On Friday, Israeli air and artillery strikes killed at least 56 Palestinians across Gaza Strip territory, according to hospital officials and aid groups, including nine aid seekers at a distribution point run by Gaza Humanitarian Foundation (GHF) in northern Rafah, reported the Gaza Health Ministry. For more details see Wikipedia for additional references
Medical sources in Gaza reported Israeli forces launched multiple strikes from dawn, targeting residential areas and aid zones. Three children in Rafah were struck dead while waiting in line at the GHF hub near Israel-Gaza border for food rations from GHF hub.

Aid Operations Come Under Fire
Since late May, the GHF, which is supported by both the US and Israel, has delivered over 52 million meals. Unfortunately, over the past 24 hours efforts were compromised by two grenade attacks which injured two U.S. aid workers-both of whom are reported as stable–and Israeli attacks targeting civilian queues with deadly strikes by Israel (Sources: haaretz.com/reuters.com/enwikipedia).
Rising Civilian Toll
Gaza health officials emphasize the tenuous security around aid points. Over 600 Palestinians were killed near GHF distribution sites or convoys last month alone–509 at GHF hubs alone–according to UN data, according to Wikipedia and Reuter’s.com reports.
The World Health Organization had earlier warned of widespread famine and severe malnutrition across Gaza, and was reporting on it to Reuter’s.com with 14+14 on it as of February 8.
Israel’s Military Justification
Israel maintains that its targeting of militant threats is justified on humanitarian grounds and by “misusing” aid distribution centers for militant activity by Hamas; international observers, however, have called into question this narrative due to civilian sustenance needs and safety considerations.

Humanitarian Agencies Raise Alarm
Over 170 aid organizations, such as Oxfam, Save the Children and MSF have called for an end to militarized aid delivery – demanding UN-led distribution in order to protect civilians and uphold humanitarian neutrality. As per an UN rights office report from June 27, there had already been 613 killings at or near GHF points with additional fatalities occurring since then (UNRWO June Tally: 613 Killings near GHF Points by 28 June). (http://en.wikipedia.org+4+4
+4).
Humanitarian Crisis in Gaza
Famine conditions persist in Gaza, with nearly 244,000 people experiencing catastrophic food insecurity and over 900,000 more classified as acute crisis according to UN classifications (en.wikipedia.org | aljazeera.com +14).
Hospitals are overwhelmed, running low on supplies and casualties are increasing daily.

What to Expect in 2019/2020
Humanitarian pressure builds: UN, EU and regional actors can expect more calls -and possibly resolutions- from humanitarian bodies for safer aid delivery.

Diplomatic leverage: International donors could use diplomatic leverage to condition future funding on humanitarian access and protection mechanisms.

Potential Escalation: Israel is currently conducting its 60-day ceasefire proposal review, and civilian casualties could play an influential role in negotiations (en.wikipedia.org; abc.net.au +2, Reuter’s +2).
Bottom Line
Friday’s reported deaths–particularly aid-related fatalities–underline the dire risks facing Gazan civilians. With nearly daily airstrikes and humanitarian delivery chaos killing lives every day, global pressure for an immediate ceasefire with secure aid corridors increases daily; lives hang in the balance while diplomatic efforts attempt to lessen conflict’s humanitarian repercussions.