The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reports that the humanitarian consequences of the escalation in the Middle East are worsening by the day. Civilians are increasingly at risk, and essential infrastructure is being disrupted across the region. Meanwhile, UN Secretary-General António Guterres warns that what began as a regional conflict is increasingly becoming a driver of global instability.
Since Wednesday, there have been reports of civilian casualties in Iran and Kuwait, and of damage or disruption to infrastructure in Iran, Kuwait, Saudi Arabia and Egypt. Jordan and Egypt remain vital lifelines for humanitarian operations, including medical evacuations and aid deliveries.
On Thursday, OCHA stated that it is continuing to monitor the humanitarian impact and called on all parties to uphold their obligations under international humanitarian law, including protecting civilians and vital infrastructure.
On June 17, the United States and Iran had reached an agreement on a Memorandum of Understanding (MoU) concerning the cessation of hostilities. Since the announcement of the MoU and the subsequent ceasefire, the overall intensity of hostilities had declined. However, military activities continue to impact civilian infrastructure and access to essential services. A further intensification of hostilities began on June 27, with airstrikes being reported daily.
On Thursday, six months into the military escalation in the Gulf, a new wave of US strikes was reported in Iran’s provinces of Fars, Hormozgan, Bushehr and Khuzestan, encompassing the country's primary oil-producing region. According to local sources, a strike in Qeshm, Hormozgan Province, hit a residential building, killing three civilians, including a two-year-old child. Two other children were reportedly injured.
According to Iran's Ministry of Health, at least 60 people have been killed and 670 injured since hostilities escalated again on June 27.
US and Israeli attacks against Iran kill more than 3,400 people and injure more than 34,000
Following the February 28 start of the war against Iran with US and Israeli strikes across the country, the Iranian military responded with attacks on Israel and US-allied states in the Gulf.
More than 3,400 people have reportedly been killed and more than 34,000 injured in airstrikes by Israel and the United States across Iran. According to the Iranian Red Crescent Society (IRCS), nearly 150,000 civilian structures were damaged during the escalation, including over 123,000 residences and over 24,000 commercial buildings.
The US-Israeli air campaign in densely populated areas has triggered massive displacement, with millions fleeing the capital, Tehran, in search of safety. At the beginning of the war, approximately 3.2 million people were displaced.
On Thursday, the International Organization for Migration (IOM) reported that population movements in Iran are currently localized, temporary, and economically driven, with no signs of mass displacement.
Amid temporary signs of de-escalation, some families have begun returning to their homes. However, thousands continue to shelter in hotels due to housing and civil infrastructure damage.
Six months into the crisis, UN agencies and non-governmental organizations (NGOs) operating in Iran continue to support the response to growing humanitarian needs.
The escalation in the Middle East and beyond has triggered a humanitarian crisis affecting multiple regions in an already fragile context. A resurgence of hostilities in recent weeks has placed pressure on humanitarian access and threatens essential civilian services.
Vulnerable groups are the most impacted
Earlier this week, Médecins Sans Frontières (Doctors Without Borders, MSF) reported an unprecedented demand for healthcare among refugees, migrants, and other marginalized communities in Iran.
From January to June of this year, MSF teams provided 84,615 consultations, an 80 percent increase compared to all of 2025. MSF teams also recorded a 50 percent increase in mental health consultations for post-traumatic stress disorder (PTSD), depression, and anxiety.
This increase is reportedly due to growing needs and barriers to public healthcare for refugees, migrants, and other vulnerable people.
“During periods of intensified hostilities and ceasefire, the communities we support often face limited access to medical care,” said Grigor Simonyan, MSF head of mission in Iran, in a statement on Tuesday.
“We have urgently scaled up core medical and mental health services to meet needs that continue to grow.”
Simonyan noted that medical consultations spiked during both periods, prompting MSF to scale up services.
“While healthcare services focus on emergency and trauma care in conflict, mothers still need to have antenatal care and older people still need non-communicable disease care. Especially those who are more vulnerable, with already limited access to healthcare,” he said.
The health system in Iran has faced further strain from repeated escalations of violence by the United States and Israel since the beginning of the year. This has disrupted the continuity of basic healthcare services, particularly affecting communities that already had limited access.
To date, the World Health Organization (WHO) has verified 27 attacks on health facilities, with 11 health worker deaths recorded.
A driver of global instability
The Iran crisis has disrupted shipping in the narrow Strait of Hormuz, thrown the world’s energy supply network into disarray, and seriously impacted aviation. It has also restricted humanitarian aid flows. This has caused a broader crisis affecting people across the region and beyond, which could lead to a worsening global hunger crisis. The World Food Programme warns that as many as 45 million additional people could face acute hunger as a result of ongoing hostilities.
“We are now six months into the military escalation in the Gulf. What began as a regional conflict is increasingly becoming a driver of global instability,” UN Secretary-General Guterres told journalists in New York on Friday.
“Trade through the Strait of Hormuz has collapsed. Energy markets have been upended. Prices of food and key fertilizers have surged. Supply chains are buckling.”
Guterres warned that, worldwide, “we see families struggling to put food on the table, farmers unable to afford basic inputs, and vulnerable countries pushed closer to the edge.”
The UN Secretary-General added that rising prices and slowing growth also threaten to push millions more back into poverty.
“Let me be clear: The fighting must stop on all fronts in the region,” Guterres said, referring to the situations in Lebanon and Gaza as well.
“International navigational rights and freedoms in and around the Strait of Hormuz and Bab al-Mandab must be fully restored. And diplomacy must prevail.”