The International Court of Justice has ordered Israel to allow unrestricted access to food supplies in Gaza, where sections of the population are facing imminent hunger, in a significant legal rebuke to Israel’s claim that it is not preventing aid delivery.

A panel of justices at the UN’s top court, which is already considering a complaint from South Africa that Israel is committing genocide in the Palestinian area, delivered the order after an earlier emergency measure in January obliging Israel to receive humanitarian aid.

The judges, who were united in their verdict, stated Palestinians in Gaza endure worsening circumstances of life, and famine and malnutrition are spreading. “The court observes that Palestinians in Gaza are no longer facing only a risk of famine, but that famine is setting in,” the judges said in their order.

In its legally binding order, the court told Israel to take “all necessary and effective measures to ensure, without delay, in full cooperation with the United Nations, the unhindered provision at scale by all concerned of urgently needed basic services and humanitarian assistance,” including food, water, fuel, and medical supplies.

The ICJ also ordered Israel to immediately ensure “that its military does not commit acts which constitute a violation of any of the rights of the Palestinians in Gaza as a protected group under the Convention on the Prevention and Punishment of the Crime of Genocide, including by preventing, through any action, the delivery of urgently needed humanitarian assistance.”

Israel denies it is committing genocide and says its military campaign is self-defence. The judges also urged for the immediate release of all captives being held by Hamas, echoing the demand of a UN security council resolution that was enacted on Monday.

While Israel has stated that it is allowing supplies into Gaza, senior UN, US, and other international officials, as well as international NGOs, have accused the country of impeding life-saving aid to Gaza’s population of 2.3 million.

The verdict comes on top of warnings by the UN’s top rights officer that Israel may be committing a war crime by obstructing aid, despite Israel’s plea to the court in The Hague not to issue fresh penalties.

The latest penalties were demanded by South Africa as part of its ongoing case that accuses Israel of state-led genocide in Gaza as well as incitement to genocide in statements by top Israeli officials.

Under international law, using starvation as a weapon of war is clearly illegal, but occupying troops are also legally required to ensure that citizens in areas they rule are supplied with the means of life.

The UN said late on Wednesday that famine was “ever closer to becoming a reality in northern Gaza” and that the territory’s health system was disintegrating owing to the continued warfare and “access constraints.”.

The ICJ order came as severe combat took place around two vital hospitals in Gaza on Thursday, while a third was apparently under Israeli blockade, amid rising international concern for the safety of patients, civilians, and remaining medical staff in the facilities.

The most intensive combat once again looked to be focused on the al-Shifa complex, Gaza City’s major hospital before the conflict, where the Israeli army said it continued to operate around the site after attacking it more than a week ago.

Israeli tanks and armoured vehicles have also massed around Nasser hospital in the southern city of Khan Younis, the Gaza health ministry claimed, adding that shots were fired but no raid had yet been launched. The Red Crescent stated that thousands of people were trapped inside.

Israeli forces were also blockading al-Amal hospital in Khan Younis, and numerous other sites in the city had come under Israeli fire, residents claimed.

The Israel Defense Forces claim to have killed roughly 200 militants in the region of al-Shifa hospital since the commencement of the operation there, “while preventing harm to civilians, patients, medical teams, and medical equipment.”.

Early on Thursday, the Israeli army claimed terrorists had shot at troops from within and outside the hospital’s emergency room.

Gaza’s Hamas-run health ministry claimed wounded people and patients were being confined inside an administration building in al-Shifa that was not suited to give them treatment, adding that five patients have died since the Israeli raid because of shortages of food, water, and medical care.

Unverified footage on social media shows al-Shifa’s surgery unit charred by flames and surrounding buildings on fire or damaged.

The armed wings of the Israel and Islamic Jihad militant factions stated in a statement that they had “bombed, with a barrage of mortar shells, gatherings of Israeli soldiers in the vicinity of the al-Shifa complex” in a combined operation. The assertions on neither side could be independently verified.

The Palestinian Red Crescent (PRC) said seven people working for the group who were seized in a raid on al-Amal hospital on February 9 had finally been released after 47 days in Israeli prisons.

The World Health Organization stated al-Amal hospital had ceased to function as a result of the fighting, leaving only 10 of 36 facilities in the Gaza Strip partly active. The WHO’s director general, Tedros Adhanom Ghebreyesus, wrote on X on Thursday: “Once more, the WHO demands an immediate end to attacks on hospitals in Gaza and calls for the protection of health staff, patients, and civilians.”

A succession of horrific witness reports from international medical teams who visited healthcare institutions have emerged in recent days. On Thursday a team of doctors who visited al-Aqsa hospital in the town of Deir al-Balah in central Gaza told the Associated Press that a toddler there had died from a brain injury caused by an Israeli strike that fractured his skull, while his infant cousin is fighting for her life with part of her face blown off by the same strike.

The team stated a 10-year-old kid, who was not related, shouted out in pain for his parents, not understanding that they had been killed in the hit; he could not recognise his sister alongside him because burns covered practically her entire body, they said.

“I spend most of my time here resuscitating children,” said Tanya Haj-Hassan, a paediatric intensive-care doctor from Jordan who has significant experience in Gaza and often speaks out about the war’s catastrophic impacts. “What does that tell you about every other hospital in the Gaza Strip?”

On Thursday, the Palestinian prime minister, Mohammad Mustafa, announced a new government in which he will also serve as foreign minister, making an early ceasefire and Israeli disengagement from Gaza a high goal

Mustafa, an ally to the president, Mahmoud Abbas, and a renowned business figure, was appointed premier this month with a mandate to help modernize the Palestinian Authority, which exercises limited self-rule in the Israeli-occupied West Bank.

The authority’s forces were ousted from Gaza when Hamas seized power in 2007, and it has no power there. The US has proposed a reinvigorated authority to oversee postwar Gaza before ultimate statehood. Israel has rejected that plan, claiming it would maintain open-ended security control over Gaza.

On the diplomatic front, the White House said it was working to rearrange a visit by an Israeli delegation to Washington that was abruptly cancelled by Benjamin Netanyahu after the US decision not to veto Monday’s UN security council resolution calling for an immediate ceasefire in Gaza and the release of hostages held by militants.

Karine Jean-Pierre, the White House press secretary, verified reports that the Israeli prime minister had climbed down over the visit and agreed to delay it. “We’re now working with them to find a convenient date that’s obviously going to work for both sides,” she said.