The Integrated Food Security Phase Classification, or IPC, today said famine is occurring in Gaza City, home to hundreds of thousands of Palestinians, and that it could spread south to Deir al-Balah and Khan Younis by the end of next month.

The IPC said hunger has been driven by fighting and the blockade of aid, and magnified by widespread displacement and the collapse of food production in Gaza, pushing hunger to life-threatening levels across the entire territory after 22 months of war.

More than half a million people in Gaza, about a quarter of the population, face catastrophic levels of hunger, and many are at risk of dying from malnutrition-related causes, the IPC report said.

Last month, the IPC said the “worst-case scenario of famine” was unfolding in Gaza, but stopped short of an official determination.

Israeli Prime Minister Benjamin Netanyahu has denied there is hunger in Gaza, calling reports of starvation “lies” promoted by Hamas.

After the publication of images of emaciated children in Gaza and reports of hunger-related deaths, Israel announced measures to let more humanitarian aid in. Yet the UN and Palestinians in Gaza say what’s entering is far below what’s needed.