It was heartbreaking to read the latest independent assessment of hunger in Gaza. The situation is desperate – and projected to get worse. According to the World Food Programme (WFP), nine out of every 10 Palestinians in northern Gaza may be eating less than one meal a day. With families displaced and sanitation close to nonexistent, disease and illness will spread. Almost 40% of Gaza’s population is aged under 15. Death and despair haunt these children’s lives. We all know we must act. The question is how. Some say we must have an immediate ceasefire. I do not want to see this conflict go on a moment longer than necessary. But this means achieving a sustainable ceasefire, one that will last and prevent another generation of children living under the constant threat of war. That means no more Hamas, and its rocket attacks and commitment to terror. Given that, I have argued for further humanitarian pauses, to get more hostages out of and more aid in to Gaza. But what if neither of these things happens soon? How do we avoid hunger turning into famine? How can we alleviate suffering while supporting Israel’s right to self-defence? We need more aid – and fast. In recent days, the Royal Navy made its first maritime shipment of aid into Egypt, sending in more than 80 tonnes of blankets and life-saving medical supplies. And France and Jordan have dropped some aid by air into Gaza. The British government and our partners are committed to being as creative as possible in getting life-saving assistance to those in need. But the fact is the need is too great for direct delivery via air and sea to make a significant difference in the short term. What matters is simpler: more aid delivered by land, more quickly and more effectively. Last week, about 131 trucks were entering Gaza each day via the Rafah and Kerem Shalom crossings. The figure is creeping towards 200 daily. But even this is nowhere near enough – the number should be close to 500. We recognise Israel’s own pain and anger after the horrors of 7 October, and with hostages still held in appalling conditions. Two British citizens are among them. Of course, Hamas shows no regard for the lives of civilians, Israeli or Palestinian. The situation on the ground is complex, and no one country can resolve it alone. Yet it will do nothing for those hostages or Israel’s war aims if the situation turns into an even greater catastrophe. And I believe there is much more we can do that will make an immediate difference. As I saw in al-Arish in Egypt, too much aid is presently piled up, unable to enter Gaza. I have appointed a representative for humanitarian affairs in the occupied Palestinian territories. Based on their intensive work, we have identified the bottlenecks and how to unblock them. Take crossing points. With extended opening hours and capacity at the Nitzana screening facility and Kerem Shalom checkpoint, much more aid could enter Gaza. Opening Kerem Shalom in December helped – opening it seven days a week would help even more. Opening more routes for aid to come in and be loaded on to trucks would also be transformative. Ashdod port in Israel is much closer to Gaza than Port Said in Egypt. The facilities for mass delivery are there now, ready to be used. The new land corridor from Jordan into Gaza – run by WFP, with British backing – has made a first delivery of 750 tonnes of food aid. Both these options could deliver enormous quantities of aid, especially if the Erez crossing at the north end of Gaza was open. Greater consistency of the goods allowed in is vital. More rational and transparent explanations of what is restricted by Israel, and why, will allow governments, aid organisations and the private sector to scale up aid considerably. Israel could also restore water supply lines, reconnect electricity supplies and let in sufficient fuel to power critical infrastructure such as bakeries. Finally – and perhaps most importantly of all – we need to help the United Nations, whose brave staff are trying to manage distribution in desperate circumstances inside the Gaza Strip. It is no good getting aid in if it cannot be safely and effectively distributed. More visas and imports of vehicles for them will mean their staff can enter Gaza, enhancing our confidence that aid will reach those in genuine need. These steps may seem technical, at odds with the scale of the human tragedy unfolding in Gaza. But our focus must be practical solutions that save lives, not empty slogans that make no difference on the ground. Such solutions exist. The time to act is now. David Cameron is Britain’s foreign secretary