[Source: Reuters]

Extreme food shortages in parts of the Gaza Strip have already exceeded famine levels, and mass death is now imminent without an immediate ceasefire and surge of food to areas cut off by fighting the global hunger monitor said on Monday.

The Integrated Food-Security Phase Classification (IPC), whose assessments are relied on by U.N. agencies, said 70% of people in parts of northern Gaza were suffering the most severe level of food shortage, far exceeding the 20% famine threshold.

The IPC said it did not have enough data on death rates, but estimated residents would be dying 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.

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.

“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 Josep Borrell said at the opening of a conference on humanitarian aid for Gaza in Brussels.

“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”.

Israel allowed “extensive humanitarian aid into Gaza by land, air, and sea for anyone willing to help”, Katz said on X, and aid was “violently disturbed” by Hamas militants with “collaboration” by the U.N.’s aid agency UNRWA.

U.N. Secretary-General Antonio Guterres called the IPC report an “appalling indictment” and said Israel must allow complete and unfettered access to all parts of Gaza.

“This is an entirely manmade disaster — and the report makes clear that it can be halted.”

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, as well as allowing sea shipments and airdrops. The first boat carrying aid arrived last week.

Aid agencies say they still cannot get enough supplies through or distribute them safely, especially in the north.

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.

Israel said it had killed 20 Hamas fighters, including a senior Hamas commander, Fayeq al-Mabhouh, in the hospital. Hamas confirmed his death in a statement and said he was a Palestinian police official tasked with overseeing the protection of aid deliveries in Gaza.

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.

U.S. President Joe Biden spoke to Israeli Prime Minister Benjamin Netanyahu on Monday and discussed efforts to “surge” aid into Gaza in the first call between the two leaders since Feb. 15, the White House said.

The leader in the U.S. Senate from Biden’s Democratic Party called on Israelis last week to replace Netanyahu, saying he was wrecking Israel’s international standing by allowing too much suffering in Gaza.

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 its hostages without a deal that would end the war.

The Israeli army said troops had entered Al Shifa based on intelligence that the hospital was being used by senior Hamas leaders. The soldiers were fired on and responded. One soldier was killed.

Residents described some of the heaviest fighting in northern Gaza for months.

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 a.m.

“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 displaced people inside the hospital had been killed in a fire caused by the raid: “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.”