NEW YORK (AP) — Human Rights Watch on Thursday accused Israel of causing the deaths of thousands of Palestinians by systematically restricting and targeting Gaza’s water supply in a campaign that amounted to “acts of genocide.”

The rights group was the latest among a growing number of critics to accuse Israel of genocidal acts in its war in Gaza. Israel vehemently denies the allegations, saying its war is directed at Hamas militants, not Gaza’s civilians.

In Thursday’s report, HRW alleged that countless infants, children and adults have died from malnutrition, dehydration and illness as a result of actions by Israeli authorities over more than a year of war to deliberately cut the flow of water and electricity to Gaza, destroy infrastructure and prevent the distribution of critical supplies.

“As a state policy, these acts constitute a widespread or systematic attack directed against a civilian population. Israeli officials are therefore committing the crime against humanity of extermination,” the New York-based group said.

The rights group said that the “pattern of conduct” outlined in its report and statements from Israeli officials “may indicate” genocidal intent, but it did not come down definitively on one side. Under international law, proving intent is key in concluding whether the crime of genocide has been committed.

Israel, founded as a refuge for Jews in the wake of the Nazi Holocaust, strenuously denies such allegations. It says Hamas is responsible for the destruction in Gaza because the group hides and operates in schools, hospitals and residential areas. It says the October 2023 Hamas attack that triggered the war — the deadliest attack on Jews since the Holocaust — amounts to genocide.

“Human Rights Watch is once more spreading its blood libels in order to promote its anti-Israel propaganda,” Israel’s Foreign Ministry said. It claimed Israel has worked to facilitate the flow of water and humanitarian aid into Gaza throughout the war.

“Israel will continue to ensure humanitarian aid enters Gaza, in full compliance with international law,” the statement said.

The new report by Human Rights Watch outlined what the organization described as an extended, methodical campaign by Israeli officials to deprive Palestinians in Gaza of water.

That has drastically reduced the water supply in Gaza, from about 83 liters (21 gallons) per person each day before the war began to between two and nine liters in the months since, the human rights group says.

The World Health Organization says people require 50 to 100 liters per day to meet basic needs and keep sickness in check.

Human Rights Watch said Israeli forces deliberately razed the solar panels that powered four of Gaza’s six wastewater treatment plants and destroyed a key reservoir. The group alleged Israel also cut off electricity required to run desalination plants and other infrastructure and restricted fuel for backup generators.

When the International Court of Justice issued orders in January that Israel provide Palestinians with basic services and assistance, officials ignored them, the group alleged.

Human Rights Watch said its findings were based on interviews with more than 60 Palestinians, accounts from utility employees, doctors and other healthcare workers and aid workers, and analysis of satellite images, photos and video.

“Doctors and nurses told Human Rights Watch that they had seen numerous infants, children, and adults die from a combination of malnutrition, dehydration, and disease,” the group said.

In its statement, the Israeli Foreign Ministry said it has continued the operation of four water pipelines as well as water pumping and desalination facilities, and allowed international aid groups to deliver water in tankers.

The Oct. 7, 2023, attack by Hamas killed some 1,200 people in Israel, mostly civilians, and took 250 others hostage. Israel’s 14-month offensive has killed over 45,000 Palestinians, over half of them women and children, according to local health officials who do not distinguish between civilians and combatants. The offensive has caused widespread destruction and displaced roughly 90% of Gaza’s population, according to U.N. estimates, plunging the territory into a humanitarian crisis.

The U.N. and international aid groups say Israel has repeatedly restricted aid shipments into Gaza and done little to provide security inside Gaza to allow deliveries to reach their destinations. They say only a fraction of the amount of aid necessary to sustain life in Gaza is reaching Palestinians. The war has led to a breakdown in law and order, with armed gangs repeatedly stealing truckloads of aid.

HRW’s report came two weeks after Amnesty International accused Israel of committing genocide in Gaza. Israel dismissed the allegation as as “entirely false and based on lies.” Israel has previously refuted charges lodged by South Africa in the International Court of Justice that its forces have carried out inhumane acts in the embattled enclave. Meanwhile, the International Criminal Court is seeking the arrests of Prime Minister Benjamin Netanyahu and former Defense Minister Yoav Gallant for allegedly committing war crimes.