DEIR AL-BALAH, Gaza Strip — More than 100 charity and human rights groups said Wednesday that Israel’s blockade and ongoing military offensive are pushing Palestinians in the Gaza Strip toward starvation, as Israeli strikes killed another 29 people overnight, according to local health officials.

Meanwhile, the Trump administration’s Mideast envoy, Steve Witkoff, was set to meet with a senior Israeli official about ceasefire talks, a sign that lower-level negotiations that have dragged on for weeks could be approaching a breakthrough.

Experts say Gaza is at risk of famine because of Israel’s blockade and the offensive launched in response to Hamas’ Oct. 7, 2023, attack. The head of the World Health Organization said Gaza is “witnessing a deadly surge” in malnutrition and related diseases, and that a “large proportion” of its roughly 2 million people are starving.

Israel says it allows enough aid into the territory and faults delivery efforts by U.N. agencies, which say they are hindered by Israeli restrictions and the breakdown of security.

Hamas has said it will only release the remaining 50 hostages it holds, around 20 of them believed to be alive, in exchange for a lasting ceasefire and an Israeli withdrawal. Israel has vowed to recover all the captives and continue the war until Hamas has been defeated or disarmed.

‘Chaos, starvation and death’

In an open letter, 115 organizations, including major international aid groups such as Doctors Without Borders, Mercy Corps and Save the Children, said they were watching their own colleagues, as well as the Palestinians they serve, “waste away.”

The letter blamed Israeli restrictions and “massacres” at aid-distribution points. Witnesses, health officials and the U.N. human rights office say Israeli forces have repeatedly fired on crowds seeking aid, killing more than 1,000 people. Israel says its forces have only fired warning shots and that the death toll is exaggerated.

The Israeli government’s “restrictions, delays, and fragmentation under its total siege have created chaos, starvation, and death,” the letter said.

WHO Director Tedros Adhanom Ghebreyesus echoed that criticism, telling reporters that acute malnutrition centers in Gaza are full of patients and lack adequate supplies. He said rates of acute malnutrition exceed 10% and that among pregnant and breastfeeding women, more than 20% are malnourished, often severely.

The U.N. health agency’s representative in the occupied Palestinian territories, Dr. Rik Peeperkorn, said there were more than 30,000 children under 5 with acute malnutrition in Gaza and that the WHO had reports that at least 21 children under 5 have died so far this year.

Israel says critics are ‘echoing Hamas’ propaganda’

The Israeli Foreign Ministry rejected the criticism in the open letter and accused the groups of “echoing Hamas’ propaganda.” It said it has allowed around 4,500 aid trucks into Gaza since lifting a complete blockade in May, and that more than 700 trucks are waiting to be picked up and distributed by the U.N.

That’s an average of around 70 trucks a day, the lowest rate of the war and far below the 500 to 600 trucks a day the U.N. says are needed, and which entered during a six-week ceasefire earlier this year.

The U.N. says it has struggled to deliver aid inside Gaza because of Israeli military restrictions, ongoing fighting and a breakdown of law and order. An alternative system established by Israel and an American contractor has been marred by violence and controversy.

Top adviser to Netanyahu will meet US envoy in Rome

White House press secretary Karoline Leavitt said Witkoff was headed to Europe to meet with key leaders from the Middle East to discuss the latest ceasefire proposal and release of hostages.

“We want this ceasefire to happen as soon as possible, and we want these hostages to be released,” Leavitt said.

An official familiar with the negotiations said Ron Dermer, a top adviser to Israeli Prime Minister Benjamin Netanyahu, was traveling to Rome to meet Witkoff on Thursday. The official spoke on condition of anonymity because they were not authorized to discuss the sensitive negotiations.

The evolving deal is expected to include a 60-day ceasefire in which Hamas would release 10 living hostages and the remains of 18 others in phases in exchange for Palestinians imprisoned by Israel. Aid supplies would be ramped up, and the two sides would hold negotiations on a lasting truce.

Overnight strikes kill at least 29

Israel has continued to carry out waves of daily airstrikes against what it says are militant targets but which often kill women and children. Israel blames civilian deaths on Hamas because the militants operate in densely populated areas.

One of the overnight strikes hit a house in Gaza City, killing at least 12 people, according to Shifa Hospital, which received the casualties. The dead included six children and two women, according to Gaza’s Health Ministry. The Israeli military said it struck an Islamic Jihad militant, and that the incident was under review because of reports of civilian casualties.

Shifa said another strike late Tuesday in Gaza City killed three children.

A strike on an apartment in northern Gaza killed at least six people. Among the dead were three children and two women, including one who was pregnant, the ministry said. The military said it struck a Hamas operative.

In central Gaza, a strike in a densely populated part of the built-up Nuseirat refugee camp killed eight people and wounded 57, according to Awda Hospital, which received the casualties.

Hamas-led militants abducted 251 people in the Oct. 7 attack and killed around 1,200 people, mostly civilians.

More than 59,000 Palestinians have been killed during the war, according to Gaza’s Health Ministry. Its count doesn’t distinguish between militants and civilians, but the ministry says that more than half of the dead are women and children. The U.N. and other international organizations see it as the most reliable source of data on casualties.

Goldenberg reported from Tel Aviv, Israel. Associated Press Writer Michelle Price in Washington contributed to this report.