US Secretary of State Antony Blinken has told Israel that it must account for the safety of Palestinian civilians before resuming any military operations in Gaza, where a week-long truce has allowed the exchange of captives held by Hamas for Palestinians imprisoned in Israel.

As negotiators from Qatar and Egypt were in difficult talks on Thursday for a new two-day extension to the pause in fighting between Hamas and Israel, the United States’s top diplomat made his third trip to the region since the Israel-Palestinian war began on October 7.

Blinken said Washington remains committed to supporting Israel’s right to self-defence, but also stepped up calls for Israel to comply with international law and protect civilians if it starts major military operations in southern Gaza.

His message was in keeping with the administration of US President Joe Biden’s shifting rhetoric on the war, which began as a full-throated embrace of Israel’s response to the Hamas attacks but gradually tempered as the number of Palestinian civilian casualties began to rise dramatically.

More than 15,000 Palestinians have been killed in Gaza since October 7, including more than 6,000 children. The death toll and scale of destruction have prompted widespread international criticism.

As Israel bombarded hospitals, schools and homes, the Gaza Ministry of Health said at least 7,000 people are still missing or feared buried under the rubble, and more than 36,000 Palestinians have been wounded, many with life-altering injuries. With 26 of Gaza’s 35 hospitals out of service, their chances of getting treatment are slim.

According to Ibrahim Abusharif of Northwestern University in Qatar, Blinken’s continued trips to Israel and meetings with Israeli leaders “doesn’t seem like it’s moving the needle in any direction”.

“What set the tone was the early rhetoric from the Biden administration that gave unconditional support for what turned out to be a genocidal war,” he told Al Jazeera. “Blinken can try to soften his rhetoric and apply pressure, but in the end, it won’t bring back the dead in Gaza.”

During a meeting in Jerusalem, Blinken assured Israeli Prime Minister Benjamin Netanyahu that he could count on US support.

But, he said that such support requires Israel’s “compliance with international humanitarian law,” and “urged Israel to take every possible measure to avoid civilian harm,” the US Department of State said.

To prevent a further significant increase in civilian casualties, Blinken “stressed the imperative of accounting for humanitarian and civilian protection needs in southern Gaza before any military operations there,” the department said.

Later on Thursday, US National Security Council spokesperson John Kirby said Washington supports the resumption of fighting in Gaza after the end of the truce, which Netanyahu has affirmed would happen.

“We continue to believe that Israel has the right and responsibility to go after Hamas … and as they make that decision, they’ll continue to find support from the United States,” Kirby told reporters.

Settler violence

Blinken also “urged immediate steps to hold settler extremists accountable for violence against Palestinians in the West Bank” and said the US places great importance on the resumption of a peace process that would eventually lead to the creation of a Palestinian state.

Israeli officials have pledged to the US on multiple occasions that Israeli settler violence will be punished, but Netanyahu’s office released a statement about the meeting with Blinken that contained no mention of either settler violence or a two-state solution.

Netanyahu said he told Blinken, “We will continue this war until we achieve the three goals – to release all our abductees, to eliminate Hamas completely and to ensure that Gaza will never again face such a threat.”

Blinken also met Israel’s war cabinet in Jerusalem before travelling to the occupied West Bank for talks with Palestinian President Mahmoud Abbas and then back to Tel Aviv where he held talks with Israeli Defence Minister Yoav Gallant and opposition leader Yair Lapid.

Humanitarian aid, Palestinian state

In his meeting with Abbas, Blinken focused on efforts to increase the delivery of humanitarian aid to Gaza and condemned Jewish settler attacks against Palestinians in the occupied West Bank.

Blinken told Abbas “he would continue to insist on full accountability for those responsible,” and that Washington “remains committed to advancing tangible steps for a Palestinian state,” the State Department said.

Abbas presented Blinken with “a comprehensive file documenting Israeli occupation crime in Gaza, and the West Bank, including Jerusalem”, Palestinian state news agency Wafa reported.

Israeli army raids have taken place on a daily basis across the West Bank since the war began. The total number of people arrested since October 7 is now more than 3,325, according to the Palestinian Prisoner’s Society (PPS).

At least 248 Palestinians, including more than 50 children, have been killed in the occupied West Bank since October 7. More than 2,750 have been injured.

Abbas also raised the topic of the forced displacement of Palestinians in Gaza and the occupied West Bank, particularly in light of increased attackers from settlers.

The top US diplomat will close out his latest Middle East tour in the United Arab Emirates on Friday, where he will discuss the Gaza situation with Arab leaders gathered in Dubai for the COP28 United Nations climate change conference.

Another truce extension?

Blinken’s meetings came as Israel and Hamas agreed at the last minute to a third extension of a truce under which Israel has paused most military activity in return for the release of captives held by Hamas.

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Qatar, which has been mediating between the two sides, said the agreement was being extended under the same terms as in the past, under which Hamas has released 10 Israeli captives per day in exchange for 30 Palestinian prisoners.

Late on Thursday, the Israeli military said two released captives have been handed over to its soldiers by the Red Cross and the Palestinian Prisoners’ Club released a list containing the names of 30 Palestinian prisoners – eight women and 22 children – who are expected to be released later in the day.

But as the number of civilians held in Gaza dwindles, Daniel Levy, a former Israeli negotiator, said the current iteration of the truce deal will have to be renegotiated.

“Can one do that in time to extend this cessation without getting back to the intention of the Israeli political and military leadership, which is to resume its all-out assault on Gaza? They are being clear that that’s where they want to go,” Levy told Al Jazeera.

“The Americans are apparently saying, ‘Hey, we’re with you on you continuing your military mission, but can you do it differently’ – that sounds like a disingenuous position to me. Why would anyone have faith that Israel will do this differently.”