TEL AVIV, Israel — U.S. Secretary of State Antony Blinken on Friday once again left the Middle East empty-handed as Israel’s prime minister rejected American appeals to call off a promised ground invasion of the southern Gaza city of Rafah, which is overflowing with displaced civilians.

The tough message from Prime Minister Benjamin Netanyahu sets the stage for potentially difficult talks next week in Washington between top U.S. officials and a high-level Israeli delegation. Netanyahu said Israel is ready to “do it alone” in Rafah if necessary. Despite their differences, the Biden administration has continued to provide crucial military aid and diplomatic support, even as Israel’s war against Hamas has killed more than 32,000 people in Gaza and led to a worsening humanitarian crisis.

Israel’s Stand on Rafah

Israel says Rafah is the last remaining stronghold of Hamas and says the militant group’s forces there must be defeated for Israel to meet its war objectives. Israel vowed to destroy Hamas following the group’s Oct. 7 attack, which killed some 1,200 people, took 250 others hostage and triggered the fierce Israeli air and ground offensive in Gaza.

But Rafah now shelters over 1 million homeless Palestinians who fled fighting elsewhere in Gaza. The U.S., along with most of the international community, fears an Israeli ground invasion will endanger civilians’ lives and impede the flow of desperately needed humanitarian aid into the territory, most of which comes through Rafah.

Netanyahu said he told Blinken that Israel is working on ways to evacuate civilians from combat zones and to address the humanitarian needs of Gaza, where international aid officials say the entire population is suffering from food insecurity and famine is imminent in the hard-hit north.

“I also said that we have no way to defeat Hamas without entering Rafah,” Netanyahu said. “I told him that I hope we would do this with U.S. support but if necessary – we will do it alone.”

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Blinken, wrapping up his sixth visit to the Mideast since the war broke out, told reporters that the U.S. shares Israel’s goal of defeating Hamas.

“But a major ground operation in Rafah is not, in our judgment, the way to achieve it and we were very clear about that,” he said, adding that Israel faces growing isolation if it presses ahead.

Rafah Tensions Rising

The looming Rafah invasion has cast a shadow over ongoing efforts to forge a cease-fire deal between Israel and Hamas. Blinken, who also met with Arab leaders during his trip this week, acknowledged “there’s still a lot of work to be done.”

Blinken spoke shortly after a U.S.-sponsored cease-fire resolution in the U.N. Security Council was vetoed by Russia and China. Blinken said it was “unimaginable” that the measure had been rejected.

The U.S. initially sided strongly with Israel after the Oct. 7 attack. But relations have increasingly soured as the war, drags on into its fifth month.

Palestinian health officials in Gaza said Friday that at least 32,070 people have been killed, with at least two thirds of them women and children. Israel claims at least one-third of those killed are Hamas militants, and says the group is responsible for civilian casualties by hiding and operating in residential areas.

The U.S. position on a Rafah operation has shifted in recent days. Initially, U.S. officials called for a plan to get civilians out of harm’s way. Now, they say there is no credible way to do that.

“It risks killing more civilians. It risks wreaking greater havoc with the provision of humanitarian assistance. It risks further isolating Israel around the world and jeopardizing its long term security and standing,” Blinken said.

U.S. officials say other options, including specifically targeted operations against known Hamas fighters and commanders, are the only way to avoid a civilian catastrophe.

Roughly three quarters of Gaza’s 2.3 million people have fled into Rafah, the farthest south they can go before the Egyptian border. Sprawling tent camps now dot the city.

The U.S. will share its ideas for alternatives at next week’s meetings, when a delegation led by Netanyahu’s national security adviser and a member of Israel’s War Cabinet heads to Washington. Israel’s defense minister, another member of the War Cabinet, will also visit.

Blinken said talks would focus on post-war plans, another area of disagreement.

The U.S. wants the internationally recognized Palestinian Authority – which Hamas ousted from Gaza in 2007 – to return to power in the territory, along with a clear path toward an independent Palestinian state beside Israel. Netanyahu rejects Palestinian independence or a role for the Palestinian Authority, which administers parts of the occupied West Bank, and says Israel must maintain long-term security control over Gaza.

An Elusive Cease-Fire

International mediators, led by the U.S., Qatar and Egypt, have been working on a cease-fire to pause or end the war in Gaza.

Israel is seeking the release of the more than 100 hostages still held by Hamas, while Hamas wants an end — not a temporary pause — to the war along with the withdrawal of Israeli forces from Gaza. Hamas is wants Israel to release large numbers of Palestinian prisoners.

After his talks with Israeli leaders, Blinken met with families of hostages who hold U.S. citizenship before departing. He later greeted a small group of protesters who gathered in solidarity with the families outside his hotel.

Protesters chanted “Blinken, thank you,” as he walked by the crowd. He said the U.S. was “working to bring them home” as he shook hands.

Blinken told reporters that progress has been made in recent weeks, but the final gaps “tend to be the hardest.”

“There’s still a lot of work to be done, hard work to be done,” he said.

Toward those efforts, he said he also discussed the need to increase humanitarian aid entering Gaza. He said “some positive steps” have been taken in recent days. “But it’s not enough.”

Israel says it places no restrictions on the amounts of humanitarian aid it allows into Gaza. But international aid groups say deliveries have been impeded by Israeli military restrictions, ongoing hostilities and the breakdown of public order.

So little food has been allowed into Gaza that up to 60% of children under 5 are now malnourished, compared with fewer than 1% before the war began, the head of the World Health Organization said Thursday.

U.N. Resolution Was ‘Cynically Vetoed’

At the United Nations, Russia and China vetoed a U.S.-sponsored U.N. resolution supporting “an immediate and sustained cease-fire” in the Israel-Hamas war. The two countries called the measure ambiguous and said it was not the direct demand to end the fighting that much of the world seeks.

The vote in the 15-member Security Council was 11 members in favor and three against, including Algeria, the Arab representative on the council. Guyana abstained.

A key issue was the unusual language that said the Security Council “determines the imperative of an immediate and sustained cease-fire.” The phrasing was not a straightforward “demand” or “call” to halt hostilities.

It also appeared to loosen, but not drop, previous U.S. demands that Hamas release all hostages as part of a cease-fire.

Blinken said the measure had been “cynically vetoed” and should have been embraced.

“We were trying to show the international community’s sense of urgency about getting a cease-fire tied to the release of hostages,” Blinken said. He also said it had sought to condemn Hamas. “It’s unimaginable why countries wouldn’t be able to do that.”