There were two agreements, ratified by an overwhelming vote of the Israeli Knesset. One was a peace treaty that was signed 6 months later between Egypt and Israel, and which has been meticulously honoured by both sides. The other was a commitment by Israel to withdraw its political and military forces from Palestinian territory and grant the Palestinians full autonomy over their own affairs.
During my visits to the region, I have seen how basic survival is gravely hindered by limited supplies of food, fuel, electricity, and potable water. It is devastatingly apparent how decades of military occupation, unemployment, poverty, imprisonment, and fighting have left the Palestinian people vulnerable to ideological extremism and without hope for a more peaceful future.
The Gazan health-care system is severely damaged, overstretched, demoralised, and short on essential supplies. Skilled health personnel are scarce, and those that are available often are encumbered by inefficiencies and danger from military attack.
1,500,000 people are imprisoned in Gaza, with no access to the air or sea and extremely limited—mostly non-existent—opportunities to enter or leave through land portals. Many needless deaths have occurred as a result of Israel’s denial of permits to those seeking tertiary care. Even in the West Bank, despite heroic efforts by Palestinian doctors, the tightening occupation results in severe restrictions on movement that cost lives and feed deep resentments.
The health situation in the occupied Palestinian territory shows the urgency of finding a political solution, as restraints and insecurities will continue to undermine the creation of a health infrastructure able to address the dire public-health needs of Palestinians. And as long as significant segments of Palestinians are hungry, sick, and without hope of alleviating their plight, a meaningful peace cannot be achieved.
This Lancet Series on health in the occupied Palestinian territory
3–7 highlights the important relation between human security and sustainable peace in the Holy Land. By shedding more light on the public-health challenges at hand, be they maternal and child health, trauma, or the transition from infectious to noncommunicable diseases, the Series provides a basis for understanding the greater picture of need in Palestine. The Series also includes solutions to improving the Palestinian health-care system, with an emphasis on primary care.
Under the new Obama Administration in the USA, there is hope that the USA and other members of the Quartet (European Union, Russia, and the UN)
8 might achieve a sustainable peace settlement. Already, President Obama has taken steps for this effort to begin in earnest by appointing a proven peacemaker and skilled negotiator, Senator George Mitchell, as his envoy to the area.
9
After service in the White House, I have devoted my efforts to advancing peace and health worldwide through the Carter Center.
10 Recognising the impact that peace and health have on each other, the Center works to address the root causes of violence and to protect basic human rights, including health. We have concentrated our attention on neglected tropical diseases, mostly in Africa.
People everywhere share the dream of a caring global community that prevents unnecessary suffering from disease, war, and oppression. This Series should give the international community added urgency to resolve this enduring conflict and bring both Palestinians and Israelis the peace, health, and hope they deserve.
Jimmy Carter
The Carter Center, Atlanta, GA
32 years ago, one of my highest priorities as President of the USA was to bring peace to the Middle East. For 13 days, I led intense negotiations between Israel and Egypt, resulting in the Camp David Accords in 1978.1 
