Now the primary vehicle for food distribution inside Gaza, the controversial U.S.- and Israeli-backed operation is an issue in ongoing ceasefire negotiations.

DEIR AL-BALAH, Gaza Strip (AP) — The U.N. food agency accused Israel of using tanks, snipers and other weapons to fire on a crowd of Palestinians seeking food aid, in what the territory’s Health Ministry said was one of the deadliest days for aid-seekers in over 21 months of war.

It is one of the highest reported death tolls among repeated recent cases in which people have been killed while looking for aid.