CAIRO — The reconnected U.S.-built pier off the coast of the Gaza Strip cannot supply Palestinians with anywhere near the level of aid they need, the head of the World Health Organization's Eastern Mediterranean region said Monday.

Dr. Hanan Balkhy made the remarks after the U.S. military began delivering aid through the floating pier again, after it was removed a second time because of rough seas.

''The pier has supported a little bit, but it's not to the scale that is needed by any stretch of the imagination,'' Balkhy told The Associated Press in an interview. ''So we need to emphasize on the land routes to ensure the amount and the quantity and the efficiency.''

The organization says that since Israel launched its ground operation into Rafah, aid delivery had declined by 67%, with over 50 WHO trucks stuck on the Egyptian side of the crossing into the southern city. Meanwhile, just three trucks were allowed into Gaza through the Kerem Shalom crossing.

Israel says it has allowed hundreds of truckloads of aid through the crossing, but says the U.N. has failed to pick it up. The U.N. says it is too dangerous for trucks to move through the area due to rampant lawlessness, despite Israeli pledges to carve out a safe corridor.

Israel's war against Hamas, now in its ninth month, continues to face growing international criticism over widespread destruction in Gaza and a huge toll in civilian lives.

Aid groups have regularly criticized the plan to deliver aid to Gaza by sea as ineffective and a distraction that has taken pressure off Israel to open land border crossings that can deliver aid in larger numbers.

The Israeli military's ground offensives and bombardments, following Hamas' surprise attack on southern Israel on Oct. 7, have killed over 37,600 people and wounded over 86,000 others, according to Gaza's Health Ministry. Some 1.3 million people displaced from the southern city of Rafah, over half the strip's population, now shelter in tents and cramped apartments in central Gaza.

And despite some increased aid into northern Gaza, experts say the enclave is at ''high risk'' of famine. Overcrowded hospitals struggle to keep the lights on due to lack of fuel and there are medicine shortages, while also sheltering many displaced Palestinians.

Delivering aid through two key Gaza land border crossings has been especially difficult after Israeli troops seized the strategic Rafah crossing with Egypt in May. WHO has also struggled to evacuate some 10,000 patients in Gaza who it says urgently need treatment abroad.

WHO says its last dispatch of aid that reached Gaza was a rare delivery into the north to the Kamal Adwan and Al Awda hospitals.

''Almost everything is being prohibited, and some of the needed commodities are being delivered, but as I mentioned not at the scale that is needed for the people of Gaza,'' Balkhy said.

She warned that the dire condition of hospitals as well as poor living conditions and ''significant malnutrition,'' is ripe for the spread of infectious diseases.

''We're talking about larger numbers of children, and patients with scabies, diarrhea, lice, rashes of unknown causes,'' she said. ''Every time there's a lack of hygiene, infectious diseases caused by pathogens start to flourish."

___

Chehayeb reported from Beirut.

___

Follow AP's coverage of the war in Gaza at https://apnews.com/hub/israel-hamas-war