KHAN YOUNIS, Gaza Strip — Palestinians sheltering in tents or seeking scarce food aid were among at least 25 people killed by Israeli strikes and shootings Saturday in Gaza, as the world confronted an unprecedented announcement that famine has now gripped Gaza’s largest city.

The famine determination by the Integrated Food Security Phase Classification, or IPC, galvanized aid groups and foreign governments to intensify pleas for Israel to halt its 22-month offensive.

Relief agencies have warned for months that starvation was spreading as a result of Israel’s military campaign and restrictions on food entry.

Hospitals in Khan Younis said at least 14 people were killed overnight when Israeli strikes hit tents sheltering displaced families. More than half of the victims were women and children.

“The entire Gaza Strip is being bombed ... in the south. In the north. Everywhere,” said Awad Abu Agala, who lost two young relatives in the attack.

In northern Gaza, health workers at Sheikh Radwan field hospital reported at least five people shot dead by Israeli fire while waiting for aid near the Zikim crossing. Six more were killed in separate incidents, according to hospitals and the Palestinian Red Crescent.

Israel’s military did not immediately comment. Prime Minister Benjamin Netanyahu’s office rejected the famine report as “an outright lie,” insisting that sufficient aid had been allowed into Gaza and accusing Hamas of starving hostages.

The IPC report said nearly half a million Gazans — roughly a quarter of the population — are facing catastrophic hunger, with famine confirmed in Gaza City for the first time. It warned the crisis will worsen without a ceasefire and unrestricted humanitarian access.

Aid groups, including Doctors Without Borders, said clinics around Gaza City are overwhelmed as civilians flee bombardments. The Israeli military said it is preparing a widescale operation in the city, which it maintains is a Hamas stronghold.

Efforts toward a ceasefire are stalled, even as Netanyahu ordered immediate talks on releasing hostages held by Hamas.

The group has signaled willingness to release captives in exchange for ending the war but rejects disarmament without a Palestinian state. — Agencies