The world's top court has ordered Israel to ensure urgent humanitarian assistance reaches people in the Gaza Strip, where fighting continued Friday including around hospitals despite a binding UN ceasefire call.
In its order, the International Court of Justice (ICJ) in The Hague said: "Palestinians in Gaza are no longer facing only a risk of famine, but... famine is setting in."
In January the court had ruled that Israel must facilitate "urgently needed" humanitarian aid to the Palestinian territory and prevent genocidal acts, but Israel rejected the case, brought by South Africa.
The latest binding ruling from the court, which has little means of enforcement, came as Israel's military said Friday it was continuing operations in Al-Shifa Hospital, the territory's largest, for a 12th day.
Throughout the coastal territory, dozens of people were killed overnight, the health ministry in Hamas-run Gaza said early Friday.
Among the dead were 12 people killed in a home in the southern city of Rafah, which has been regularly bombed ahead of a mooted Israeli ground operation against Hamas militants there.
In darkness, men worked under the light of mobile phones, digging with their hands to free people trapped under concrete blocks after an air strike, AFPTV images showed.
The ICJ ordered Israel to "take all necessary and effective measures to ensure, without delay" the supply "of urgently needed basic services and humanitarian assistance" such as food, water and medical supplies.
'Immediate ceasefire'
The war began with Hamas's October 7 attack that resulted in about 1,160 deaths in Israel, mostly civilians, according to an AFP tally based on Israeli official figures.
Israel's retaliatory campaign to destroy Hamas has killed at least 32,623 people, mostly women and children, according to Gaza's health ministry.
Large parts of the territory have been reduced to rubble, and most of Gaza's population are now sheltering at its southern tip, Rafah.
On Monday the United Nations Security Council demanded an "immediate ceasefire" in Gaza, the release of hostages held by militants, and "ensuring humanitarian access".
Member states are obliged to abide by such resolutions, but fighting has continued and the Doctors Without Borders (MSF) charity on Friday said nothing has changed on the ground.
Aid groups say only a fraction of the supplies required to meet basic humanitarian needs have been allowed in since October, when Israel placed Gaza under near-total siege.
Israel has blamed shortages on the Palestinian side, namely a lack of capacity to distribute assistance once it gets in.
Humanitarians say trucking is the most effective way to deliver the aid but, they say, the number of vehicles allowed in is still far from sufficient.
With limited ground access, several nations have begun aid airdrops, and a sea corridor from Cyprus has delivered its first cargo of food.
People rushing for food drowned and were trampled to death when parachuted aid parcels fell into the sea this week, illustrating the dangers and desperation.
Heavy damage
The UN says Gaza's health system is collapsing "due to ongoing hostilities and access constraints".
The Israeli military accuses Hamas and another militant group, Islamic Jihad, of hiding inside medical facilities, using patients, staff and displaced people for cover -- charges the militants have denied.
On Friday the army said it was "continuing precise operation activities in Shifa Hospital" where it began a raid early last week.
Troops had raided Al-Shifa in November, before Israel in January announced it had "completed the dismantling" of Hamas's command structure in northern Gaza. Palestinian militants and commanders had since returned to Al-Shifa, the army said at the start of its latest operation there.
About 200 militants have been killed during the current operation, the military said.
Near Al-Amal Hospital in Gaza's main southern city of Khan Yunis, troops carried out "targeted raids on terrorist infrastructure", killing dozens in combat backed by air support, the army said on Thursday.
Israeli tanks and armoured vehicles have massed around another Khan Yunis health facility, the Nasser Hospital, the Gaza health ministry said.
An analysis of satellite images shows heavily damaged areas around the Nasser and Al-Amal hospitals.
Deadliest toll
Since the Gaza war began, Israel has increased its strikes in Syria, targeting army positions and Iran-backed forces including Lebanon's Hezbollah movement, an ally of Damascus and Hamas.
A British-based war monitor said Israeli air strikes on Friday in Syria's north killed at least 42 including six from Hezbollah and 36 Syrian soldiers.
And Israel's military said it killed Ali Abdel Hassan Naim, deputy commander of Hezbollah's rocket unit, in an air strike on a car in south Lebanon Friday.
Mediators from the United States, Egypt and Qatar have tried to secure a truce in Gaza, but those talks appear deadlocked more than halfway through the Muslim holy month of Ramadan.
Tensions have risen between Israeli Prime Minister Benjamin Netanyahu and Washington, which provides billions of dollars in military aid but has grown increasingly vocal about the war's impact on civilians.
Washington has also raised the issue of Gaza's post-war rule. It has suggested a future role for the Palestinian Authority, which has partial administrative control in the Israeli-occupied West Bank.
On Thursday, Palestinian president Mahmud Abbas approved the new government of prime minister Mohammed Mustafa, who said his cabinet will work on "visions to reunify the institutions, including assuming responsibility for Gaza".
Hamas forcibly took over from Abbas's government in the Gaza Strip in 2007.
Netanyahu says Israel must have "security responsibility" in Gaza, and has defied Washington by rejecting calls for a Palestinian state.
His ruling coalition, which includes ultra-Orthodox members, is at risk over a defence ministry reform that would see ultra-Orthodox Jews called up for military service.
Netanyahu has asked the Supreme Court for a delay to allow more discussion of the measure.
He is also under domestic pressure over his failure to bring home all of the hostages seized by militants on October 7. Israel says about 130 captives remain in Gaza, including 34 presumed dead.