CNN  — 

More than 30,000 people have been killed in Gaza since Israel’s war with Hamas began in October, the health ministry in the besieged enclave said Thursday, a bleak milestone that comes amid growing international pressure on Israel to halt fighting and fears of further bloodshed in the southern city of Rafah.

The towering figure underscores a horrific, months-long ordeal for Palestinians inside the strip, during which Israel’s bombing and ground campaigns have displaced the vast majority of the population and created a dire humanitarian crisis.

Israel is facing mounting pressure globally to halt the conflict, but its campaign in Gaza has retained the support of the United States, its key ally and largest supplier of military aid. The US proposed a “temporary ceasefire” at the United Nations earlier this month, but has vetoed calls for an immediate halt in the conflict.

The new milestone highlights fears of more suffering in Rafah, Gaza’s southernmost city where more than 1 million people are crammed, and where Israel is expected to launch a fresh offensive.

Gaza’s health ministry does not distinguish between civilians and fighters but has said in recent updates that around 70% of the casualties are women and children.

Israel estimates about 10,000 Hamas fighters have been killed since October 7, when Israel declared war on the militant group. More than 1,200 people in Israel were killed during Hamas’ attacks on that day, and more than 250 were kidnapped and taken hostage in Gaza.

CNN cannot independently verify the casualty tolls in Gaza or the Israeli estimates of Hamas fighters killed.

Nearly five months on, Israel has said that more than 100 hostages remain in captivity. Its political and military leaders have pledged to press ahead with their objectives to return those hostages and “destroy” Hamas, despite international pressure to reduce the intensity of their campaign.

Israeli war cabinet minister Benny Gantz on February 17 warned that Israeli forces will expand military operations in Rafah if hostages are not returned by Ramadan, which is expected to begin on March 10 or 11.

“The world must know, and Hamas leaders must know – if by Ramadan our hostages are not home – the fighting will continue to the Rafah area,” Gantz said at a gathering of the Conference of Presidents of Major American Jewish Organizations in Jerusalem.

Israel’s Western allies have grown increasingly concerned over the nature of its bombing and ground campaigns in Gaza, with even its most important partner, the United States, raising with increased regularity the plight of the millions of Palestinians caught in the path of its offensive.

President Joe Biden remarked earlier this month that the Israel Defense Forces’ conduct has been “over the top,” his most direct rebuke to date.

Biden subsequently told Netanyahu that the military action in Rafah “should not proceed without a credible and executable plan for ensuring the safety of and support for the civilians,” according to a readout of a phone call between the two leaders, and the US later proposed a UN resolution on a “temporary ceasefire,” though it has not supported calls by other countries for a ceasefire to be immediately implemented.

As well as displacing the majority of Gaza’s 2.2 million people, the war has drastically diminished supplies of water, electricity and food, and cut off access to vital life-saving care. The hospitals in the enclave have become battlegrounds, with dozens of facilities no longer functional.

The UN Humanitarian Affairs Coordination Office, OCHA, said on Tuesday that at least 576,000 people across Gaza are “facing catastrophic levels of deprivation and starvation” and are “one step away from famine.”

Almost the entire population of 2.2 million people require food aid, according to the UN World Food Programme (WFP), which added one in six children under the age of two is acutely malnourished.

“Gaza is seeing the worst level of child malnutrition anywhere in the world,” Carl Skau, WFP Deputy Executive Director, told the UN Security Council on Tuesday.

A sprawling tent city has meanwhile been formed around Rafah, as more and more displaced Palestinians make the trek to the city – the last place to which they can flee north of the shuttered border with Egypt.

In recent weeks, hopes for a ceasefire-for-hostages deal have repeatedly risen and then fallen, as high-stakes diplomatic efforts to secure a pause in the fighting continue.

On Monday, CNN reported Hamas had backed off some key demands in the negotiations for a hostage deal and pause in the fighting in Gaza following Israeli accusations that its position was “delusional,” according to two sources familiar with the discussions.

Biden said that he hopes there’ll be a ceasefire in the Israel-Hamas conflict by “next Monday,” saying that a deal was “close” but “not done yet.”

However, officials from Israel, Hamas and Qatar have cautioned against Biden’s optimism, suggesting that differences remain as negotiators work to secure an agreement.

This is a developing story. More to follow.

CNN’s Lauren Izso, Mohammed Tawfeeq, Catherine Nicholls, Pauline Lockwood and Alex Marquardt contributed reporting.