RAFAH, Gaza Strip — Israeli Prime Minister Benjamin Netanyahu said Thursday he has told the United States that he opposes the establishment of a Palestinian state as part of any postwar scenario, underscoring the deep divisions between the close allies three months into Israel’s assault on Gaza aiming to eliminate its Hamas rulers.

The U.S. has called on Israel to scale back its offensive and said that the establishment of a Palestinian state should be part of the “day after.”

But in a nationally broadcast news conference, Netanyahu vowed to press ahead with the offensive until Israel realizes a “decisive victory over Hamas.” He also rejected the idea of Palestinian statehood. He said he had relayed his positions to the Americans.

“In any future arrangement … Israel needs security control all territory west of the Jordan,” Netanyahu told a nationally broadcast news conference. “This collides with the idea of sovereignty. What can you do?”

“The prime minister needs to be capable of saying no to our friends,” he added.

More than 100 days after Hamas triggered the war with its Oct. 7 attack, Israel continues to wage one of the deadliest and most destructive military campaigns in recent history, with the goal of dismantling the militant group that has ruled Gaza since 2007 and returning scores of captives. The war has stoked tensions across the region, threatening to ignite other conflicts.

The Humanitarian Crisis

More than 24,600 Palestinians have been killed, some 85% of the narrow coastal territory’s 2.3 million people have fled their homes, and the United Nations says a quarter of the population is starving.

Hundreds of thousands have heeded Israeli evacuation orders and packed into southern Gaza, where shelters run by the United Nations are overflowing and massive tent camps have gone up. Israel has continued to strike what it says are militant targets in all parts of Gaza, often killing women and children.

Early Thursday, medics said an Israeli airstrike on a home killed 16 people, half of them children, in the southern Gaza town of Rafah.

Dr. Talat Barhoum at Rafah’s el-Najjar Hospital confirmed the toll and said dozens more were wounded. Associated Press footage from the hospital showed relatives weeping over the bodies of loved ones.

“They were suffering from hunger, they were dying from hunger, and now they have also been hit,” said Mahmoud Qassim, a relative of some of those who were killed.

Footage emerged Thursday of Israeli troops blowing up the main campus of a university outside Gaza City in a controlled detonation — one of multiple universities they have destroyed. The video, apparently taken by drone, showed a giant explosion engulfing the complex of buildings of Al-Israa University.

The university, a private institution founded in 2014, said in a statement that its main building for graduate studies and bachelor’s colleges were destroyed. It said Israeli forces seized the complex 70 days ago and used it as a base. It was unclear when the explosion took place. The Israeli army had no immediate comment.

According to Hamas, Israeli forces have destroyed more than 390 schools, universities, and educational institutions across Gaza.

Internet and mobile services in Gaza have been down for five days, the longest of several outages during the war, according to internet access advocacy group NetBlocks. The outages complicate rescue efforts and make it difficult to obtain information about the latest strikes and casualties.

There was meanwhile no word on whether medicines that entered the territory Wednesday as part of a deal brokered by France and Qatar had been distributed to dozens hostages with chronic illnesses who are being held by Hamas.

War Reverberates Across Region

The war has rippled across the Middle East, with Iran-backed groups attacking U.S. and Israeli targets. Low-intensity fighting between Israel and Hezbollah militants in Lebanon threatens to erupt into all-out war, and Houthi rebels in Yemen continue to target international shipping despite United States-led airstrikes.

The Israeli military said it fired an interceptor at a “suspicious aerial target” — likely a drone or missile — approaching over the Red Sea on Thursday, triggering air raid sirens in the southern Israeli coastal city of Eilat. The Houthis have launched drones and missiles toward Israel that mostly fell short or were intercepted and shot down.

Iran has meanwhile launched a series of missile attacks targeting what it described as an Israeli spy base in Iraq and militant bases in Syria as well as in Pakistan, which carried out reprisal strikes against what it described as militant hideouts in Iran early Thursday.

It was not clear if the strikes in Syria and Pakistan were related to the Gaza war. But they showcased Iran’s ability to carry out long-range missile attacks at a time of heightened tensions with Israel and the U.S., which has provided crucial support for the Gaza offensive and carried out its own strikes against Iran-allied groups in Syria and Iraq.

Israel has vowed to dismantle Hamas to ensure it can never repeat an attack like the one on Oct. 7. Militants burst through Israel’s border defenses and stormed through several communities that day, killing some 1,200 people, mostly civilians, and taking around 250 hostage.

Israel has also vowed to return all the hostages remaining in captivity after more than 100 — mostly women and children — were released during a November cease-fire in exchange for the release of scores of Palestinians imprisoned by Israel.

Family members and supporters were marking the first birthday of Kfir Bibas, the youngest Israeli hostage, in a somber ceremony Thursday in Tel Aviv.

The red-haired infant and his 4-year-old brother Ariel were captured along with their mother, Shiri, and their father, Yarden. All four remain in captivity.

Medicines Bound for Hostages Enter Gaza

The agreement to ship in medicines was the first to be brokered between the warring sides since November. Hamas said that for every box of medicine bound for the hostages, 1,000 would be sent for Palestinian civilians, in addition to food and humanitarian aid.

Qatar confirmed late Wednesday that the medicine had entered Gaza, but it was not yet clear if it had been distributed to the hostages, who are being held in secret locations, including underground bunkers.

Both France and Hamas had said the International Committee for the Red Cross, which helped facilitate the hostage releases, would have a role in distributing the medications. But on Thursday, the Red Cross said “the mechanism that was agreed to does not involve the ICRC playing any part in its implementation, including the delivery of medication.”

Hamas has continued to fight back across Gaza, even in the most devastated areas, and launch rockets into Israel. It says it will not release any more hostages until there is a permanent cease-fire, something Israel and the United States, its top ally, have ruled out.

Gaza’s Health Ministry says at least 24,620 Palestinians have been killed since the start of the war, around two-thirds of them women and children, with over 61,800 wounded. It says many other dead and wounded are trapped under rubble or unreachable because of the fighting. The ministry does not differentiate between civilian and combatant deaths.

Israel blames the high civilian death toll on Hamas because it fights in dense residential areas. Israel says its forces have killed roughly 9,000 militants, without providing evidence, and that 193 of its own soldiers have been killed since the Gaza ground offensive began.