Food shortages in parts of the Gaza Strip have already far exceeded famine levels, and mass death is now imminent without an immediate ceasefire and surge of food into areas cut off by fighting, the global hunger monitor said on Monday.
The U.N.-backed Integrated Food-Security Phase Classification, or IPC, which formally declares famines, said two of its three criteria - the overall shortage of food and prevalence of malnutrition - had probably already been met.
It did not have enough full data on death rates, its third criterion, but believed residents in affected areas would be dying of starvation and malnutrition at famine scale imminently, and children under four may already be.
"The actions needed to prevent famine require an immediate political decision for a ceasefire together with a significant and immediate increase in humanitarian and commercial access to the entire population of Gaza," it said.
"All efforts must be made to ensure the provision of food, water, medicines, and protection of civilians, as well as to restore and provide health, water, and sanitation services, and energy."
In all, 1.1 million Gazans, around half the population, were experiencing "catastrophic" shortages of food, the worst category, with around 300,000 in the areas now facing the prospect of famine-scale death rates.
The prospect of a man-made famine in Gaza has brought the strongest criticism of Israel from Western allies since it launched its war against Hamas militants following their deadly attack on Israeli territory on Oct. 7.
"In Gaza we are no longer on the brink of famine, we are in a state of famine, affecting thousands of people," EU foreign policy chief
"This is unacceptable. Starvation is used as a weapon of war. Israel is provoking famine."
Israeli Foreign Minister Israel Katz responded that Borrell should "stop attacking Israel and recognise our right to self-defence against Hamas' crimes".
Katz, in a post on X, said Israel allowed "extensive humanitarian aid into Gaza by land, air, and sea for anyone willing to help", but that aid was "violently disturbed" by Hamas militants with "collaboration" by the U.N.'s aid agency UNRWA.
Israel, which initially allowed aid into Gaza through only two checkpoints on the enclave's southern edge, says it is opening more routes by land, sea and air.
Aid agencies say they still cannot get enough supplies through or distribute them safely, especially in the north, without better access and security, Israel's responsibility to provide since storming Gaza's cities.
In the ruins of Gaza City, the main settlement in the north of the Gaza Strip, Israeli forces launched a major assault on Al Shifa hospital overnight. Once the Gaza Strip's biggest hospital, it is now one of the only medical facilities still even partially functioning in the north of the territory.
Negotiations for a ceasefire in the war, now in its sixth month, were due to resume on Monday with an Israeli delegation led by the country's spy chief heading to Qatar. But an Israeli official said nailing down any deal would probably take at least two more weeks, a clear disappointment for Washington which had sought a deal by the start of the Ramadan holy month last week.
The war began when Hamas fighters stormed into Israel, killing 1,200 people and capturing 253 hostages according to Israeli tallies. Since then, Israel's assault has killed more than 31,000 Gazans, according to Palestinian health officials.
Both sides have been discussing a truce of around six weeks during which around 40 hostages would be freed in exchange for hundreds of Palestinian prisoners and aid would be rushed into the Gaza Strip. Israel says it will discuss only a temporary pause in fighting; Hamas says it will not free hostages without a deal that would end the war.
ASSAULT ON AL SHIFA
Israel's assault on Al Shifa hospital overnight appeared to be one of its biggest ground attacks in the northern sector of Gaza since it declared at the start of the year that it had successfully completed its operations there.
The Israeli military said soldiers had conducted a "precise operation" based on intelligence that the hospital was being used by senior Hamas leaders.
Troops were fired upon when they entered the compound. They "responded with live fire and hits were identified. Our troops are continuing to operate in the area of the hospital," the army said.
Mohammad Ali, 32, a father of two who lives around 1 km from the hospital, told Reuters via a chat app that the sound of the assault awoke the neighbourhood at around 1:00 am.
"Soon tanks started to roll, they came from the western road and headed toward Al Shifa, then sounds of gunfire and explosions increased," he said. "We don't know what is happening, but it looked as if it was a re-invasion of the Gaza City."
The health ministry in Hamas-run Gaza said a fire broke out at the entrance of the hospital complex, causing cases of suffocation among displaced women and children sheltering there. Communication had been cut off, with people trapped inside the surgery and emergency units of one of the buildings.
"There are casualties, including deaths and injuries, and it's impossible to rescue anyone due to the intensity of the fire and targeting of anyone approaching the windows," the ministry said.
The Israeli army dropped new leaflets in the area telling residents and displaced people to evacuate south: "You are in a dangerous combat zone. The IDF is operating hard in its residential areas to destroy terror infrastructure," the leaflets said.
Sami Abu Zuhri, a senior Hamas official in exile, told Reuters the assault on the hospital was proof that Israel was not serious about negotiating a ceasefire.
"The occupation's raid of Al Shifa, the killing and wounding of dozens of people, and the destruction of Al Shifa property is a challenge to the whole world and a message that it (Israel) isn't interested in reaching any agreement. It aims to kill only," he said.
Israel came under fierce criticism last year when troops first raided the hospital, where they uncovered tunnels they said were used as command and control centres by Hamas. Hamas and medical staff deny the hospital has been used for military purposes or to shelter fighters.
