BACKGROUND:
The precautionary principle is now accepted as a key strategy to prevent environmental illness and injury1. Equally, war is currently accepted as a public health concern.2 Some public health organisations have, as advocates for public health, publicly called for an end to the genocide in Gaza3-5. The ongoing Israeli assault on Gaza twice served before the International Court of Justice (ICJ) on allegations of genocide. This presentation explores how the precautionary principle could have been applied to Gaza for earlier preventive action.

RESULTS:
Careful analysis shows that the criteria for incitement to genocide6 against Palestinians were present in Israeli speech, writings, imagery and actions, before and since the war crimes committed on 7th October 2023. Dehumanization of Palestinians in the Israeli schooling system was documented by Israeli researchers7 before the October 7th attacks but has since been compounded in popular media and articulated by Israeli politicians. Blaming Palestinians as responsible for their fate has demonised the victims and denial of Palestinian land claims has delegitimised them as a group. Disinformation about military action in Gaza and denial of atrocities is commonplace8. Coupled with threats to commit harm to civilian populations and glorification of military actions resulting in civilian deaths9, the elements of incitement to genocide were present as early as the first quarter of 2024. Israel ignored two ICJ orders10,11 to cease killing of civilians, openly used starvation of children as a weapon of war and continues to restrict humanitarian aid needed to avoid preventable deaths. Conclusion. Early advocacy to protect the Gazan health system may have saved thousands of lives and prevented lifelong disability. The Public Health community can still stand together to call for an unequivocal stop to Israeli military attacks and ensure accountability for all war crimes, including harms to the health system and the environment.