More children have died in the Palestinian territories over the past five months of war than have been killed in all armed conflicts worldwide over the past four years a startling statistic that puts the casualties from Israels ongoing bombardment in perspective.

The current military offensive in Gaza began after Hamas militants launched a deadly attack in southern Israel on Oct. 7 that killed about 1,200 people and took about 250 captive. Hamas released roughly half the hostages during a temporary pause in fighting late last year, and is estimated to still have about 100 captives who are still alive.

An estimated 50 minors were killed in the Oct. 7 attack, the Times of Israel reported in December. Of those 50, two were reportedly infants, 12 were children under 10 years old and 38 were between the ages of 10 and 19.

Since the attack, Israeli forces have launched a massive military offensive on Gaza, displacing most of the territorys 2.3 million Palestinians, blocking humanitarian aid and killing an estimated 31,000 people, according to the Gaza Health Ministry.

Of that tally, 13,500 were children, the ministry said on Tuesday.

The ministry is part of the Hamas-controlled government. However, most outside organizations and even members of the U.S. State Department have treated the ministry as credible . The United Nations and other international institutions claim that the ministry has for years made a good-faith effort to account for the territorys dead in difficult conditions.

The death toll for children in Gaza since Oct. 7 has now surpassed the number of children killed in armed conflicts around the world for the last four years combined.

A total of 12,193 children were killed in conflict globally between 2019 and 2022, according to the annual reports by the U.N. By year: 4,019 children were killed in 2019, 2,674 children were killed in 2020 , 2,515 children were killed in 2021 and 2,985 children were killed in 2022.

The Israeli offensive has increasingly drawn anger from the international community, which has begun pressuring Israel to halt its offensive and for the country to agree to a permanent cease-fire with Hamas.

Philippe Lazzarini, the commissioner-general for the U.N. agency tasked with helping Palestinian refugees (UNRWA), said on Tuesday that the difference in death tolls is staggering.

This war is a war on children. It is a war on their childhood and their future, he posted on X , formerly Twitter, repeating his call for an immediate cease-fire in the region for the sake of children in Gaza.

The stark figures come as humanitarian workers warn of a starvation crisis in Gaza as a result of the war. About one in four Palestinians in Gaza is close to famine, amounting to at least 576,000 people now at risk, according to the U.N.

Northern Gaza has been particularly affected by hunger, with people resorting to animal fodder and plants to sustain themselves as aid is slow to trickle in. According to the U.N. aid coordination office, 25 people in north Gaza have died from severe acute malnutrition and dehydration. An estimated 21 of those 25 were children. The Gaza Health Ministry reported a similar tally Tuesday, recording 27 Palestinians had died of malnutrition, including 23 children and elderly.

Children are among the least able to cope with hunger and disease, warned the U.N. Childrens Fund (UNICEF). Youth who are orphaned, maimed, displaced or sickened have a particularly difficult time accessing food in a territory already struggling to feed its people.

In 5 months Israel has killed more children in a strip of land the size of Philadelphia than all conflicts worldwide did in the past 4 years combined, Francesca Albanese, U.N. special rapporteur on the occupied Palestinian territories, posted on X.

Destroying a population from its roots, she continued. Genocide is a process, not an act, and what is happening in Gaza is a tragedy foretold.