US top diplomat Antony Blinken touched down Wednesday in the Middle East to bolster efforts for a truce in the war in Gaza, as Israeli forces pushed on with a raid on the territory's largest hospital.

Global concern has mounted over the military conflict now in its sixth month, in which Israeli Prime Minister Benjamin Netanyahu has vowed to destroy Hamas in response to a deadly attack by its fighters on October 7.

The latest fighting included an Israeli assault on Gaza City's Al-Shifa hospital, a vast complex crowded with patients and people seeking refuge, where Israel says Palestinian militants are holed up.

The Israeli army said "over 300 suspects were apprehended" in the hospital raid that began early Monday, including "dozens of senior terrorists and those with key positions".

Hamas meanwhile condemned Israeli "crimes" at Al-Shifa "for the third day in a row, the executions of dozens of displaced persons, patients and staff".

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UN agencies have warned that Gaza's 2.4 million people are on the brink of famine, and UN rights chief Volker Turk said Israel may be using "starvation as a method of war".

The dire plight of Palestinians and the fate of Israeli hostages held in Gaza have pushed negotiators back to the table in Qatar to try to thrash out a truce deal, but officials have so far reported little progress.

The United States, long Israel's top ally, has also ratcheted up its diplomatic efforts and increasingly voiced concern over humanitarian issues.

US Secretary of State Blinken, who began his regional tour with meetings in regional powerhouse Saudi Arabia, has warned that Gaza's "entire population" is suffering "severe levels of acute food insecurity".

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- Feared Rafah invasion -

As Blinken arrived, Riyadh announced it would donate $40 million to the UN agency for Palestinian refugees, UNRWA, which has been central to aid operations in Gaza but has faced massive funding cuts and calls for its abolition spearheaded by Israel.

UNRWA chief Philippe Lazzarini warned that "siege, hunger and diseases will soon become the main killer in Gaza".

"This fabricated and catastrophic level of hunger can still be reversed by flooding Gaza with food and life saving assistance," he wrote on social media platform X.

Blinken is also due in Israel on Friday, where he will meet with leaders to discuss the release of hostages, humanitarian aid and a planned Israeli assault on Rafah, State Department spokesperson Matthew Miller said.

Rafah, the last area in Gaza to remain free from a large-scale invasion, is now home to some 1.5 million Palestinians, many of them sheltering in tents along the Egyptian border after fleeing from other parts of the coastal territory.

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Washington wants Israel to hold back from a full-scale ground assault citing concern for civilians, but Netanyahu has repeatedly said it was the only way to eradicate Hamas.

Israel has continued to bombard Rafah and on Wednesday said it had "eliminated senior Hamas operatives" in the city.

On Thursday, Blinken is due to visit Egypt, the main entry point for aid deliveries to Gaza and a key mediator in truce efforts.

Israeli Defence Minister Yoav Gallant will visit Washington in the coming week for talks with Pentagon chief Lloyd Austin, though neither side gave a date.

Netanyahu's office said a separate delegation would visit Washington at "the request of US President Joe Biden" to discuss the planned Rafah assault.

The bloodiest ever Gaza war broke out after Hamas's unprecedented attack on October 7 resulted in about 1,160 deaths in Israel, mostly civilians, according to an AFP tally of Israeli official figures.

Militants also seized about 250 hostages, of whom Israel believes 130 remain in Gaza, including 33 who are presumed dead.

Relatives and friends of the captives, who have consistently lobbied for action to get them freed, held several protests on Wednesday, including blocking a main road in Tel Aviv.

Israel's military has waged a relentless offensive against Hamas that has killed at least 31,923 people, most of them women and children, according to Gaza's health ministry.

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- 'Step backwards' -

Mediators met for a third day in Qatar in a renewed effort to secure a ceasefire, but there was little indication of an imminent agreement.

A source with knowledge of the negotiations, speaking on condition of anonymity because of their sensitivity, told AFP talks between technical teams in Doha "are ongoing".

But a senior Hamas official based in Lebanon, Osama Hamdan, said Israel's response to the group's latest proposal was "largely negative... and constitutes a step backwards".

The plan would temporarily halt the fighting as hostages are exchanged for Palestinian prisoners and the delivery of relief supplies is stepped up.

The war has meanwhile ground on unabated, with Israel saying its forces had "killed approximately 90 terrorists" around Al-Shifa hospital during the days-long assault.

Israeli army chief Herzi Halevi said the aim of the hospital raid was "not to allow such a place to be controlled" by Hamas.

Tensions have also flared in the occupied West Bank, where Israeli forces and settlers have killed at least 435 Palestinians since the Gaza war began.

The death toll includes three Palestinians killed Wednesday in a strike on a car in the West Bank city of Jenin that the Israeli army said targeted "senior" militants.

The military said it had "eliminated" Ahmed Barakat, who it accused of a May 2023 attack that killed an Israeli settler.

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