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ROME (AP) — The United Nations received pledges Thursday of nearly $100 million in new funding for the U.N. relief agency for Palestinians after the U.S. slashed its aid, but it is still facing a nearly $350 million shortfall this year.

A dozen countries announced new funding during an emergency donor conference called as the U.N. Relief and Works Agency experiences the worst funding crisis in its 68-year history. Stepping up were Qatar, Canada, Switzerland, Turkey, New Zealand, Norway, South Korea, Mexico, Slovakia, India and France, U.N. officials said.

U.N. Secretary-General Antonio Guterres said “an important first step was reached” with the new pledges. But he said “a long way is in front of us” to fully fund the agency, which went into the conference facing a $446 million gap in financing this year after the U.S., which has provided a third of the agency’s budget, announced it was withholding aid.

“If UNRWA would not exist, if these services were not provided, the security of region would be severely undermined,” Guterres told reporters. “Now it is very clear, it is absolutely essential, that the extraordinary unanimity in political support to UNRWA and its activities translates itself into cash.”

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The agency, the oldest and largest U.N. relief program in the Middle East, provides health care, education and social services to an estimated 5 million Palestinians in the West Bank, Gaza Strip, Jordan, Syria and Lebanon. Hundreds of thousands of Palestinians either fled or were forced from their homes during the war that led to Israel’s establishment in 1948.

Guterres told the conference that cutting sanitation, health care and medical services in already poverty-wracked and conflict-ridden areas “would have severe impact — a cascade of problems that could push the suffering in disastrous and unpredictable directions.”

The Trump administration announced in January it was withholding $65 million of a planned $125 million funding installment. It released $60 million so the agency wouldn’t shut down but made clear that additional U.S. donations would be contingent on major reforms at the agency.

Agency spokesman Christopher Gunness said the actual cut was around $300 million because the U.S. had led the agency to believe it would provide $365 million in 2018. He said the agency went into 2018 with a $146 million shortfall that ballooned to $446 million without the anticipated U.S. funds.

Egyptian Foreign Minister Sameh Shoukry, who co-hosted the meeting with Jordan and Sweden, was hopeful the U.S. would continue to support the agency and the creation of a viable Palestinian state that can care for its own people.

“We recognize the important contributions of the United States in the past and look forward that it continues to play its fundamental role in support of UNRWA and in also support of the peace process to enable the establishment of the Palestinian state,” he said.

The U.S. had been UNWRA’s largest donor, supplying nearly 30 percent of its budget. In announcing the cuts in January, the U.S. State Department said it wanted reforms at the agency, which Israel has strongly criticized.

Shoukry said the agency had already streamlined some of its activities but said “there is a limit to its ability to do so” given the enormous needs faced by 5 million people.

“It is vital and it is necessary to address these very basic services, but also to provide dignity for multitudes of Palestinians and to (protect) many of them from the potential threats of radicalization and terrorism,” he told reporters.