Israeli attacks have killed at least 71 Palestinians seeking humanitarian aid amid a deepening hunger crisis in Gaza, medical sources told Al Jazeera, as hospitals in the besieged territory recorded seven more deaths from famine and malnutrition.

At least 51 people were killed and more than 648 others were wounded by Israeli forces on Wednesday as they were heading towards the Zikim crossing point for aid trucks entering northern Gaza, according to the Gaza Government Media Office.

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Another 20 people seeking aid were killed near the so-called Morag Corridor near Khan Younis in southern Gaza, the Nasser Medical Complex reported.

More than 1,000 Palestinians seeking aid have been killed by Israeli forces near aid distribution sites run by the US and Israeli-backed GHF, which launched operations in late May.

The GHF has been heavily criticised by the UN and other humanitarian organisations for failing to provide enough aid and for the dire security situation at and around its aid distribution sites.

The attacks come as aid agencies and health officials warn of a sharp rise in starvation, particularly among children and the elderly.

The Gaza Health Ministry said 154 people, including 89 children, have died of malnutrition, most in recent weeks. A global hunger monitor said on Tuesday that a famine scenario is unfolding.

Among those struggling to survive is Jihan al-Quraan, a mother who spoke to Al Jazeera while holding her young daughter. “Look at her stomach! There is no flesh, just bones from the lack of food – an entire month without bread,” she said.

Al-Quraan said she tried to get food at a crowded soup kitchen, but returned empty-handed. “I only found some dry pasta shells on the floor,” she added.

Despite mounting needs, aid entering Gaza remains far below required levels. Adnan Abu Hasna, a spokesman for UNRWA, the United Nations agency for Palestinian refugees, told Al Jazeera Arabic that the trickle of aid allowed into Gaza “does not reach the majority of the population”.

According to the UN, Gaza needs at least 500 to 600 aid trucks per day to meet basic humanitarian needs. Yet, only 269 trucks have entered the territory over the past four days.

“Most of them were looted by hungry crowds,” reported Al Jazeera’s Tareq Abu Azzoum from Gaza. “Now, looting aid is not very shocking. It has been a predictable outcome for a prolonged period of a starving population that has been denied access to water, food and medical supplies.”

“People have gone days without getting any kind of food,” he added. “The number of trucks sent to the Gaza Strip falls short of meeting the needs of the population.”

The Euro-Med Human Rights Monitor said it had documented the deaths of dozens of elderly people in displacement camps “due to starvation, malnutrition, or lack of treatment”.

“Many of these deaths were recorded as natural causes, owing to the absence of a clear reporting mechanism within the ministry and the tendency of families to bury their loved ones immediately,” the group said in a statement on X.

It added that hospitals and primary care centres have seen an “unprecedented surge” in daily deaths over the past two weeks, with hundreds of elderly people arriving in “states of extreme exhaustion, seeking nutritional fluids”.

Israeli bombardment continues

At least 15 other people were killed in Israeli attacks across Gaza on Wednesday, medical sources told Al Jazeera.

That includes the minimum three people, including Palestinian photojournalist Ibrahim Mahmoud Hajjaj, 35, were killed in two separate Israeli air strikes in Gaza City. One strike targeted a group of people near az-Zahra School in the central Daraj neighbourhood, killing two and wounding others. A second strike in eastern Gaza City killed Hajjaj.

According to the Committee to Protect Journalists, 178 journalists have been killed during Israel’s war on Gaza since October 7.

Since the war began, Israeli attacks have killed at least 60,138 Palestinians and wounded more than 146,000 others, according to Gaza’s Health Ministry. An estimated 1,139 people were killed in Israel during the Hamas-led attack on October 7, and more than 200 others were taken captive.

Gaza annexation threat

Meanwhile, an Israeli minister hinted at the possibility of annexing parts of Gaza – a move that could any remaining hopes of a two-state solution and further entrench Israel’s occupation in violation of international law.

Accusing Hamas of trying to drag out ceasefire talks to gain Israeli concessions, security cabinet member Zeev Elkin told public broadcaster Kan that Israel may give the group an ultimatum to reach a deal before further expanding its military actions.

“The most painful thing for our enemy is losing lands,” he said. “A clarification to Hamas that the moment they play games with us they will lose land that they will never get back would be a significant pressure tool.”

The remarks came just days after Heritage Minister Amichai Eliyahu said the Israeli government is “advancing the destruction of Gaza”.

“The government is racing ahead for Gaza to be wiped out,” Eliyahu told Haredi radio station Kol Barama. “Thank God, we are wiping out this evil. We are pushing this population that has been educated on ‘Mein Kampf’,” he said, referring to the 1925 autobiographical and political work by Adolf Hitler, the leader of Germany’s Nazi Party.

Eliyahu’s comments drew widespread outrage, including from within Prime Minister Benjamin Netanyahu’s own coalition. However, Israeli media reports suggest the government is preparing a formal ultimatum to Hamas: agree to their terms of a ceasefire or face the annexation of territory.

Israel’s Channel 13 reported that Israel may seek to annex land adjacent to the Gaza perimeter fence, pushing up to one kilometre inside the Strip.

These threats come as negotiations continue between Hamas and Israel, with mediation from the United States, Qatar and Egypt. Channel 12 reported that Israel has proposed a 60-day ceasefire that would include a partial withdrawal of troops from Gaza, but not an end to the war.

A US official confirmed that special envoy Steve Witkoff would travel to Israel on Thursday to discuss “next steps” to address the situation. Earlier this week, US President Donald Trump said he expected centres to be set up to feed more people inside Gaza.

But for many Palestinians on the ground, those promises remain far removed from the daily fight for survival.