The head of the UN Palestinian refugee agency on Thursday voiced concern that children suffering from malnutrition in Gaza will die if emergency provisions are not immediately put in place during Israel’s Gaza City military operation.

UNRWA Commissioner-General Philippe Lazzarini said that its data showed a six-fold increase in the number of children suffering from malnutrition in Gaza City since March.

“We have a population that is extremely weak that will be confronted with a new major military operation,” he told a Geneva press club meeting.

“Many will simply not have the strength to undergo a new displacement.”

“Many of them will not survive,” he said of the children, addressing the audience in French.

“It is a manufactured and fabricated famine. It is deliberate. Food has been used as an instrument of war,” he said.

In May, a global hunger monitor said that half a million people in the Gaza Strip faced starvation but stopped short of using the term famine.

Israel’s military agency that coordinates aid, COGAT, has previously said it invests considerable efforts to ensure aid reaches Gaza and has denied restricting supplies.