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The US has given Israel 30 days to improve the humanitarian situation in Gaza or face possible restrictions on arms supplies. This is their strongest ultimatum since Benjamin Netanyahu started the war in the besieged territory more than a year ago.

US Secretary of State Antony Blinken and Defense Secretary Lloyd Austin called for concrete measures to address the deteriorating humanitarian situation in the Palestinian enclave in a letter to their Israeli counterparts. The letter was reportedly sent as the Israeli military bombed a hospital campground in central Gaza, killing four people. At least one of them was captured on video burning alive while still connected to an IV.

The ministers said Israel denied or obstructed about 90 percent of humanitarian movements between north and south Gaza last month. They are “particularly concerned” that “the Israeli government’s recent actions” are “contributing to an accelerated deterioration of conditions in Gaza.”

The letter cited Israel's rejection of most humanitarian movements between northern and southern Gaza and its “onerous and excessive” restrictions on the entry of goods into Gaza.

To ensure that Israel continues to receive military funding, the ministers outlined concrete steps that the Netanyahu government must take within 30 days.

They stressed the need to increase aid to Gaza to at least 350 trucks per day and that Israel must introduce additional humanitarian pauses and provide greater security at these sites.

Failure to “demonstrate a sustained commitment to implementing and sustaining these measures could have implications for U.S. policy,” the letter said.

It cited Section 620i of the Foreign Assistance Act, which prohibits the delivery of military aid to countries that impede the delivery of U.S. humanitarian assistance.

Israeli human rights groups have warned that their country is laying siege to the northern Gaza Strip and allowing remaining Palestinians to starve.

The Gisha, B'Tselem, PHR-I and Yesh Din groups said over the weekend that there were “alarming signs” that Israel was “quietly” beginning to implement the “generals' plan” to close the northern Gaza Strip Declare a military zone Financial Times reported.

The United Nations World Food Program said last week it was unable to provide food to over a million Palestinians “due to limited access to aid.”

It also said that the main crossings to the north had been closed due to renewed Israeli bombing and that no food or basic supplies had entered the region since October 1st.

The Israeli military claimed it had not stopped “the entry or coordination of humanitarian assistance” in the north.

An Israeli official in Washington DC told Reuters that the US secretary's letter had been received and was being reviewed. “Israel takes this matter seriously and intends to address the concerns raised,” the official said.

White House national security spokesman John Kirby said the letter was not intended as a “threat” but reiterated the urgency of increasing humanitarian assistance in Gaza.

“However long overdue, this official warning that Israel must stop blocking humanitarian aid to Gaza or face a suspension of U.S. military aid is an important and unprecedented signal that Israel is abandoning even the permissive red lines of the Gaza Strip Biden administration has exceeded,” said Sarah Leah Whitson, executive director of the nonprofit DAWN The Independent.

“We now need the Biden administration to show action, not just words, to enforce U.S. laws that prohibit aid to Israel, not only in the face of the relentless obstruction of humanitarian assistance, but also the deliberate starvation and incessant bombardment of civilians in the Gaza Strip ” she said.

U.S. officials said a similar letter from Mr. Blinken in April elicited a constructive response and led to “concrete action by the Israelis.”

State Department spokesman Matthew Miller claimed that Israel made changes at the time that resulted in 300 to 400 aid trucks entering Gaza daily, but that number has since fallen by over 50 percent.

“We really want change not to wait 30 days, but to be implemented immediately,” Mr. Miller said.

Israel's years-long war in Gaza has killed about 42,300 Palestinians and injured more than 99,000 others, according to the Health Ministry in the Hamas-controlled Gaza Strip. It has since launched an attack on Lebanon and also bombed Syria. The militant group Hamas attacked southern Israel on October 7 last year, killing around 1,200 people and taking more than 250 hostages.

Joe Biden's administration appeared to balance its criticism of Israel's actions in Gaza with a show of military support, announcing on Sunday that it would send US troops and the advanced THAAD missile defense system to the country.