The US secretary of state, Antony Blinken, has ended his tour of the Middle East admitting that his efforts to secure a sustained humanitarian pause and greater constraint in Israel’s assault on Gaza was still “a work in progress”. His comments on Monday followed a meeting with Hakan Fidan, the Turkish foreign minister, in Ankara. He will now head to a meeting of G7 foreign ministers in Japan where he will brief colleagues on the US approach to the crisis, and its impact on western standing. Over four days of talks, which started in Jerusalem, diplomatic progress appears if anything to have gone into reverse. Blinken was unable to persuade the Israeli prime minister, Benjamin Neyanyahu, to adopt a humanitarian pause while talks on hostages stalled over the sequencing and length of the pause in hostilities required for their release. In a further bombardment on Sunday night, Israel also imposed another temporary communication blackout in Gaza, despite US requests not to do so. The number of aid trucks crossing the Egyptian border into Gaza at the Rafah crossing went down from 100 on Friday to closer to 30 in the following days. The US said Hamas – the Islamist group that runs Gaza and carried out the 7 October attacks on Israel in which 1,400 people, mainly civilians, were killed – had broken the agreement on injured civilians crossing into Egypt. The US said Hamas was trying to reserve a third of the places for its injured fighters. Blinken tried to strike an optimistic if cautious note, saying: “We know the deep concern here for the terrible toll on Palestinians – on men, women, and children in Gaza, innocent civilians – a concern that we share and that we’re working on every single day. We’ve engaged the Israelis on steps that they can take to minimise civilian casualties. We’re working very aggressively on getting more humanitarian assistance into Gaza.” He added: “I think you’ll see in the days ahead that assistance can expand in significant ways so that more gets to people who need it as well as making sure that people can continue to come out of Gaza.” He was speaking amid reports that the crossing, closed for two days, had reopened to allow six ambulances out of Gaza. But even Blinken’s claims to have found a regional consensus to stop further escalation of the crisis was tempered by the renewal of exchanges of heavy fire on the southern Lebanese border between Israel and Hezbollah, the Iranian-backed militia group. Diplomats in many Middle East countries normally allied with the US believe Blinken has the leverage with Israel to rein in the attacks in Gaza by calling for a permanent ceasefire or withholding US funding. They argue that the US refuses to do so either because it believes the military removal of Hamas is an achievable goal at an acceptable price, or because the Biden administration sees the US national interest lying with public unity with Israel above the saving of civilian lives in Gaza. Blinken’s unproductive talks in Ankara ended a tour that also took him to Jerusalem, Amman in Jordan, Ramallah in the West Bank and Baghdad. Turkey withdrew its ambassador from Israel on Saturday morning, a move welcomed by the West Bank-based Palestinian Authority. The Turkish president, Recep Tayyip Erdoğan, said: “Netanyahu is no longer someone we can talk to. We have written him off.” Erdoğan did not meet Blinken. Turkey built a large cancer hospital in Gaza that has been repeatedly attacked by Israeli forces. Turkey and Egypt had agreed for about 1,000 of these cancer patients and other injured civilians needing urgent care in Gaza to be sent to Turkey for treatment, the Turkish health minister, Fahrettin Koca, said on Sunday, adding work was under way to plan the move. Large protests have been held outside US bases in Turkey. Potentially the most worrying aspect of the past month is the slow erosion of the US’s diplomatic standing, and the gradual, if limited, signs of cooperation between Iran and Arab states. Tehran announced that Saudi Arabia and Iran would jointly convene an Organisation of Islamic Cooperation conference in Riyadh shortly. Iran has stepped up its diplomatic efforts, with the Iranian president, Ebrahim Raisi, speaking to the Indian prime minister, Narendra Modi, urging him to do more to support the Palestinian cause. The US has been pushing Israel to do more to explain its case, and on Monday Netanyahu met dozens of envoys in Tel Aviv to tell them that after Israel destroys Hamas, it will offer the people of Gaza “a real future, a future of promise and hope”. He said the conflict was a battle between barbarism and civilisation in which everyone needed to engage. In Baghdad on Sunday, Blinken warned that attacks by militias affiliated with Iran were “unacceptable and we will take every measure to protect our citizens”. On Monday, the Iraqi prime minister, Mohammed Shia al-Sudani, travelled to Tehran possibly to convey a more detailed version of this message. Al-Sudani would also like to see Iranian-backed militia constrained.