Over the past 24 hours US drones have launched multiple drone strikes against tribal areas inside of Pakistan, killing at least 48 people across multiple sites and injuring dozens of others.

The largest of the attacks hit North Waziristan Agency overnight, where one of the attacks on a home killed at least 25 “suspects.” If confirmed this would be the largest toll for a single strike since the June 2009 attack of a funeral procession.

The attacks come as tensions between the US and Pakistan have dramatically escalated in recent weeks, and just days after the Obama Administration announced a halt of military aid to the Pakistani forces. In response, Pakistan is threatening to withdraw a number of its troops from the regions along the Afghan border.

Pakistan has repeatedly demanded that the US end its drone strikes, and while the calls were long seen as insincere, they have recently demanded that the US leave the Shamsi air base, a base in Pakistan’s Balochistan Province from which drones are continuing to be launched. The US has said it does not intend to leave.