The number of Palestinians allowed to move in and out of Gaza declined significantly in 2017 compared with 2016. At the Erez crossing, movement via Israel has been in decline since mid-2016. Palestinian access via Rafah, the Egyptian-controlled crossing, also declined during the year from an already extremely low level. As the internal Palestinian divide escalated, access for medical purposes was also restricted during most of 2017 by the PA Ministry of Health, which delayed or suspended payments for patients referred for medical treatment outside Gaza.