The U.S. has warned that U.S. military aid to Israel is at risk if the country does not take steps to improve humanitarian conditions in Gaza.

In an attempt to deescalate tensions in the Middle East, the Biden administration has sent a letter to the Israeli government demanding it take steps to improve humanitarian conditions in Gaza or risk losing U.S. military aid.

The letter, which was obtained by Axios, is dated Oct. 13 and co-written by U.S. Secretary of State Antony Blinken and Defense Secretary Lloyd Austin. In it, they express a “deep concern” from the Biden administration over the dire humanitarian situation in Gaza and give their Israeli counterparts one month to facilitate aid shipments into the region or face potential cuts in U.S. arms shipments to Israel.

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“Since Israel’s assurances in march and the April letter which produced important improvements in the provision of humanitarian assistance the amount of aid delivered has dropped by more than 50 percent,” the letter states. “The amount of assistance entering Gaza in September was the lowest of any month during the past year.”

“To reverse the downward humanitarian trajectory and consistent with its assurances to us, Israel must, starting now and within 30 days, act on the following concrete measures,” the letter adds. “Failure to demonstrate a sustained commitment to implementing and maintaining these measure may have implications for U.S. policy under NSM-20 and relevant U.S. law.”

The list of U.S. demands is lengthy, and includes that Israel must allow a minimum of 350 aid trucks into Gaza each day, end its isolation of northern Gaza, and ensure that the commercial and Jordan Armed Forces corridors function at their “full and continuous capacity.”

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Secretaries Blinken and Austin close out the letter by requesting that the U.S. and Israel “establish a new channel” to “raise and discuss civilian harm incidents,” with the first meeting to be held by the end of October.

The letter comes as Israel’s year-long war against Hamas in Gaza has expanded into a multi-front operation to also combat Iranian-backed Hezbollah militants in Lebanon. Late last month, the Israeli military said it had launched a “limited, localized” ground operation into the country, that has since boiled over into all-out war between the two sides and risks a wider regional conflict.

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