Secretary of State Antony Blinken arrived in Israel on Tuesday on his 11th visit to the region since the outbreak of the Israel-Hamas war. The U.S. hopes to revive cease-fire efforts after the killing of top Hamas leader Yahya Sinwar, but so far all the warring parties appear to be digging in.

Israel is still at war with Hamas more than a year after the militant group’s Oct. 7 attack, and with Hezbollah in Lebanon, where it launched a ground invasion earlier this month. Israel is also expected to strike Iran in response to its ballistic missile attack on Oct. 1.

Blinken landed just hours after Hezbollah launched a barrage of rockets into central Israel, setting off air raid sirens in the country’s most populated areas and its international airport, but causing no apparent damage or injuries.

The Israeli military said it intercepted most of the five projectiles, with one landing in an open area. Another 15 projectiles were fired from Lebanon into northern Israel at around the same time, it said.

In a separate development, the death toll from an Israeli airstrikes late Monday that destroyed several buildings facing one of Beirut’s main hospitals climbed to 13. Lebanon's Health Ministry said 57 others were wounded in the strikes, including seven who were in critical condition.

It said the airstrikes caused significant damage to the Rafik Hariri University Hospital, the country's largest public hospital, located on the outskirts of southern Beirut. There was no immediate comment from the Israeli military.

Blinken expected to focus on Gaza
The State Department said ahead of the visit that Blinken would focus on ending the war in Gaza, securing the release of hostages held by Hamas and alleviating the suffering of Palestinian civilians.

State Department spokesman Matthew Miller said Blinken would underscore the need for a dramatic increase in the amount of humanitarian aid reaching Gaza, something that Blinken and Defense Secretary Lloyd Austin made clear in a letter to Israeli officials last week.

That letter reminded Israel that the Biden administration could be forced by U.S. law to curtail some forms of military aid should the delivery of humanitarian aid continue to be hindered.

Blinken's previous trips have yielded little in the way of ending hostilities, but he has managed to increase aid deliveries to Gaza in the past.

The United States, Egypt and Qatar have brokered months of talks between Israel and Hamas, trying to strike a deal in which the militants would release dozens of hostages in return for an end to the war, a lasting cease-fire and the release of Palestinian prisoners.

But both Israel and Hamas accused each other of making new and unacceptable demands over the summer, and the talks ground to a halt in August. Hamas says its demands have not changed following the killing of Sinwar.

US and Iran both step up outreach ahead of expected Israeli strike
Blinken is expected to meet with Israeli Prime Minister Benjamin Netanyahu and other top officials. Following Israel, he’s expected to visit a number of Arab countries, likely to include Jordan, Saudi Arabia, Qatar and the United Arab Emirates.

Iran’s Foreign Minister Abbas Araghchi has been criss-crossing the region in recent days to try and built support ahead of Israel’s threatened retaliatory strike. Speaking in Kuwait on Tuesday, he said Gulf Arab countries had assured him they would not allow their territory to be used for any Israeli strike.

“All the neighbors assured us that they will not allow their lands and air to be used against Iran,” Araghchi said, according to the state-run IRNA news agency. “This is an expectation from all friendly and neighboring countries and we consider this a sign of friendship.”

Gulf Arab nations like the UAE and Qatar host major military installations, and there are concerns that an all-out regional war could draw them in. Iran has repeatedly vowed to respond to any Israeli strike.

War rages in Lebanon and northern Gaza
The U.S. has also tried to broker a cease-fire between Israel and Hezbollah, but those efforts fell apart as tensions spiked last month with a series of Israeli strikes that killed the militant group’s top leader, Hassan Nasrallah, and most of his senior commanders.

Israel is currently waging another major operation in already-devastated northern Gaza, which has killed hundreds of Palestinians over the last two weeks, according to local health authorities.

In Lebanon, Israel has carried out waves of heavy airstrikes across southern Beirut and the country’s south and east, areas where Hezbollah has a strong presence. Hezbollah has fired hundreds of rockets, missiles and drones into Israel, including some that have reached the country’s populous center.

Hamas-led militants stormed into southern Israel on Oct. 7, 2023, killing some 1,200 people, mostly civilians, and taking another 250 hostage. Around 100 of the captives are still held in Gaza, a third of whom are believed to be dead.

Israel’s offensive has killed over 42,000 Palestinians in Gaza and wounded tens of thousands, according to local health authorities, who do not say how many were combatants but say more than half were women and children. It has also caused massive devastation across the territory and displaced around 90% of its population of 2.3 million.