US President Joe Biden has said he backs Israel’s account that an Islamic militant group was responsible for a blast that killed a large number of Palestinians at a Gaza hospital.

Mr Biden arrived in Tel Aviv on Wednesday as war between Israel and Hamas continued.

The US president pledged solidarity with Israel while meeting with Israeli Prime Minister Benjamin Netanyahu.

Palestinian officials blamed an Israeli air strike for the blast at Al-Ahli al-Arabi hospital.

Gaza healthy ministry spokesman, Ashraf Al-Qidra, said in a statement that 471 Palestinians were killed and more than 314 wounded. 

Israel said the blast was caused by a failed rocket launch by the Palestinian Islamic Jihad militant group, which denied blame.

“I was deeply saddened and outraged by the explosion of the hospital in Gaza yesterday, and based on what I’ve seen, it appears as though it was done by the other team, not you,” Mr Biden said, speaking alongside Mr Netanyahu.

“But there’s a lot of people out there not sure, so we’ve got a lot, we’ve got to overcome a lot of things.

“The world is looking. Israel has a value set like the United States does, and other democracies, and they are looking to see what we are going to do.”

Mr Biden later said he based his conclusion on who was responsible for the hospital blast on “the data I was shown by my defence department”.

Mr Biden’s trip to the Middle East was supposed to calm the region, even as he demonstrated US support for its ally Israel, which has vowed to annihilate the Hamas movement whose gunmen killed 1,400 Israelis in a rampage on October 7.

But after the hospital blast, Jordan cancelled the second half of Mr Biden’s itinerary — a planned summit in Amman with the leaders of Jordan, Egypt and the Palestinian Authority.

Mr Netanyahu thanked Mr Biden for his “unequivocal support”.

He said Israel will try to avoid civilian casualties in its war with Hamas.

“This will be a different kind of war because Hamas is a different kind of enemy,” Mr Netanyahu said in televised remarks.

“As we proceed in this war, Israel will do everything it can to keep civilians out of harm’s way.”

Israel President Isaac Herzog’s office said the head of state had told Mr Biden: “God bless you for protecting the nation of Israel.”

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The US announced new sanctions aimed at disrupting the Hamas militant group’s funding on Wednesday, citing “a secret Hamas investment portfolio”.

The sanctions target 10 Hamas members, operatives and financial facilitators in Gaza and elsewhere, including Sudan, Türkiye, Algeria and Qatar, the US Department of Treasury said.

“The United States is taking swift and decisive action to target Hamas’s financiers and facilitators following its brutal and unconscionable massacre of Israeli civilians, including children,” Treasury Secretary Janet Yellen said.

“We will continue to take all steps necessary to deny Hamas terrorists the ability to raise and use funds to carry out atrocities and terrorise the people of Israel.”

Both sides blaming each other

In an English-language briefing televised shortly before Mr Biden landed, an Israeli military spokesperson said an investigation had “confirmed that there was no IDF (Israel Defence Forces) fire from the land, sea or air that hit the hospital”.

Israel has released drone footage of the scene of the hospital explosion, which it said showed it was not responsible because there was no impact crater from any missile or bomb.

The Israeli military also published what it said was an audio recording of “communication between terrorists talking about rockets misfiring”.

Hamas, the Palestinian militant group that controls Gaza, has blamed the blast on Israel.

Palestinians were convinced the explosion was an Israeli attack, which they said came with no warning on a hospital that was being used as a shelter by thousands of Gazans already made homeless by Israeli bombing.

“This place created a safe haven for women and children, those who escaped the Israeli bombing came to this hospital,” Ibrahim Al-Naqa, who is a doctor at the hospital, told Reuters.

He said hospital staff had been working normally on Tuesday evening and had received no warning when the explosion ripped through the building.

“We don’t know what the shell is called but we saw the results of it when it targeted children and ripped their bodies into pieces.”

Footage obtained by Reuters from inside the hospital in the aftermath showed around two dozen destroyed vehicles, many turned into mangled skeletons. Some vehicles nearby in the yard still had mattresses of displaced people on top of them.

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Protests around the Middle East

The blast unleashed new fury on streets across the Middle East, even as Mr Biden was desperately trying to calm emotions and prevent the conflict from sweeping across borders.

Palestinian security forces fired tear gas and stun grenades to disperse anti-government protesters in the West Bank city of Ramallah, seat of Palestinian Authority President Mahmoud Abbas, one of the Arab leaders who cancelled meeting Mr Biden.

Protests also erupted at Israel’s embassies in Turkey and Jordan and near the US embassy in Lebanon, where security forces fired tear gas toward demonstrators.

The US State Department issued a new warning to Americans not to travel to Lebanon, where border clashes between the Iran-backed Hezbollah movement and Israel over the past week have been the deadliest since the last all-out war in 2006.

Countries and international officials around the world denounced the blast, often with statements carefully worded to avoid saying who was to blame.

Biden backs Israel

Mr Biden has strongly backed Israel following the attack by Hamas on October 7.

But he is under intense pressure to win a clear Israeli commitment to alleviate the plight of civilians in the Gaza Strip, where 2.3 million Palestinians are under total siege, with no access to food, fuel, water or medical supplies.

The number of people killed in Gaza since the recent war began has risen to 3,478, according to the Palestinian health ministry.

The United Nations says half of Gaza’s population has already been driven from their homes. Israel has ordered civilians to evacuate the entire northern half of the enclave, forcing families to cram into houses, schools and makeshift shelters in the southern half, even as it continues to pound the breadth of the enclave with air strikes.

The Israeli military announced on Wednesday that humanitarian aid would be made available in a “humanitarian zone” in Al-Mawasi on the south of the Gaza Strip coast near the Egyptian border. It did not spell out how aid would get there.

Hundreds of trucks carrying supplies have been backed up in Egypt at the city of Al-Arish, in hope that the Rafah crossing into Gaza would be opened, but talks have so far failed to let them in.

Egypt says the route is open on its side, but that Israeli bombardment of the Gaza side makes letting in aid impossible. Washington says the Israelis want systems in place to confirm that the aid will not benefit Hamas.

Speaking to reporters as Mr Biden flew to Tel Aviv, White House national security spokesperson John Kirby said Mr Biden would put “tough questions” to Israeli leaders, but did not give details.

“He’ll be asking some tough questions, he’ll be asking them as a friend, as a true friend of Israel, but he’ll be asking some questions of them,” Mr Kirby said.

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Reuters