More than 12,300 children in Gaza have been killed since Israel began its retaliatory assault on the enclave after Hamas’ Oct. 7 attack, according to the Gaza Health Ministry — a staggering toll that surpasses the number of children killed in wars globally in the four years prior.

From October 2022 to February 2023, the number of children killed, according to the Health Ministry’s count, is more than that of children killed in conflicts around the world from 2019 through 2022, according to the UNRWA, the United Nations’ relief agency for Palestinian refugees.

“This is a war on children,” Philippe Lazzarini, the UNRWA commissioner-general wrote in a post on X. “It is a war on their childhood and their future.”

The Gaza Health Ministry is an agency of the Hamas-controlled government in the Gaza Strip. Outside groups and multiple news outlets have said that its figures are generally reliable, and its recorded death toll from the current war is likely an undercount given the number of people who remain unaccounted for.

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More than 30,000 people in Gaza have died — 70% of whom are women and children — and more than 70,000 people have been injured since October, the local health ministry said in its latest report. Those numbers illustrate the staggering cost of human life in the war, now in its fifth month. Israel’s assault on Gaza has killed women, children, aid workers and journalists; destroyed housing and critical civilian infrastructure; pushed the strip to the brink of famine; and led to the spread of a host of diseases.

The White House has repeatedly stressed the need for more aid to enter Gaza, and officials have airdropped supplies into the enclave beginning this month, though aid workers criticized the strategy as “inefficient.” President Joe Biden has publicly pressured Israeli Prime Minister Benjamin Netanyahu about the humanitarian crisis and pushed unsuccessfully for a temporary cease-fire, but has continued approving sales of weapons to Israel.

Aid trucks carrying urgently needed supplies like food and medical equipment have been delayed or rejected by Israeli officials on “very vague,” sometimes “very unreasonable” grounds, Democratic Sen. Jeff Merkley said after a visit to Egypt’s Rafah border in January. Some Israeli settlers also attempted to block humanitarian aid deliveries to Gaza without interference from Israeli border officials for weeks.

In northern Gaza, where entire neighborhoods have been wiped out and where hunger is most acute, at least 20 people — most of whom were children — have died of malnutrition and dehydration, the Health Ministry said.