Washington, DC – US President Barack Obama faces a difficult challenge as he prepares to meet Israeli Prime Minister Benjamin Netanyahu at the White House as a wave of violence sweeps Jerusalem and the occupied Palestinian territories.

Obama hosts his Israeli counterpart with whom he has a strained relationship and few practical points of leverage to address a situation that analysts and rights activists say may spin out of control.

“Unless we have a much more proactive engagement by the current administration we could see ourselves slipping quickly into a major conflagration between groups in Gaza and Israel again,” said Brian Katulis, a Middle East analyst for the Center for American Progress, a policy think-tank in Washington closely aligned with the Democratic party.

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Netanyahu and Obama meet on Monday at the White House for the first time since the Israeli prime minister opened a bitter and partisan split with the US president over the Iran nuclear agreement.

Ahead of the meeting, White House officials acknowledged Obama has concluded there is no realistic prospect for peace between Israelis and Palestinians.

Officially, this meeting is designed to strengthen the US-Israel strategic relationship with talks on US military support, implementation of the Iran deal, and the US diplomatic initiative in Syria.

But the situation in Israel and the Palestinian territories is increasingly untenable. The humanitarian crisis in Gaza has deepened since Israel’s 2014 bombing campaign.

The new wave of violence that began in October with stabbings, shootings, car assaults and clashes between security forces, settlers and protesters has cost the lives of 77 Palestinians and 10 Israelis with hundreds wounded.

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Complicating Obama’s task, Netanyahu in March rejected the notion of a two-state solution to the Palestinian conflict, a statement that drew criticism in the US. Netanyahu tried to revise his position in interviews with American broadcasters but the damage was done. Netanyahu had said what many in Israel and the US long believed was his true position.

“He once again reaffirmed the two-state solution would not happen under his watch,” said Matt Duss, president of the Foundation for Middle East Peace, a US non-profit organisation that advocates an end to the occupation.

“More importantly the actions of his government – the building of settlements, the expulsion of Palestinians – shows their true intention, which is never to leave,” Duss told Al Jazeera.

Obama called Netanyahu after his re-election in March and warned his abandonment of the two-state solution would force Washington to “reassess” its policies towards Israel, a hint the US may yield to international pressure at the UN to begin sanctioning Israel. Analysts doubt Obama would take such a step.

Meanwhile, aid groups are raising alarms about the situation in Gaza where 1.8 million people are grappling with the aftermath of the 2014 bombing campaign that killed more than 2,140 and destroyed thousands of civilian homes.

The Israeli government now is prohibiting import of cement, steel, and wood into Gaza, materials needed to build new houses and apartments for displaced Gaza Palestinians, according to Donna Baranski-Walker, executive director of the Rebuilding Alliance, a non-profit group that organised a US speaking tour for Israeli and Palestinian care providers in Gaza.

“These things need to change if reconstruction is going to happen,” Baranski-Walker said.

“Eighteen thousand homes were demolished and only the first 1,000 are under construction now, and that leaves a lot of people homeless.”

“There is a humanitarian crisis in Gaza especially when we talk about the medical community, the health system,” Ran Goldstein, executive director of the Israeli group Physicians for Human Rights, told an audience of US congressional staff.

“And since we don’t see any policy changes, we are afraid that another war is just a matter of time.”

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Yasser Abu-Jamei, executive director of the Gaza Community Mental Health Programme, said an estimated 370,000 children in Gaza, many of them exposed to trauma in 2014, still are in need of social support.

Common manifestations of psychological stress among children in Gaza include bedwetting, night terrors, poor performance in school, and behavioural issues, he said.

“When we tell the children that Ramadan is coming, and it’s such a joy, they ask us strange questions that we don’t know how to reply. ‘Are we going to have one more war? Are they going to attack us again? Will we hear the loud bombardments?'” Abu-Jamei said.

Netanyahu continues to enjoy strong bipartisan support in the US among Jewish advocacy groups, leading presidential candidates, and lawmakers in Congress, although sentiment is shifting in some quarters.

The American Enterprise Institute, a conservative think-tank with links to top Republicans such as former Vice President Dick Cheney, plans to award Netanyahu its highest honour while he’s in Washington.

“Israel serves as a reminder that a commitment to free enterprise, democracy, human dignity and the courage to defend one’s values are the best model to lift up all people,” AEI President Arthur C Brooks said in a statement.

While in Washington, Netanyahu will address the annual meeting of the Jewish Federations of North America, an umbrella Jewish charity association with a $16bn endowment.

Hillary Clinton, the top contender for the Democrat presidential nomination penned an Op-Ed in the Jewish website Forward pledging to repair the US-Israel relationship if elected. Netanyahu will also speak to an audience at the Center for American Progress.

Still, not all Democrats in the US are as supportive of Netanyahu and his government’s policies. Netanyahu’s speech to Congress in March opposing Obama’s diplomatic initiative with Iran drew anger from a number of lawmakers in the House of Representatives.

“I’ve personally given up believing that [Netanyahu’s] government wants to talk,” Representative Jim McDermott, a Democrat, told Al Jazeera. “They want a state of continued conflict because they can keep getting Congress to give them money and they can keep the world all stirred up, ‘Oh we’ve got this terrible problem with the Palestinians.'”

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Pro-peace and pro-Palestinian groups plan a series of protests at Netanyahu’s public appearances during his US visit. A coalition of 28 groups including students from six nearby universities is organising a large rally outside AEI’s event with the message: “No US tax dollars to Israel.”

“The shift in Israel to the extreme right shows that Israel is not going to change on its own and there needs to be outside pressure,” Rabbi Joseph Berman, government affairs liaison for the Jewish Voice for Peace, told Al Jazeera.

“The United States needs to begin pressuring Israel to end the occupation and to begin Palestinian self-determination. That’s the only thing that is going to guarantee Israel’s security,” Berman said.

Follow William Roberts on Twitter: @BillRoberts3