The administration of United States President Joe Biden has once again bypassed Congress to greenlight an emergency weapons sale to Israel, which has only intensified and broadened its attacks on the Gaza Strip despite growing international outrage.
US Secretary of State Antony Blinken told Congress that he had made a second emergency determination in less than a month, covering a $147.5m sale of equipment to Israel, the State Department said on Friday.
“Given the urgency of Israel’s defensive needs, the secretary notified Congress that he had exercised his delegated authority to determine an emergency existed necessitating the immediate approval of the transfer,” it said.
“The United States is committed to the security of Israel, and it is vital to US national interests to ensure Israel is able to defend itself against the threats it faces.”
The package includes ancillary items, including fuses, charges and primers that Israel would require to make the 155mm shells that it had previously purchased, function.
Friday’s emergency determination, which is rare but has been used by at least four previous US administrations, means that a requirement for a potentially lengthy congressional review for foreign military sales will be bypassed.
Reporting from Washington, DC, Al Jazeera’s Patty Culhane said it was important to point out the broader context of the messaging.
“We’ve been hearing from all the top Biden administration officials for weeks that it is time for Israel to move to a lower-intensity conflict. In essence, stop the mass bombing. Stop the mass deaths of civilians,” she said.
“So, in that context – knowing that is what they say they want – they are now selling to Israel the exaction munitions they need to continue a high-intensity campaign.”
Culhane reported that Israel will also be purchasing 155mm M107 projectiles, which are artillery shells that will cause widespread destruction in a densely populated area such as Gaza.
“They didn’t say exactly how many [shells] were going to be in this $147.5m package. But, in previous packages, it really does mean that thousands and thousands of bombs will be going to Israel.”
On December 9, the administration made another emergency determination to approve the sale to Israel of nearly 14,000 rounds of tank ammunition worth more than $106m.
This comes as Biden’s request for an enormous $106bn package that includes aid for Ukraine, Israel and other perceived national security needs has yet to pass Congress, as it is entangled in a debate over US immigration and border security policies.
The Biden administration has tried to counter criticism over the mounting death toll in Gaza and continued US arms sales to Israel by saying it constantly maintains contact with Israel to stress the importance of minimising civilian casualties.
However, Luciana Zaccara, an associate professor of Gulf politics at Qatar University, told Al Jazeera it was pursuing a “dual-track” approach when it comes to the war.
“On the one hand they are trying to convince the public opinion that the US is really concerned about civilian casualties but also they keep sustaining Israel (militarily),” he said. “It is totally contradicting … it is hard to understand how this is in the national interest.”
The policy was especially perplexing in light of “mounting pressure” in the US, including among Democrats, against the war as civilian casualties in Gaza continue to rise, Zaccara said.
Some Democratic lawmakers have suggested further significant aid to Israel should be contingent on concrete promises by Prime Minister Benjamin Netanyahu’s government to curb civilian casualties in Gaza.
More than 21,000 Palestinians have now been killed in the besieged enclave since October 7, most of them children and women, in what has been widely described as collective punishment. Thousands more are missing.
Philippe Lazzarini, the head of the United Nations Relief and Works Agency for Palestine Refugees (UNRWA), said on Saturday that Israeli authorities continue to impose “severe restrictions” on humanitarian access despite deliveries of aid from Egypt and through the Rafah crossing.
He also said they are “creating a stream of baseless misinformation” to accuse aid agencies over gaps in deliveries.
South Africa files case of genocide against Israel, as attacks on Gaza, occupied West Bank and southern Lebanon continue – here is the latest.
Here’s how things stand on Saturday, December 30, 2023:
Latest updates and human impact
Israeli ground forces and tanks are pushing into the eastern, southern and northern outskirts of the Bureij refugee camp in central Gaza. But they have not yet reached the western side and Hamas fighters are resisting the incursion.
Israel’s bombardment of southern Gaza has intensified with the Israeli army, navy and air force targeting multiple locations in Khan Younis and Rafah. Israel has hit residential areas and civilian infrastructure, resulting in a large number of deaths. According to the United Nations, between Thursday and Friday afternoon, 187 Palestinians were killed and 312 wounded in these attacks.
The Palestinian Red Crescent Society (PRCS) released video footage of its emergency ambulance crews evacuating seriously wounded children in Khan Younis city following an attack on a residential apartment building amid continuing Israeli bombing raids.
Israel’s military has claimed to have destroyed a network of tunnels and a hideout belonging to Yahya Sinwar, Hamas’s leader in Gaza.
Israel’s military says two more Hezbollah sites have been hit in southern Lebanon, after an Israeli official at the United Nations Security Council on Friday promised “full-scale war” on Hezbollah if attacks on Israel’s north continue.
Philippe Lazzarini, the head of the UN Palestine relief agency (UNRWA), has accused Israeli officials and media outlets of “creating a stream of baseless misinformation” about gaps in aid deliveries to Gaza. His comments come amid Israeli attacks on aid convoys.
In Gaza, at least 21,507 people have been killed and 55,915 injured in Israeli attacks since October 7. The revised death toll from Hamas’s attack on Israel stands at 1,139.
Diplomacy
South Africa has initiated proceedings against Israel at the International Court of Justice (ICJ), saying its operations in Gaza amount to “genocide”- a move that has been welcomed by the Palestinian foreign ministry.
Israel has rejected South Africa’s move as a “blood libel”. Foreign ministry spokesperson Lior Haiat said on X that the claim “lacks both a factual and a legal basis”.
Israeli officials see it as a “positive sign” that Hamas may be open to new talks on captives. Speaking anonymously, the officials said they are approaching it with an abundance of caution, but that it is a step in the right direction, according to Al Jazeera correspondents reporting from Jerusalem.
United States President Joe Biden’s administration has bypassed Congress to approve a possible “emergency” weapons sale to Israel.
At the UN Security Council, the United Kingdom’s ambassador to the UN has warned that “many more” people will die in Gaza without humanitarian action.
Escalation in occupied West Bank
Israeli forces have arrested 14 Palestinians from the Jalazone refugee camp, north of Ramallah in the occupied West Bank, as raids in the territory intensify.
The Palestinian Ministry of Health has said that a 17-year-old boy who was shot in the chest by Israeli forces on Friday has been detained in the occupied West Bank. The teen was arrested in an ambulance at a checkpoint while he was being moved to a medical facility.
Israeli authorities barred Palestinians from entering the Al-Aqsa Mosque in occupied East Jerusalem for the 12th consecutive Friday.
According to Anadolu Agency, the Israeli police set up barriers at the entrances to the Old City and allowed only the elderly to reach Al-Aqsa Mosque.
The Israeli police also set up checkpoints at the outer gates of Al-Aqsa Mosque compound – Islam’s third holiest site.
Hundreds of people performed Friday prayers in the streets near the Old City, after they were prevented from reaching the mosque.
A large number of Israeli forces were also deployed in the Wadi al-Joz neighbourhood near the Old City, and prevented worshipers from reaching the mosque, witnesses added. Israeli forces sprayed “skunk water” and used tear gas canisters against worshippers, the Wafa news agency reported.
The move is the latest shift in economic and foreign policy by newly elected hard-right President Javier Milei.
Argentina has announced that it will not join the BRICS bloc of developing economies, fulfilling a campaign promise by newly elected far-right President Javier Milei who has pledged to pursue closer ties with the West.
In a letter dated December 22 but released on Friday, Milei told the leaders of Brazil, Russia, India, China and South Africa that the timing for Argentina’s membership in the bloc was not opportune.
Milei said in his letter that his approach to foreign affairs “differs in many aspects from that of the previous government. In this sense, some decisions made by the previous administration will be reviewed.”
Argentina’s new president, a self-described anarcho-libertarian who has pushed forward a series of radical economic reforms since taking office in December, has said that he will pursue a foreign policy that aligns with Western countries, moving away from the previous administration’s efforts to build ties with other developing countries.
Former centre-left President Alberto Fernandez had promoted Argentina’s inclusion in BRICS as a way to foster economic relations with the bloc, whose members account for about 25 percent of world GDP. Argentina had been set to join on January 1, 2024.
Reporting from the capital city of Buenos Aires, Al Jazeera correspondent Monica Yanakiew said that Milei has already issued sweeping changes during his three weeks in office.
“He has already made dramatic changes in all walks of life, from expediting divorce procedures to deregulating prices to eliminating subsidies, everything is changing here now,” she said.
During his campaign, Milei railed against countries ruled “by communism” such as China and neighbouring economic power Brazil and said he would pursue greater alignment with “free nations of the West” such as Israel and the US in his economic and foreign policy.
However, in his letter to the BRICS leaders, Milei said that Argentina would seek to “intensify bilateral ties” in order to increase “trade and investment flows” without joining the group.
Domestically, Milei is also facing substantial pushback from the country’s powerful organised labour groups as he embarks on a programme of economic “shock therapy” and deregulation as Argentina reels from sky-high inflation.
An overnight barrage of Russian missiles and drones ripped across Ukraine, killing at least 30 people and injuring many more. Officials said the hours-long bombardment involved 122 missiles and dozens of drones. Ukraine’s Air Force commander called it ‘the most massive aerial attack’ since Russia first invaded Ukraine in February 2022.
South Africa has filed an application instituting proceedings against Israel at the International Court of Justice (ICJ), accusing it of crimes of genocide against Palestinians in Gaza after nearly three months of relentless Israeli bombardment has killed more than 21,500 people and caused widespread destruction in the besieged enclave.
In an application to the court on Friday, South Africa described Israel’s actions in Gaza as “genocidal in character because they are intended to bring about the destruction of a substantial part of the Palestinian national, racial and ethnical group”.
“The acts in question include killing Palestinians in Gaza, causing them serious bodily and mental harm, and inflicting on them conditions of life calculated to bring about their physical destruction,” the application said.
The ICJ, also called the World Court, is a UN civil court that adjudicates disputes between countries. It is distinct from the International Criminal Court (ICC), which prosecutes individuals for war crimes.
As members of the UN, both South Africa and Israel are bound by the court.
South African President Cyril Ramaphosa has compared Israel’s policies in Gaza and the occupied West Bank with his country’s past apartheid regime of racial segregation imposed by the white-minority rule that ended in 1994.
Several human rights organisations have said that Israeli policies towards Palestinians amount to apartheid.
South Africa said Israel’s conduct, particularly since the war began on October 7, violates the UN’s Genocide Convention, and called for an expedited hearing. The application also requests the court to indicate provisional measures to “protect against further, severe and irreparable harm to the rights of the Palestinian people” under the Convention.
“South Africa is gravely concerned with the plight of civilians caught in the present Israeli attacks on the Gaza Strip due to the indiscriminate use of force and forcible removal of inhabitants,” a statement from South Africa’s Department of International Relations and Cooperation (DIRCO) said, adding that the country has “repeatedly stated that it condemns all violence and attacks against all civilians, including Israelis.”
“South Africa has continuously called for an immediate and permanent ceasefire and the resumption of talks that will end the violence arising from the continued belligerent occupation of Palestine,” the statement added.
Israel has rejected global calls for a ceasefire saying the war would not stop until the Hamas group, whose October 7 attack triggered the current phase of the conflict, was destroyed. Some 1,200 people were killed in the Hamas attack in Israel. The Palestinian group has said its attack was against Israel’s 16-year-old blockade of Gaza and expansion of settlements in the occupied Palestinian territories.
In the latest development in Israel’s war on Gaza, tens of thousands of newly displaced Palestinians in the centre of the Palestinian enclave on Friday were forced to flee as Israel expanded its ground and air offensive in the centre of the enclave.
Israel has faced global condemnation for the mounting toll and destruction and accused of meting out collective punishment on Palestinian people.
‘A very important step’
The court application is the latest move by South Africa, a vociferous critic of Israel’s war, to ratchet up pressure after its lawmakers last month voted in favour of closing down the Israeli embassy in Pretoria and suspending all diplomatic relations until a ceasefire was agreed in Israel’s war with Palestinian Islamist group Hamas in Gaza.
Al Jazeera’s Gabriel Elizondo, reporting from the United Nations headquarters in New York, said the move was “clearly a very important step to try to hold some accountability to Israel.”
“Now that South Africa is pushing this to the ICJ, it will be on [the UN’s] agenda to try to make a ruling on this very important question,” he added.
On November 16, a group of 36 UN experts called on the international community to “prevent genocide against the Palestinian people”, calling Israel’s actions since October 7 a “genocide in the making”.
“We are deeply disturbed by the failure of governments to heed our call and to achieve an immediate ceasefire. We are also profoundly concerned about the support of certain governments for Israel’s strategy of warfare against the besieged population of Gaza, and the failure of the international system to mobilise to prevent genocide,” the experts said in a statement.
Israel has rejected South Africa’s move as “baseless”, calling it “blood libel.”
“South Africa’s claim lacks both a factual and a legal basis, and constitutes despicable and contemptuous exploitation of the Court,” Israel’s minister of foreign affairs, Lior Haiat, said in a statement posted on X.
“Israel has made it clear that the residents of the Gaza Strip are not the enemy, and is making every effort to limit harm to the non-involved and to allow humanitarian aid to enter the Gaza Strip,” the statement added.
“It does rally public opinion to the reality of what’s going on in Palestine, not just in Gaza but also in the West Bank,” said Al Jazeera’s senior political analyst Marwan Bishara.
According to Article 2 of the Genocide Convention, genocide involves acts committed with the “intent to destroy, either in whole or in part, a national, ethnic, racial, or religious group.”
“Where the disagreement lies is whether there is intent or no intent,” Bishara said.
“The three leading Israeli officials have declared the intent, starting with Israeli President Herzog when he said there are ‘no innocents’ in Gaza, the defence minister who said Israel will impose collective punishment on the people of Gaza because they are ‘human animals’,” Bishara said, adding that prime minister Netanyahu also used a biblical analogy in a statement widely interpreted as a genocidal call.
NATO chief Jens Stoltenberg says organisation is ‘monitoring the situation’ as Poland says it has confirmed incident.
Polish military authorities have said that a Russian missile briefly passed through the country’s airspace before leaving, prompting concern from the country that borders Ukraine on the day Russia carried out attacks across several Ukrainian cities killing at least 30 people.
Poland, a member of the NATO military alliance, says that the object entered from the direction of Ukraine on Friday morning, entering about 40 kilometers (24 miles) before leaving after about three minutes.
“Everything indicates that a Russian missile intruded in Poland’s airspace,” said Poland’s defence chief, General Wieslaw Kukula. “It was monitored by us on radars and left the airspace. We have confirmation of this on radars and from [NATO] allies.”
Russian officials have yet to comment on the incident, which comes at a time of high tensions between Russia and European nations located near Ukraine, which Russia invaded in February 2022.
Spoke with President @AndrzejDuda about the missile incident in #Poland. #NATO stands in solidarity with our valued Ally, is monitoring the situation & we will remain in contact as the facts are established. NATO remains vigilant.
Polish officials say they are working to further verify their findings and rule out the possibility of a technical malfunction.
In a social media post on Friday, NATO Secretary General Jens Stoltenberg said that the security alliance is monitoring the situation and communicating with Polish officials.
“I spoke with President Andrzej Duda about the missile incident in Poland. NATO stands in solidarity with our valued ally, is monitoring the situation and we will remain in contact as the facts are established. NATO remains vigilant,” Stoltenberg said.
Operational commander of the Polish army Maciej Klisz said that the country’s air defence network had been on high alert due to recent Russian missile and drone attacks in Ukraine and that fighter jets were sent to intercept the missile before it left Polish territory.
The military also said that a ground search was being carried out in the area where the missile disappeared off the radar.
The White House on Friday said that US President Joe Biden was closely following the development in Poland. White House National Security Adviser Jake Sullivan “expressed the United States’ solidarity with Poland, our close NATO ally” and pledged technical assistance as needed in a call with Polish Secretary of State Jacek Siewiera, according to a statement from the White House.
The incident is not the first time that the war in Ukraine has threatened to spill over into Polish territory. In November 2022, an errant Ukrainian air defence missile killed two civilians when it landed in the border village of Przewodow.
Poland’s newly elected Prime Minister Donald Tusk, who won the election with a bloc of pro-EU and pro-Ukraine parties that overthrew the country’s far-right government after eight years in power, has promised full support for Ukraine in its war against Russia.
That war has ground on for nearly two years, with little end in sight as Ukraine fights to expel Russian forces that have established strong defences along the captured territory.
While Ukraine still has substantial support from many Western governments, schisms have started to emerge over the provision of further military assistance, including in the US, which has provided more support than any other country.
On Friday, the British defence ministry said that it would send 200 air defence missiles to Ukraine, which is currently under heavy bombardment from Russian forces.
Ukrainian President Volodymyr Zelenskyy said on Friday that he visited Avdiivka, an eastern town near the front line that has seen heavy fighting.
“This is one of the most difficult areas of the front line,” he wrote on Telegram along with a video of him in front of a sign with the name of the town, giving medals to soldiers.
“I thank all those who are at the first line [of fire] for their service, for this year during which the entire country survived thanks to its soldiers,” he said.
Tens of thousands of displaced Palestinians in Gaza have been forced to flee again towards the south after Israel intensified assaults in the centre of the besieged enclave killing more than 180 people in the past 24 hours.
The Israeli army on Friday said in a post on X that it was “expanding the operation in the Khan Younis area” of Gaza, previously sheltering hundreds of thousands of people displaced from the north – initially the focus of Israel’s ground assault.
Israeli shelling near El Amal hospital in Khan Younis killed 41 people over the past two days, the Palestinian Red Crescent Society (PRCS) said on Thursday, adding that the casualties in repeated Israeli attacks near the facility include “displaced persons seeking shelter”.
The UN humanitarian office said an estimated 100,000 more displaced people had arrived in the already-teeming southern border city of Rafah in recent days following the intensification of fighting around both Deir el-Balah in central Gaza and Khan Younis to its south.
Earlier this week, Israeli forces ordered Palestinians out of the crowded central districts of Bureij, Maghazi and Nuseirat, as tanks advanced from the north and east.
Attacks on those areas have intensified in recent days, with many residents fleeing to the already-crowded Deir el-Balah, pitching makeshift tents made from sheets of plastic on whatever open ground they could find.
“We suffered a lot. We had the whole night without shelter, under rain and it was cold, we were with our kids and elderly women,” Um Hamdi, a woman cooking porridge over an open woodfire, surrounded by children, told the news agency Reuters.
Nearby, grey-bearded Abdel Nasser Awadallah stood inside a wooden frame set up to be wrapped in plastic to make a tent, and spoke of the family he had lost.
“I buried my children, a child 16-year-old, another one aged 18. Something I really can’t believe, I buried my children at 6:00am while their bodies were still warm. Also my nephew was two years old, I buried him, I buried my wife,” he said.
‘Death or displacement’
Addressing the UN Security Council on Friday, the Palestinian UN envoy Majed Bamya said the widescale destruction of Gaza by Israeli operations has made it clear their sole goal is forced displacement.
“They want to make sure that Palestinians in Gaza have no homes to return to,” he said. “They want to make sure they have no life to return.”
“They want to make sure that life in Gaza is no longer possible, with one aim, what they call ‘voluntary migration’ … the codename for forced displacement. These are the options for Palestinians: Destruction or displacement, death or displacement,” he said.
On Christmas Eve, the Maghazi refugee camp witnessed one of the deadliest attacks since Israel launched its military offensive on October 7. While the official number of those who were killed stands at 90, residents of the camp near Deir el-Balah told Al Jazeera that in reality, the figure is much higher as entire residential blocks were wiped out.
Israel issued a rare apology on Thursday for killing civilians in the massive air raid that triggered one of the biggest exoduses of the war so far, saying the munitions used were not appropriate for a packed refugee camp and that the high death toll “could have been avoided”.
Displaced Palestinians, who fled their homes due to Israeli attacks, shelter in a tent camp, amid the ongoing conflict between Israel and the Palestinian group Hamas, in Rafah, southern Gaza Strip, December 29, 2023. [Ibraheem Abu Mustafa/Reuters]
Rafah hit ahead of Egypt talks
The UN says more than 90 percent of Gaza’s 2.3 million people have been displaced, and many are now fleeing for the third or fourth time.
Many now live in cramped shelters in the 365sq km (141sq miles) of land or in makeshift tents around the southern city of Rafah, on the border with Egypt – which has also not been immune from Israeli attacks.
Rafah was hit by new air raids on Friday as Egypt prepared to host a high-level Hamas delegation for talks to try and end the nearly 12-week war that has devastated the besieged Palestinian territory.
Reuters journalists at the scene of one air raid that obliterated a building in Rafah saw the head of a buried toddler sticking out of the rubble.
The child screamed as a rescue worker shielded his head with a hand, while another swung a sledgehammer at a chisel, trying to break up a slab of concrete to free him.
Neighbour Sanad Abu Tabet said the two-storey house had been crowded with displaced people. After morning broke, relatives came to collect the dead wrapped up in white shrouds.
Israel’s relentless aerial bombardment and ground invasion in Gaza have killed at least 21,507 people, mostly women and children, according to Gaza’s health ministry.
Egypt has taken more of a leading role in pushing for a ceasefire, including introducing a plan to end the fighting. It includes captive and prisoner exchanges between Israel and Hamas.
Egypt’s State Information Services chief Dia Rashwan said the plan was “intended to bring together the views of all parties concerned, with the aim of ending the shedding of Palestinian blood”.
Senior Hamas official Osama Hamdan said on Thursday that the group will not release more Israeli captives without a “complete and full ceasing of aggressive activities against our people through negotiations that are aligned with our people’s interest”.
#Gaza – Israeli soldiers fired at an aid convoy as it returned from Northern Gaza along a route designated by the Israeli Army – our international convoy leader and his team were not injured but one vehicle sustained damage – aid workers should never be a target.@UNRWA
The director of the UN agency for Palestinian refugees in Gaza (UNRWA), Thomas White, said on Friday that a UN aid convoy had come under fire by the Israeli military on Thursday. While there were no casualties, White condemned the attack on humanitarian workers.
“Essentially, we are delivering aid under fire,” White told Al Jazeera, explaining that the incident took place as a convoy was returning from northern Gaza along a route designated by the Israeli Army.
“They took that route, they encountered some tanks, and those tanks used heavy machine guns to fire at the vehicles,” White said, adding that while there was some damage to one of the vehicles, UNRWA staff was not injured.
Philippe Lazzarini, the head of the UNRWA, on Friday slammed Israeli forces for firing at the aid convoy. In a post on X, Lazzarini said “shooting” and “other attacks” on aid workers and convoys obstruct “lifesaving” operations in the Strip.
A “total siege” imposed by Israel since the war began on October 7, and following years of crippling blockade, has deprived Palestinians in Gaza of food, water, fuel and medicine.
The severe shortages have been only sporadically eased by humanitarian aid convoys entering primarily via Egypt.
International bodies say supplies being let in through Israeli inspections are a small fraction of the enclave’s vast needs. Last week Israel bowed to international pressure to open a second crossing it said would double the number of supply trucks daily to 200, but just 76 were able to enter on Thursday, according to the United Nations, compared with 500 before the war.
Last week, a UN-backed report warned that the entire 2.3 million population of Gaza is facing crisis levels of hunger, with 576,600 people at catastrophic – or starvation – levels.
UN humanitarian chief Martin Griffiths described on social media what he called “an impossible situation for the people of Gaza, and for those trying to help them”.
“You think getting aid into Gaza is easy? Think again,” he wrote Friday on X.
Washington, DC – It was a hot summer day in July when Shekita McBroom received a phone call from a local hair salon.
The stylist on the other end of the line urgently needed a resupply — not of hair dye or shampoo, but of the overdose-reversal drug naloxone.
Commonly known by the brand name Narcan, naloxone is a life-saving medication, often taken as a nasal spray to counteract the symptoms of opioid consumption.
That a hair salon had a backroom supply of the drug came as no surprise, though, to McBroom, a community advocate in Washington, DC, who campaigns to prevent overdoses. If anything, she would like to see naloxone available more widely — including through vending machines.
“I try to connect people with more supply because they don’t always know where to find it,” she told Al Jazeera. But with vending machines, she sees a convenient solution: a quick and easy way to dispense emergency care at all hours of the day, in neighbourhoods where services might otherwise be limited.
More and more communities in the United States are adopting that approach. In 2023, there has been a boom in vending machines dispensing overdose reversal drugs for free — as well as fentanyl testing strips, clean needles and other “harm reduction” items.
Community advocate Shekita McBroom helps to connect people in the community with Narcan, in an effort to prevent overdoses [Joseph Stepansky/Al Jazeera]
US ‘behind everyone’ in adopting method
Washington, DC, was among several cities to launch a vending machine programme this year. It currently has seven vending machines overseen by two local community health organisations.
Four of those machines, overseen by the Family and Medical Counseling Service Inc, dispensed 204 packages of Narcan from October to November. That meant, on an average day, about three boxes of Narcan, each containing two doses, made their way to those in need.
“We’ve been surprised at the amount of activity that the machines actually can get,” said Angela Wood, the group’s chief operating officer.
She pointed out that the vending machines do not require users to produce any personal information — or even interact with a real person, thereby reducing the potential for stigma.
“It’s a way for people to gain access to these products in their own time, in their own way, without having to fully engage with a programme,” she told Al Jazeera.
Chicago likewise introduced a pilot programme for naloxone vending machines in November, and New York City opened its first machine in Brooklyn in June.
There were also advances on the state level. West Virginia, Wisconsin, Vermont, Missouri, Kansas and Connecticut all either unveiled or approved deployments of the vending machines this year.
Even tribal governments have embraced the strategy. In April, the Pala Band of Mission Indians installed what it described as the first naloxone vending machine on tribal land in the US. Four months later, the Tulalip reservation in Washington state set up its own machine.
The spread of the vending machines has been dramatic, according to Rebecca Stewart, an assistant professor at the Penn Center for Mental Health who studies substance abuse treatment.
“They’re really popping up all over the country,” she said.
The trend began in the US only five years ago, in 2017, with a vending machine programme in Nevada. But as Stewart pointed out, similar programmes had already existed for years in Europe, Australia and even Puerto Rico.
“The United States is sort of behind everyone in this aspect,” she said. “In terms of harm reduction vending machines, these have been implemented for decades all over the world. And so these implementations in the United States are just beginning.”
Four of the seven naloxone vending machines in Washington, DC, dispensed 204 packages of the medication over two months alone [Joseph Stepansky/Al Jazeera]
Escaping the ‘moral hazard’ argument
One of the biggest hurdles to adopting the vending machines has traditionally been public opinion.
Stewart said many Americans — including politicians and policymakers — feared that the vending machines would encourage drug use by making the practice safer. She calls it the “moral hazard” argument.
Even this year, officials echoed that line of thinking. Kentucky installed its first naloxone vending machine in 2022, but some local politicians remain opposed to their expansion into neighbouring counties.
“You’re basically promoting and enabling the people that’s got the problem with the drugs instead of maybe trying to help them get off the drugs,” Nelson County Judge-Executive Tim Hutchins told the TV news station WHAS11 in February.
Still, overdose deaths continue to rise in the US. Every year since 2021, more than 100,000 people have died from drug overdoses — double what was recorded in 2015.
The majority of those overdose deaths have been linked to opioids, with experts blaming the emergence of synthetics like fentanyl for sending the death toll skyrocketing.
Ryan Hampton, an activist and organiser who focuses on addiction, sees the increase in vending machines as evidence of the immediacy of the opioid crisis.
He fears the US continues to overlook “harm reduction” strategies as a tool to bring the death rate down. The term “harm reduction” is used broadly to describe methods that can help prevent overdoses or other knock-on effects of drug use, like disease transmission through needle sharing.
“For too long, harm reduction has been a stigmatised strategy,” Hampton said.
Instead, he explained that the US has invested more in a “prevention/interdiction” model that discourages drug use in the first place. The result, he added, has been few resources dedicated to stopping overdoses and other drug-related harms.
“What is being invested by no means meets the demand for the services or the scale for what’s needed right now,” he said.
“With the toxic drug supply that we’re faced with, harm reduction has to be a mechanism that we deploy in every setting that we can, whether that be in vending machines or community care settings.”
For her part, Stewart has noticed a shift away from perceptions that naloxone is an “enabler” for opioid use.
Rather, her research, which focused on Philadelphia, found that community members were open to the prospect of overdose-reversal medications being readily available in vending machines.
“One of the things we found from talking to these different stakeholders is that Narcan was universally accepted,” she added. “And I feel like this is a really promising finding because I don’t think Narcan was universally accepted five years ago.”
A package of Narcan sits among hair salon supplies in Washington, DC [Joseph Stepansky/Al Jazeera]
Lower tech, higher access
But the vending machines themselves are no silver bullet. Attention must also be paid to how they are deployed, said Nabarun Dasgupta, a senior scientist at the University of North Carolina at Chapel Hill’s Injury Prevention Research Center.
As the co-founder of Remedy Alliance/For the People, an organisation that seeks to make naloxone more easily available, Dasgupta said he has seen unnecessary requirements be tacked onto how the vending machines are used.
For example, several jurisdictions have required the machines to be refrigerated. But Dasgupta called that requirement a costly “commercial misdirection”, unnecessary for naloxone’s storage.
“The better version of the vending machine paradigm is to go with lower tech [and] higher access,” Dasgupta told Al Jazeera.
He believes community input is key to designing programmes that reach the people whose needs are greatest. One start-up, he pointed out, is using old newspaper stands on city streets to distribute naloxone in Michigan.
“I think, with 100,000 people a year dying of overdose, something isn’t working,” Dasgupta said. “It’s time for new solutions. And the vending machines are part of a generation of new solutions.”
Other changes are also under way to make naloxone more easily accessible across the US.
In March, the federal Food and Drug Administration (FDA) approved the first naloxone nasal spray for use without a prescription, which paved the way for drug stores, corner markets and gas stations to stock the product for over-the-counter use.
Hair salon owner LaShaun Love says she receives requests for Narcan in her shop weekly, if not daily [Joseph Stepansky/Al Jazeera]
A personal battle
Back in Washington, DC, community advocate McBroom found herself eyeing an empty vending machine in the hair salon of her friend, LaShaun Love.
Where once there had been snacks for sale, McBroom imagined rows of naloxone and other “harm reduction” items on the vending machine’s shelves, ready for anyone who might need them.
And the need is great in Washington, DC. The city saw 448 opioid-related overdose deaths in 2022, giving it one of the highest per-capita rates in the country.
Love, the salon’s owner, revealed she kept a cardboard box full of Narcan on hand, just in case.
“Normally, I keep one right here on my station and then another right up at the front,” she told Al Jazeera. That way, neighbourhood residents can have easy access.
“They’ll knock on the door and say, ‘Miss Shaun, you got any Narcan?’ Even ambulance workers have asked me for it.” Requests from the community come weekly, if not daily, Love added.
For McBroom, the fight to prevent overdoses is personal. Her own daughter Jayla died in 2021 at age 17, following a fentanyl overdose.
She hopes to see more vending machines integrated into the community, where they can have the greatest impact.
“The person who needs Narcan could be your family,” she said. “Wouldn’t you rather they were able to have access to something that could ultimately save their life?”
Saeed is accused by India and the US of being involved in the 2008 attacks, which killed 166 people.
India has formally requested that Pakistan extradite the 2008 Mumbai attacks suspect Hafiz Saeed for trial in India, according to New Delhi’s Ministry of External Affairs.
“We have conveyed a request along with relevant supporting documents to the government of Pakistan,” ministry spokesperson Arindam Bagchi told reporters in a briefing on Friday.
Bagchi said the last communication was sent to Pakistan “a few weeks ago”, local media reported.
Saeed, who is currently in custody in Pakistan, co-founded the Lashkar-e-Taiba (LeT) armed group. He is accused by India and the United States of being involved in the attacks on India’s financial hub, which killed 166 people.
India has long been asking its neighbour to hand Saeed over to face trial in the case.
Saeed denies any involvement in the 2008 attacks, in which 10 gunmen slipped into Mumbai by boat from Pakistan. The gunmen carried out attacks at city landmarks for days.
Pakistani authorities placed him under house arrest for different periods, accusing him of involvement in armed groups. Saeed was jailed on April 9, 2002, by a Pakistani court for 31 years in connection with “terrorism” financing.
Saeed’s Jamaat-ud-Dawa group has also been banned by the Pakistani government. The organisation, which has been accused of funding armed groups, was declared a “terror” outfit by the US in 2001.
The United States had offered a reward of $10m for information leading to his conviction.
India hanged the lone survivor of the 2008 attack, Pakistan national Mohammad Ajmal Kasab, in 2012.
Kashmir connection
LeT has been accused of using Pakistani soil to attack Indian security and government targets in Indian-administered Kashmir.
Pakistan and India both claim the mountainous territory of Kashmir in full but administer separate portions of it.
They have fought two of their three full-fledged wars over the territory. India has also accused Pakistan of supporting armed groups like LeT and Jaish-e-Muhammad that operate in Indian-administered Kashmir.
Pakistan denies the charges, saying it has been acting against all armed groups operating on its soil. Islamabad backs Kashmiri’s right to self-determination against Indian rule.
India’s top court last week upheld a 2019 government decision to strip the Muslim-majority region’s limited autonomy and put the region under direct rule from New Delhi. Tens of thousands of Indian troops are stationed in the region to quell an armed uprising that erupted in the late 1980s.
India has been accused of human rights violations and undermining the democratic rights of Kashmiris, but New Delhi says its tough measures are aimed at ending what it calls “terrorism”.
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