The sun sets behind the buildings in the Gaza Strip as seen from southern Israel, March 5, 2024. (PHOTO / XINHUA)

CAIRO/RAFAH, Gaza Strip - US President Joe Biden said on Tuesday that it was in the hands of Hamas whether to accept a deal for a ceasefire in the Gaza Strip in exchange for the release of Israeli hostages, as delegations held a third day of talks with no sign of a breakthrough.

Negotiators from the Palestinian militant group, Qatar and Egypt - but not Israel - are in Cairo trying to secure a 40-day ceasefire in Hamas' war with Israel in time for the Muslim fasting month of Ramadan, which begins early next week.

The deal presented to Hamas would free some hostages captured by Palestinian militants in the October attack that precipitated the war, while aid to Gaza would be increased to try to avert famine as hospitals treat acutely malnourished children, and Hamas would provide a list of all the hostages held in Gaza.

Senior Hamas official Bassem Naim said Hamas had presented its own draft deal, and was awaiting a response from Israel

The release of sick, wounded, elderly and women hostages would result in an immediate ceasefire in Gaza of at least six weeks, US National Security Adviser Jake Sullivan and Qatari Prime Minister Sheikh Mohammed bin Abdulrahman Al Thani stressed at a meeting on Tuesday, the White House said.

"This first phase of a ceasefire would also enable a surge of humanitarian assistance to the people of Gaza, and provide time and space to secure more enduring arrangements and sustained calm," the White House statement said.

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Earlier in Beirut, Hamas official Osama Hamdan repeated his group's main demands: an end to the Israeli military offensive, withdrawal of Israeli forces, and the return of all Gazans to the homes they had been forced to flee.

He said any exchange of prisoners cannot take place except after a ceasefire, reflecting Hamas' view that a ceasefire must, above all, be a step towards a settlement of the conflict.

Israel for its part wants merely a pause in fighting to get hostages out of Gaza and more aid in, insisting that it will not end the conflict before Hamas is "eliminated".

Government spokesman Avi Hyman told a briefing before Hamdan spoke that the Islamist movement would have to "come down from their delusional positions and come into our orbit".

He added: "Hamas understands military pressure and we are bringing it to them."

Washington, Israel's main political and military backer and a sponsor of the talks, also put the onus squarely on Gaza's rulers.

"It’s in the hands of Hamas right now. Israelis have been cooperating. There’s been a rational offer," Biden told reporters. "If we get to the circumstance that it (fighting) continues to Ramadan ... it’s gonna be very dangerous."

Palestinian-Israeli violence in Israel and the occupied Palestinian territories often spikes during Ramadan, as does hostility towards Israel in the Arab and Muslim world, creating a strong incentive for leaders to clinch a deal before then.

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Smoke rises following an explosion in the Gaza Strip, as seen from southern Israel, March 5, 2024. (PHOTO / AP)

Hamas says it has presented own draft

Hamas says Washington's stance is designed to deflect blame from Israel if the talks collapse.

Senior Hamas official Bassem Naim said Hamas had presented its own draft deal, and was awaiting a response from Israel, adding: "(Prime Minister Benjamin) Netanyahu doesn't want to reach an agreement and the ball now is in the Americans' court."

A source had told Reuters earlier that Israel was staying away because Hamas had refused to furnish a list of hostages who are still alive. Naim said this was impossible without a ceasefire as hostages were scattered across the war zone and held by separate groups.

The US has also urged Israel to do more to alleviate the humanitarian catastrophe in Gaza, where more than 30,000 Palestinians have been killed by Israel's assault, launched after Hamas attacks that killed 1,200 people in October.

"We must get more aid into Gaza," Biden said.

US Secretary of State Antony Blinken said this also meant "making sure it can get to the people who need it ... the situation as it stands is simply unacceptable."

Famine looms over the Gaza Strip as aid supplies, already sharply curtailed during the war, have dwindled to barely a trickle. Swathes of the territory are completely cut off from food. Gaza's few functioning hospitals, already overwhelmed by the wounded, are now filling with children starving to death.

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Four-year-old Omar Abu Kuwaik examines his new prosthetic arm at Shriners Children's Hospital on Feb 28, 2024, in Philadelphia. Omar Abu Kuwaik is far from his home in Gaza. The 4-year-old's parents and sister were killed by an Israeli airstrike, when he lost part of his arm. (PHOTO / AP)

Emaciated children in Gaza's clinics

Ahmed Cannan, a toddler with sunken eyes and an emaciated face, lay on a bed at Al-Awda clinic in Rafah, wrapped in a yellow cardigan. He had lost half his weight since the start of the war and now weighs just 6 kg.

"His situation worsens each day. God protect us from what is coming," said his aunt, Israa Kalakh.

Nurse Diaa Al-Shaer said such emaciated children were arriving at the clinic in unprecedented numbers: "We will face a large number of patients who suffer from this, which is malnutrition."

The situation is worse in the north of Gaza, beyond the reach of aid agencies or news cameras. Gaza health authorities say 15 children have now died of malnutrition or dehydration at one hospital.

The US military, in coordination with Jordan, airdropped 36,000 meals into northern Gaza on Tuesday, a programme Washington began last week. Aid agencies say this is paltry compared to the scale of the hunger.

Israel says it is prepared to let in more aid through the two checkpoints on the southern edge of Gaza that it has permitted to open, and blames U.N. and other aid agencies for failing to distribute it more widely.

The agencies say this has become impossible with a breakdown of civil administration and law and order, and that it is up to Israel, whose troops have stormed Gaza's towns and patrol them, to provide access and security for food distribution.

"The sense of helplessness and despair among parents and doctors in realising that lifesaving aid, just a few kilometres away, is being kept out of reach must be unbearable," said Adele Khodr, UNICEF regional director for the Middle East and North Africa.