The threatened U.S. deadline for Israel to allow more aid for people into the Gaza Strip or see fewer weapons shipments for its war with Hamasexpired on Tuesday but the Biden administration said it would not limit arms transfers.

Because of Israeli border controls, the amount of food and other aid getting in is at its lowest level this year. Food security experts and rights groups caution that famine may already be underway in north Gaza. Almost the entire population of around 2.3 million Palestinians is relying on international aid for survival as Israel and Hamas wage their nearly 13-month-old war.

“I witnessed during my visit to Gaza last week the deliberate starvation of almost 2 million civilians, whilst the bombardment continues,” said Jan Egeland, secretary-general of the Norwegian Refugee Council, a major relief provider. “There is barely any aid crossing into Gaza.”

Israel, which controls all crossings into Gaza, says it is committed to delivering humanitarian assistance and has scrambled to ramp up aid. It says the U.N. and international aid groups need to do a better job of distributing supplies, and criminal gangs are stealing aid before it gets to civilians.

The State Department spokesman Vedant Patel said that the progress to date must be supplemented and sustained but that “we at this time have not made an assessment that the Israelis are in violation of U.S. law" requiring recipients of military assistance to adhere to international humanitarian law and not impede the provision of such aid.

“We are not giving Israel a pass,” Patel said, adding that “we want to see the totality of the humanitarian situation improve.”

Aid into Gaza is typically measured in terms of truckloads of food and supplies entering the territory. The U.S. has demanded 350 trucks daily.

Israeli government figures show roughly 57 trucks a day entering on average in Oct and 75 a day in November. The U.N. counts trucks differently and says it has only received 39 trucks daily since the beginning of October.

In northern Gaza, where the Israeli military has been carrying out a major offensive over the past month, the figures were even lower. No aid entered the northernmost areas of Gaza — Jabaliya, Beit Lahiya and Beit Hanoun — in October, the U.N. says.

Israel says it closed all the Gaza crossings for the Jewish high holidays in October and couldn’t send aid to the north because of the offensive against Hamas fighters.

Over the last two days, the military body handling aid deliveries to Gaza — COGAT — says it has allowed aid trucks to enter the hardest-hit northern areas. But only three of the trucks have made it to their destination successfully, according to the World Food Program.

Aid groups accuse the Israeli army of blocking aid-packed trucks from reaching areas where the fighting is most intense, including northern Gaza, where hunger is most acute.

“There can be aid sitting at the border ready to come in. But if we are not provided a safe passage to go and collect it, it’s not possible for us to have it. And it will not reach the people who need it,” said Louise Wateridge, a spokesperson for UNRWA, the U.N. agency for Palestinian refugees.

UNRWA has been the main agency procuring and distributing aid in Gaza and a feud between Israel and the agency lead Israel to ban it last month.

During October, the U.N. Office for the Coordination of Humanitarian Affairs said Israeli authorities rejected roughly 43% of all humanitarian movement requests, and impeded a further 16%.

Israeli authorities have also prohibited some vehicles and goods from entering the enclave, aid groups say, often without reason. Rachel Morris, of the aid group Mercy Corps, said trucks carrying the group’s tent supplies have been turned away more than five times.

Israel says it denies entry to supplies that could be weaponized by Hamas.

Under intense international pressure, Israel has since taken measures to up aid delivery, with COGAT saying it was allowed trucks into the hard-hit north. On Monday, the Israeli security Cabinet approved increased aid for Gaza, which will increase the number of trucks that enter Gaza each day, according to an official familiar with the matter.

But aid groups say access is still an issue.

The World Food Program said vehicles filled with its supplies were denied access to Jabaliya, Beit Hanoun, and Beit Lahiya on Tuesday. The day before, the U.N. agency said it received approval from the army to deliver supplies to Beit Hanoun only to be stopped by troops on route in Jabaliya and ordered to offload the stockpile there.

Also stymying distribution is theft and criminality along aid routes.

Israel accuses UNRWA of failing to pick up hundreds of trucks worth of supplies piling up at the territory’s main southern aid crossing. It says the aid has been waiting there for months.

But the military and aid agencies both acknowledge that aid deliveries are treacherous because family-based crime groups are robbing the trucks. An Israeli official, speaking on the condition of anonymity under military briefing guidelines, estimated 30% to 40% of aid supplies are stolen by members of criminal families.

COGAT spokesperson Shani Sasson said the Israeli army has tried to secure part of the route and find alternate routes for drivers, but cannot accompany each aid truck and the criminal groups are always moving.

Many aid groups that used to use the crossing now say it is too dangerous for their staff to collect aid. Aseel Baidoun, a senior manager at Medical Aid for Palestinians, said that drivers sometimes have to pay fees to move their aid from the crossing into Gaza.

He said the Israeli military was “failing to provide an enabling environment to bring in sufficient humanitarian goods to Gaza.”

Aid groups also say their warehouses and workers have come under attack from Israeli forces. OCHA says that at least 326 aid workers have been killed since the start of the war. It is not clear how many have been killed while working.

The U.S. has not yet said how it will respond to the low aid levels. Last week, the State Department said Israel needs to do more.

Israel’s new foreign minister, Gideon Saar, appeared to downplay Washington’s deadline, telling reporters on Monday that he was confident “the issue would be solved.”

The Israeli military announced on Tuesday that it would open a fifth crossing for humanitarian aid into Gaza, a key demand by the United States. But it remains unclear when the Kissufim crossing in central Gaza will be operational.