Hopes of a ceasefire in the war in Gaza are fading amid Benjamin Netanyahu’s repeated rejection of calls to hold off on a Rafah ground offensive, and a vote by his cabinet that Israel will formally oppose international efforts at what it called the “unilateral recognition” of a Palestinian state. Diplomatic efforts led by Egypt, Qatar and the US are also stalling: on Sunday, Qatari officials acknowledged that indirect talks in Cairo between Israel and the Palestinian militant group Hamas, which restarted last week, had “hit an impasse”. Washington has also signalled it will veto this week’s expected new push for a UN security council resolution on a ceasefire. The diplomatic impasse was met with dismay by the 2.3 million inhabitants of the Gaza Strip, where almost 29,000 people have been killed, 85% of the population displaced from their homes and one in four are starving, according to the UN. The four-month-old war was triggered by Hamas’s attack on Israel on 7 October last year, when 1,200 people were killed and 250 taken hostage. Of the remaining 130 hostages still in Gaza, about 30 are presumed dead, according to Israeli officials. Airstrikes on Gaza City, Khan Younis and the strip’s southernmost border town of Rafah – Gaza’s last place of relative safety – killed at least 18 people overnight, according to local officials, including a family of seven, a relative, Sayed al-Afifi, told the Associated Press. The Israeli military blames Hamas for civilian casualties, saying it uses Gaza’s population as human shields. Israel’s ground offensive continues to target the central town of Khan Younis, where Nasser hospital, previously the territory’s largest functioning healthcare facility, has gone offline after Israeli ground forces launched a raid on the premises on Thursday. Dr Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said in a tweet on X on Sunday that a WHO team had not been allowed to enter the medical complex on Friday or Saturday to deliver fuel for generators. Seven patients on ventilators had died due to the lack of electricity, the health ministry in the Hamas-run territory said on Saturday. About 200 patients remained trapped in the hospital without food and water, including 20 who needed urgent referrals, Ghebreyesus added. A spokesperson for Gaza’s health ministry said only 25 staff remained to care for the sick and injured. Israeli attacks on struggling healthcare facilities across Gaza, which also became de facto shelters for civilians who have fled their homes, have been widely criticised as war crimes. The Israel Defense Forces say Hamas’s use of medical sites to hide out or use as bases for launching operations makes them legitimate targets. On Sunday, the IDF said it had arrested more than 100 suspected Hamas militants in the Nasser hospital compound. Gaza’s health ministry said 70 medical personnel were among those detained, as well as patients in hospital beds. The Israeli offensive shows no sign of slowing or stopping despite mounting international pressure to hold back from a ground push on Rafah, on the Egyptian border, where more than half of Gaza’s population has sought shelter. In his weekly press conference on Saturday night, Netanyahu pushed back at international criticism, saying those who were against a Rafah offensive were effectively telling the country to “lose the war” against Hamas. The prime minister also indicated that troops would go in as part of Israel’s hunt for the Hamas leadership regardless of whether a hostage release was agreed. “Even if we achieve it, we will enter Rafah,” he said. While the US, Israel’s most important ally, has provided crucial military support and diplomatic cover for the Israeli war effort, relations between Joe Biden and Netanyahu have reached a nadir over the colossal, and growing, death toll in Gaza. On Sunday, Netanyahu forcefully dismissed Washington’s proposal for after the war, which could include the creation of an independent Palestinian state in return for normalisation between Israel and Saudi Arabia. The Israeli leader’s cabinet adopted a declaration on Sunday saying Israel “categorically rejects international edicts on a permanent arrangement with the Palestinians” and would “continue to oppose unilateral recognition of a Palestinian state”. “Such recognition, following the October 7 massacre, will award an immense and unprecedented prize to terrorism, and prevent any future peace agreement,” a government statement said. Egypt, Qatar and the US have spent weeks trying to broker a ceasefire and hostage release in hopes of stabilising Gaza and dampening the escalating violence the war has triggered around the Middle East. However, large gaps remain between the parties on the number and identity of Palestinian prisoners who could be released from Israeli jails in return for the remaining Israeli hostages held in Gaza. Hamas’s exiled leadership in Qatar has said it will not release hostages without a full Israeli withdrawal from the Gaza Strip, demands Netanyahu has called “delusional”. Yahya Sinwar, the group’s leader in Gaza, is believed to have been incommunicado for at least 10 days, further complicating ceasefire efforts. Netanyahu said on Saturday night that while he had sent a delegation to ceasefire talks in Cairo last week at Biden’s request, he did not see what would be gained by sending them again. His comments were met with fury by protesters at what is now a weekly rally in Tel Aviv on Saturday night, where family members of the hostages accused the prime minister of putting his political interests ahead of the fate of their loved ones. It is widely believed that Netanyahu is slow-walking the ceasefire talks because he is likely to be ousted from office in new elections when the war ends. The longtime leader faces several corruption trials. Thousands of anti-government protesters marched in Tel Aviv on Saturday night to demand early elections, where some demonstrators scuffled with police, set off fireworks, and attempted to block roads. At the United Nations, the security council is to discuss a draft resolution circulated by Algeria demanding an immediate ceasefire and unhindered humanitarian access to Gaza, which on Saturday was rejected by the US ambassador to the international body, Linda Thomas-Greenfield. Washington has used its security council veto on similar widely supported previous resolutions. Guardian Newsroom: The unfolding crisis in the Middle East. On Wednesday 20 March, 7-8.15pm GMT, join Devika Bhat, Peter Beaumont and Ghaith Abdul-Ahad as they discuss the fast developing crisis in the Middle East. Book tickets here or at theguardian.live