At least 16 more people have died of starvation in the besieged Syrian town of Madaya since an aid convoy entered earlier this month, according to Medicines San Frontiers.
Several dozen more residents of the town are in danger of death because of severe malnutrition, the humanitarian group warned.
The latest deaths bring the number of people reported to have died of starvation in Madaya to 46 since December.
“MSF has clear medical reporting for 46 starvation deaths since December 1,” the group said.
“The real number is almost certainly higher, as MSF is aware of reports of people dying in their homes.”
Located in Damascus province, Madaya is under government siege, and its fate has been one of the sticking points for fresh peace talks on the Syrian conflict that opened on Friday after delays.
Syria’s opposition wants to see the implementation of UN Security Council resolutions demanding an end to sieges in the country before committing to new negotiations.
Madaya is one of four towns included in a rare deal last year that was intended to halt fighting and allow the entry of aid.
But despite the deal, the UN and other aid groups have had only limited access to Madaya, along with rebel-held Zabadani, and the government-held towns of Fuaa and Kafraya, under opposition siege.
Conditions in Madaya have been among the worst, with about 42,000 civilians there surrounded by government troops who have laid mines around the town.
While the government has some ability to airdrop supplies to Fuaa and Kafraya, the opposition has no similar capacity, and aid groups have regularly urged continuous access to the four towns.
They have also called for the evacuation of those suffering malnutrition or other illnesses.
Citing medics it supports in the town, MSF said there were at least 320 cases of malnutrition, including 33 that were severe.
“It is unacceptable that people continue to die from starvation, and that critical medical cases remain in the town when they should have been evacuated weeks ago,” said MSF’s director of operations Brice de le Vingne.
“The parties responsible for besiegement strategies need to allow unhindered medical and humanitarian access immediately.”
After the September deal for the four towns, an initial aid delivery was made, but no subsequent assistance was allowed in until January 11, after reports of deaths in Madaya.
Additional convoys entered Madaya, Fuaa and Kafraya on January 14 and then the four towns on January 19 but aid groups say the piecemeal deliveries are insufficient.
HALF A MILLION PEOPLE UNDER SIEGE
The UN estimates around 486,700 Syrians are living under sieges imposed by the regime, rebels or the Islamic State group.
The UN’s aid chief said this week that 75 per cent of its requests for aid deliveries went unanswered by the government.
Meanwhile, representatives of Syria’s largest mainstream opposition umbrella group arrived in Geneva on Saturday evening, allaying fears they would boycott UN-brokered talks aimed at ending the brutal civil war.
A delegation from the Saudi-backed High Negotiations Committee left Riyadh, spokesman Monzer Makhous said.
He added that HNC chief Riad Hijab would join the delegation.
The group grudgingly relented to Western and Saudi pressure to attend the biggest push to date to chart a way out of Syria’s nearly five-year war.
On Friday, a 16-member delegation representing the regime held three hours of preliminary talks with UN special envoy Staffan de Mistura.
HNC had long refused to join the talks without an end to bombardments of civilians and an agreement on relief reaching thousands stuck in besieged towns.