The International Court of Justice (ICJ) issued an order on Thursday imposing additional emergency provisional measures Israel must follow in South Africa’s genocide case against the country. The order comes after South Africa requested additional measures in light of the worsening humanitarian crisis in Gaza, a request that Israel asked the court to deny.

The court unanimously ordered Israel to “take all necessary and effective measures” to ensure the “unhindered” flow of humanitarian aid into Gaza, including food, water, fuel, medicine and sanitation supplies. It stressed that Israel must do so in coordination with the UN “without delay” and specified that this necessitated Israel opening more land crossings into the territory. The ICJ also ordered Israel to ensure that its military does not take actions that could violate the Genocide Convention, including “any action” that prevents the distribution of aid.

The ICJ previously imposed provisional measures calling for Israel to enable humanitarian assistance into Gaza, prevent a “plausible” genocide of Palestinians, punish calls for genocide and preserve any evidence of possible Genocide Convention violations in its initial ruling on the case. The Thursday order noted that the “catastrophic living conditions” in Gaza have only worsened since then, saying, “Palestinians in Gaza are no longer facing only a risk of famine, as noted in the Order of 26 January 2024, but that famine is setting in.” The changing conditions render the initial provisional measures inadequate, the court found, justifying the issuance of modifications. In addition to the new measures, the ICJ reaffirmed the provisional measures from its January 26 ruling.

Palestine welcomed the additional measures and issued a statement shortly after saying it would intervene in South Africa’s case against Israel. South Africa’s Department of International Relations and Cooperation called the order “significant” and said:

The fact that Palestinian deaths are not solely caused by bombardment and ground attacks, but also by disease and starvation, indicates a need to protect the group’s right to exist. The most effective way to uphold this right is through prevention. The Court’s actions include specific responsibilities to prevent genocide.

The Prime Minister of Israel Benjamin Netanyahu and the country’s Ministry of Foreign Affairs had yet to comment on the order at the time of publication. The US Department of State said on X (formerly Twitter) that “the people who live in Gaza continue to face a horrific humanitarian situation. Humanitarian assistance must be a priority and it must be sustained.” US Secretary of State Antony Blinken added, “100% of the population of Gaza is experiencing severe levels of acute food insecurity. We cannot, we must not allow this to continue.”

Getting aid into Gaza has been a major priority for international groups, and a source of conflict with Israel. Groups like Oxfam have accused Israel of “deliberately” blocking aid to the territory and the UN’s head of humanitarian affairs condemned an Israeli decision to block UN aid convoys from accessing northern Gaza, saying it “only pushes thousands closer to famine.” Israel also had to send additional border security to prevent protestors from blocking aid into Gaza, after facing international pressure. The country denies that it is intentionally blocking aid, and its official response to South Africa’s initial ICJ finding pointed to efforts it says it has made to expand food access. 

Gaza has been decimated in the nearly six months of war following Hamas’s October 7 attacks. Reports from the BCC and the Guardian show that at least half of the buildings in the territory have been damaged or destroyed, including entire neighborhoods. Israeli strikes have hit locations including medical facilities and refugee camps, and human rights groups have accused Israel of war crimes. This has had devastating impacts on civilians. Nearly 2 million people, 85 percent of the territory’s population, have been displaced by the violence and more than 32,000 people have been killed—mostly civilians. Survivors face a collapsed medical system and imminent famine.

The UN Security Council recently passed a resolution calling for an “immediate” ceasefire, the “unconditional” release of hostages and a dramatic surge in humanitarian aid.