, you know, the – none that – I mean, there’s the experiment on the JLOTS pier, DOD pier, which has brought in, you know, a very modest number of relief.

We’re back to where we – you know, back into a pretty nightmarish scenario that is going to carry forward. And it’s going to be of – make for a very ugly summer in our own domestic politics here. We own this in the minds of many people who are critical of the administration. We’re seen as part of this. And the NSM-20 analysis drew conclusions that assistance should not be disrupted to Israel, but it documented – in the analytic side – documented very clearly the degree to which the Israeli government was blocking humanitarian access. And the ICC request is focused on that as well.

Nick, where – how do we – how do we reset our thinking? And we’re not going to have a strategic resolution, as David has – and Jon have emphasized. We need that as the ultimate solution. But if that’s elusive – which by all signs it looks pretty elusive – we have to deal with this current reality that’s staring at us.

Mr. Schifrin: Well, yeah. And I defer to the humanitarian expert on some of those details, so I’ll turn to her. The only thing I’ll say, as Jon was about to say, the deconfliction aspect actually has gotten a little bit better. And what Ambassador Satterfield was mentioning is that the trends were going up –

Dr. Morrison: In April.

Mr. Schifrin: Ironically, because of the World Central Kitchen horrific, horrific incident – which was not only horrific because it took seven lives, it was the nature of how the Israeli military, accidentally, essentially hunted foreign aid workers. And that’s the word that Jose Andres, the head of World Central Kitchen, used. And if you just follow what the drones did, you know, that’s what the conclusion that World Central Kitchen made.

So but I want to – I’ll turn to Michelle on the details. So just want to point that out, the deconfliction – they’re trying. But, again, it took them six months. It took them the World Central Kitchen incident to have a deconfliction cell in the south. And it took extraordinary U.S. pressure, mostly from this man and others, to do those things. And I’ll just say again, anecdotally, 2014, we saw a lot of these problems back then, right? But the Israelis had a different approach tactically. They actually brought the NGOs in every morning and had extraordinarily detailed maps. And the NGOs knew exactly where the strikes would be that day. And there was a lot of communication.

That just hasn’t happened in this war. And I won’t put an opinion out there, but the people I talk to suggest that that’s a product of exactly what we’ve been talking about, the nature of the shock and horror and anger from the Israelis. They fought this war differently than previous wars that they fought in Gaza. But I’ll let you go into the details.

Dr. Morrison: I mean, Nick, in preparation for today I spoke with – in the last couple of days with a number of people, including senior U.S. officials who are involved operationally in trying to work things, and as well as international NGOs and U.N. officials. And that’s where my remarks are coming from in terms of the sharp escalation of insecurity for humanitarians, and the absence of effective deconfliction –

Mr. Schifrin: Yeah, look, I don’t –

Dr. Morrison: – in this setting. And yes, there are – people acknowledged there were modest gains in April after the president’s statement and after the killing on April 4th.

Amb. Satterfield: I’ve got to interrupt. They weren’t modest; they were dramatic. They were enormously significant. The amount of assistance moving in through two new land corridors opened – Zikim and Erez – so, what, Erez West and East – through Gate 96, the central corridor crossing point, through upgrades and expansions of the operations of both Nitsana and Kerem Shalom, the ability to open Ashdod to direct delivery of non-flour-related humanitarian assistance – these weren’t modest little steps, and for seven months, I worked with the international humanitarian operators on the ground – as well as in Geneva, as well as in New York – but on the ground we talked and met continuously, as we did with our Israeli counterparts.

We agree on the progress, but slow progress, that marked October to March, but what we had in place collectively in that first week of May was exceptional. It was no longer a question of famine or starvation, but how could you get specialized feeding in to deal – not just truckloads; we weren’t looking at the metric of truck numbers anymore. And the we, as a collective we – it’s not just the U.S. It is the actual operators on the ground from the humanitarian community. We were looking at how do we get the issue of mortality, morbidity, wasting – which is a strategic challenge – and malnutrition addressed.

We were in a far better place – still not good enough by any means – but a far better place, so I absolutely reject these modest, insignificant gains. They were enormous, the JLOTS offered the potential to augment what was already happening with at least a transitional, temporary, additional infusion of assistance that could go north or south as required. That was interrupted and interrupted catastrophically by the Rafah operation, about which I don’t think any of us have any doubts.

Mr. Schifrin: And consider – (laughs) – that narrative being presented to Israeli officials day after day after day, and yet Rafah still happened. We can talk about why and what, but just think about that. Anyway, I defer to the expert on the specifics.

Dr. Morrison: Michelle?

Ms. Strucke: No, I agree. I mean, in this broadcast we’ve talked about those asks before they happened, about, you know, echoing the need to open those specific crossings, and agree that the gains were dramatic.

At the same time, comparing it to the total siege that happened at the very beginning of the crisis for two weeks where no aid got in, and even comparing to just the immense delays, blockages, turning trucks around based on items that were called dual-use that were, you know, essentially everyday humanitarian items – all of this, I think the comparison is worth seeing, that it was – it is – it wasn’t enough at its best point, and it was at such a low bar that it literally caused a man-made famine.

So I think that while the gains should rightfully be recognized, it still is on a scale that was way too low to begin with and continues to be catastrophically low, which is – again – why people are starving. And, you know, in order to send those highly nutritious, therapeutic foods and then target them, you do need a sophisticated apparatus of distribution, which is very difficult under the circumstances we mentioned.

One thing I wanted to comment on is this, you know, very important point that Ambassador Satterfield has made and we’ve talked about, about specifically the kind of – the fact that there is strong justification for Israel conducting this war. All of this is essential. It’s obviously guiding the emotions, it’s guiding the decisions that are being made.

But under the Geneva Conventions, which just reached their 75th anniversary – we’ve just been celebrating that with the ICRC and others, and the Swiss Embassy and others the past few weeks. The whole beauty of the Geneva Conventions, which every country – 196 countries have voluntarily ratified. No one forced them to ratify the Geneva Conventions.

It doesn’t matter whether the cause is just. What it – what it regulates is that every party, no matter how horrendous your adversary is, no matter how hard operationally a conflict is on the ground – and as you mentioned, this conflict is unprecedented in its characteristics; and as the U.S. military and others and other governments are looking forward to future conflict, they may also be unprecedented in how bad they will be – that does not excuse in a single day a country saying that they can therefore do anything they want, and that war is unbound, and that the rules of war don’t apply.

So that’s why, for me, I think it’s, again, very significant to not get distracted by very good, moral justifications, valid emotions based on how terrible this is – it’s significant to me that the United States in its initial response to the Israeli government, you know, noted and reflected on the past 20 years of war, and that moment of 9/11 and how it caused essentially this, essentially, military reaction which could have been viewed as disproportionate. In this case, I think it’s really important to center the fact that the Geneva Conventions – not obstructing aid, allowing aid to go in not during certain points during the day on certain roads at certain hours, but all the time – unfettered safe humanitarian access is a requirement of the Geneva Conventions; and that, you know, the specifics of, you know, arguing over, again, the kind of what I’ve described as like a Swiss-cheese approach to international law of cherry-picking provisions; is not acceptable because the cost is – as we’ve talked about on this broadcast, the cost is human lives.

Dr. Morrison: David, what leverage do we have now to deal with this burgeoning crisis growing out of the Rafah operations? And what should we – what should we be prioritizing right now? Because it’s a – it’s a pretty awful situation that we face. I mean, there’s no dispute as to the magnitude of what’s happening right now. I mean, we can debate as to how we characterize the period of gains in April, and I take your point about, you know, acknowledging the – Ashdod coming online and the 96 – the Gate 96 and the other steps, but it’s – things are – things have seized up.

Amb. Satterfield: Indeed they have.

Dr. Morrison: And we have a million people that are in complete peril and a much bigger number than that that have been under extraordinary stress. And we’re going to see excess mortality. We’re going to see extreme malnutrition. We’re going to see all sorts of things happen. And as Nick pointed out, it’s going to be on our screens day in, day out in the middle of our own political season, and the emotions are very high. We’ve had campuses disrupted. We’ve had – you know, we’ve got a convention in Chicago coming up. We’ve got a convention in Milwaukee coming up. There’s – it’s going to be a tough summer. And what – you’ve thought deeply about all of this. What’s our leverage? And what should we be – how should we be proactively stepping in to say we’re not just going to wait for this Rafah operation to be concluded before we can revisit any of these – we don’t have the leisure of that, we own this problem in the minds of many people who are criticizing the administration, there needs to be a proactive strategy right now? What’s your – what’s your thoughts?

Amb. Satterfield: Well, our strategy is to focus on two things.

The first, and always, is the humanitarian dimension here, because the humanitarian dimension shapes both reality and perception in Israel, around the world on what is going on, and here in the United States. We know that. And it is the right thing to do. All other factors aside, it is the correct moral thing to do, value-associated thing to do. We are doing all we can with the humanitarian community, with the Israelis. We’ve worked continuously. It is very hard. It is harder, in fact, right now in this situation post-May 6/7 in Rafah than it was for most of the five months that preceded it, where the trendlines were continuously upward. Not enough – Michelle’s right, not enough – but they were upward. Now it’s all being reversed or has been reversed. So our focus is on humanitarian.

But it is also – and listen to what not just our colleagues in Israel – Gallant, Benny Gantz – are saying, but what we are saying at the highest levels of the U.S. government, the president articulating there has got to be a strategic plan for how this ends. Do Rafah, don’t do Rafah; we have other views on how Rafah could have been done, could still be done, apart from a major ground maneuver campaign into central Gaza, which has not yet taken place.

Dr. Morrison: Central Rafah, yeah.

Amb. Satterfield: Into central Rafah, right. We have our views on that, which we made clear. But there’s got to be an overarching political strategic vision as well here. A lot is at stake for Israel, its security, its future in the region, in the world. Witness the decision by the three European states to recognize a, quote, “Palestinian state,” close quote. All of this has to be addressed through political steps, not just through military steps. So we don’t see that happening. We have been as clear as can be about what is needed here. And it is the pathway to a two-state resolution. It is bringing down this ground campaign, restoring humanitarian access, restoring the ability to address the needs of Palestinians, stabilizing the situation.

I say that all. It’s easy for me to articulate. It is in the face of a Hamas which will, and is, capitalizing upon every moment that goes by. And to believe Hamas in the least cares about any international humanitarian principle is absurd on its face. They’re going to be a challenge – a challenge to the region, a challenge to Israel. And if you can’t address that, if you can’t show to an Israeli, displaced from the north, displaced from the Gaza corridor, or not displaced but who knows a hostage family, who knows someone killed in the massacres on October 7th – and almost every Israeli does – then you’ve got a traumatized nation which is not going to be able or willing to make the kinds of broad, long-term strategic decisions we think are necessary, or which we have a great ability – you’ve been quite accurate in your comments, Jon – to decisively shape.

We cannot turn on and off policymaking in a democracy. That is very hard to do. We have suspended the delivery of the two iron bomb systems, 2,000-pound, 500-pound, because we thought those systems in a Rafah urban campaign were unnecessary, and moreover inappropriate for use, based on the history of their application. But we continue to robustly supply, as we should and must, Israel’s needs in terms of prosecuting a cogent strategic campaign against this terrorist force.

Mr. Schifrin: I think it’d be – oh, sorry, Jon.

Dr. Alterman: No, I totally agree with David. I think that the very difficult reality is two-thirds of Israelis don’t believe in a two-state solution right now. I don’t know how many Palestinians do. If we’re not addressing that issue – not just say and of course you should, because they don’t. And I think a large part of our diplomatic engagement has to be working with states around the world, with regional states, with others to try to make that pathway look like one that actually increases security for both sides, rather than one that undermines security for both sides.

And this is one of the reasons why, you know, I’m concerned by the ICC decision, because it doesn’t seem calculated to get hostages home faster. It doesn’t seem calculated to end the fighting faster. It doesn’t seem calculated to do anything especially constructive, if your goal is to build the confidence of Israelis and Palestinians alike that there’s a future where there is security for both sides. And I think we have to – that, again, you’re dealing with a democratic public. And all the leverage in the world is not going to get a democratic public to flip to meet your security demands.

Mr. Schifrin: I think Karim Khan, if he were here, would say, that’s all well and good but that’s not my job. That’s the politics. And I’m about justice. And he sees in this moment his responsibility.

But leaving that aside, I think it’s important to lay out some of the oubriete (ph) – what would be next, smart guy – options, because – and I think the point that I want to get to is, the theory of the case, as Ambassador Satterfield, the national security adviser, the secretary of state, and even the president has laid out, there’s a big gap. And this is the point that I want to get to. There’s a gap between the theory of the case and the –

Dr. Morrison: What’s possible.

Mr. Schifrin: What’s possible, realistic, or likely. And so if we take on the one side the Israeli plans, right? So occupation is what Defense Minister Yoav Gallant essentially accused Netanyahu of defaulting into. For lack of a cogent plan you end with occupation. So let’s just put occupation as one option; that’s easy. Netanyahu’s plan – so let’s give him credit for one second and say he has a plan – has essentially been to find Gazans – essentially we call them Gazan families – or find influential Gazans who are neither Fatah, who are neither Palestinian Authority nor Hamas, to be able to take over security and governance while the military does what it does. Most experts – I defer to the experts – think that it’s unrealistic, and that’s charitable. Even Netanyahu himself has said Hamas has not allowed that to happen. OK, so those are options number one and two.

Three: The shining beacon on the hill, the U.S. plan, that is not only the end of the war but is like a Sadat moment of Mohammed bin Salman, the prince – the princeling of Saudi Arabia coming to Jerusalem, you know, saying I’ve got this plan, Bibi jettisoning probably his coalition in order to make the deal. I mean, wow, right? Like, giant plan on the hill.

So we’ve got occupation, which everybody says nobody wants; Bibi’s plan, which apparently isn’t possible; and this shining this on the hill, which, my god, of course everyone would love but the possibility of it happening under this prime minister and this government, very low. I’m not saying it’s no, but it’s very low – which leaves what? I’m reminded of, like, the Afghanistan debate where the military boxed Obama in, right? It was like, sir, you could have really hot or really cold. But this is kind of Goldilocks. The problem is, what’s Goldilocks in this case? The Hamas plan, right? So it’s not occupation, it’s not the shining city on the hill, it’s not the Bibi plan; it’s what Hamas has offered, which ironically is what a lot of the Israelis who are on the streets in Tel Aviv are demanding: the return of the hostages. Only problem is that Hamas survives. The war ends, Hamas gets a deal to somehow survive, even if it involves some kind of exile of its leadership, gets reconstruction money, and we go back to the status quo, which, of course, nobody wants. After so much death, after everything we’ve talked about, and yet, and yet the concern is, is that becoming almost a Goldilocks option? And that’s the problem between the huge gap between the theory of the case that you guys are presenting – hey, Yogi Berra, there’s two options here; instead of taking an option you take the fork, right? And ironically what is, unfortunately, again, you know, to most people emerging as this middle thing? Well, maybe that’s the Hamas plan –

Amb. Satterfield: But Nick, there’s a problem here with the Goldilocks solution and it’s the UAE, the Saudis –

Mr. Schifrin: Oh, that’s a good point.

Amb. Satterfield: – and the Egyptians –

Mr. Schifrin: Yeah, they don’t want to do it.

Amb. Satterfield: – who frankly are not going to put a boot, a shoe, a buck into Gaza if it is only in order to revalidate – passively, behind the curtains, or quite actively – a Hamas governance of Gaza. They’re not going to do it. They also demand elimination – let’s get rid of that word – but a sufficient disruption, derogation, diminution of Hamas’s power that, with a political vision, with some kind of stabilization, you come out with a different outcome that doesn’t have Hamas in a dominant position. If that’s a solution, then you’re going to get participation in it. That is very difficult to envision at this moment because of the extraordinary resilience of Hamas in the face of all of this.

Mr. Schifrin: Militarily, as I discussed at the beginning, right? I mean, half the tunnels, half the soldiers, after so much time – maybe it’s a little bit higher but give or take, right, and I guess the official number’s classified, but, like, you’ve got a long way to go if you are trying to defeat Hamas. And the problem, then, Ambassador, is OK, well, is there a fifth option? Is there something else, or do we just need to start – just need to keep on pressuring the Israelis to think of that shining city on the hill –

Amb. Satterfield: Well, there is another option but it’s not a satisfactory one from the standpoint of the United States, our partners or, we think, the region, which is this all just goes on, the humanitarian crisis, the military campaign, the repeat – rinse and repeat, no clear, no hold –

Mr. Schifrin: Mowing the grass, as the Israelis –

Amb. Satterfield: But it isn’t even that. It’s Dave’s – Dave Petraeus’s doctrine. You’re not clearing – not really – you’re sure not holding, and you can’t build under these circumstances.

Mr. Schifrin: And ironically, that would allow Benjamin Netanyahu to stay in power, but –

Dr. Morrison: And that is the likely possibility. We’re getting towards the end of our hour. I want to ask, I’ll start with Michelle, how bad are things going to get on the humanitarian side in the next month?

Ms. Strucke: I mean, I think that –

Dr. Morrison: They’re terrible now. How bad are they going to get?

Ms. Strucke: When you look at the issues with a potential Rafah escalation on the ground, border crossings remaining closed, you know, you could – we could see more humanitarian groups saying that they have to suspend operations. That would be significant. We could see much more escalation regarding the pier, in terms of as people feel more desperate they could, again, continue to go to those trucks and try to take the food for their families, and acts of desperation. And, of course, the reverberating effects, third-order effects, issues with not just the famine, starvation, malnutrition, infectious disease, but that on the population, I think we could see this get catastrophically worse.

That being said, no matter how long this conflict goes on – and we measure that every hour as humanitarians in the cost of human lives that are lost and futures that are – that are – you know, that are disappeared – the issue that no matter what the parties are doing and no matter what the other side is doing, they should make much more efforts to have a trust-based deconfliction system so aid workers can get aid in, and follow international law – international humanitarian law to allow that assistance to get in.

And fundamentally, you know, not shy away from facing the facts of impartial experts that are delivering that aid. So I think it’s just – it’s really important, again, to not get distracted by, you know, justifications, but to think about the fact that this is not a scenario where all – everything’s on the table, you can conduct yourself in any way in war. This is a scenario where humanitarian aid has to be, you know, tripled, quadrupled, and not completely closed off, as it is now.

Dr. Morrison: David, how bad is it going to get, do you think, in the next month?

Amb. Satterfield: If the current trend lines aren’t changed, then what is right now a near 100 percent risk of famine could see realization of famine and starvation, which would reverse six months of progressive progress in addressing basic needs, avoiding starvation, avoiding famine, and certainly make it very difficult to address the specialized feeding needs we have. Yes, it could get much more serious than it is now if there is no amelioration to these trend lines.

But they are all tied to the character of the operations in Rafah and their impact upon physical access, both from Israel – which is to say, how you get stuff from just inside Gaza, at Erez, at Kerem Shalom, into Gaza proper for distribution. And the problem of Egypt’s refusal to allow any assistance, any fuel, to move from Egyptian territory, as a political tactic. Let’s not forget what is happening here. Thousands of trucks of assistance, millions of liters of fuel, aren’t going in because Egypt refused to allow it to happen as a bargaining tool to get an end to the Rafah campaign and a reopening of Rafah as it was.

Dr. Morrison: Thank you. Nick, how bad is it going to get in terms of media visibility, in your view?

Mr. Schifrin: Well, I think, as the experts have just laid out, as we see more of that happening, and presumably the Israeli operation in Rafah, if we believe the defense minister and the prime minister, will continue and will increase, presumably we will see that. It’s what – it’s what you’ve pointed out, Steve, that you’re going to get the same level of horror on nightly newscasts around the world. But then the convention arrives, but then the election increases. And we don’t know what impact that’s going to have.

I mean, I think we see the trend lines, right? Like, for example, Arab Americans in Michigan. But we don’t know what the impact that’s going to be. But it’s going to have an impact. And if this war goes on, we’re going to be talking about a war in Gaza that is looking awful. We’re going to be talking about war in Ukraine, where Ukraine will barely be hanging on. And we know what former President Donald Trump will say is that President Biden is involved in two conflicts and hasn’t solved either one. And so you’re going to see that argument play out probably more publicly than before.

Dr. Morrison: Jon, your thoughts? I mean, what’s the next month going to look like, in your view?

Dr. Alterman: I worry the next month is really bad. I also worry that both antagonists in this war think time is on their side that they’re going to hang in there, that the stakes are so large the sacrifices are worth it.

We have – as I think David suggested, we have a timeline that’s fairly rapid. We have political urgency. We have a potential change in administrations. I think for both Palestinians in Gaza and for Israelis they see this as something that will affect generations already. This war has affected generations not just politically but in terms of stunting, malnutrition. The human costs on Gazans are going to be felt for generations.

But I worry that we have a policy process that, you know, our long – our very long term is two years. It’s the very long term, impossibly long term. It’s, like, for people who are fighting this war, prosecuting this war right now, they say this absolutely will sharply affect the future of my children and my grandchildren, and we have to dig in. And I worry that we are much further from the end than anybody on this panel in a million years would ever want.

Dr. Morrison: Thank you.

Ambassador Satterfield – David – thank you so much for your service to our country and the work that you’ve done, and thank you for being with us today and being so candid and open to all of these tough issues.

Nick, thank you for taking time out to come over with us again –

Mr. Schifrin: Thank you for having me.

Dr. Morrison: – and for all your great work. And my colleagues Jon and Michelle thank you for partnering in this and we’ll be back again soon I hope. This show will be the video from it and a transcript will be posted on the CSIS homepage so those of you who wish to access it can find it there.

Thank you.