Humanitarian Aid During the Syrian Civil War

The Syrian conflict began in 2011 when Bashar al-Assad's government responded to local unrest with military force; an insurgency spread across the country in 2012 and produced more than a decade of conflict and foreign intervention that displaced millions.[1] By mid-June 2014 — just three years into the fighting — an estimated 9.3 million people inside Syria needed humanitarian assistance, including more than 3.5 million in hard-to-reach areas and at least 242,000 in areas besieged by government or opposition forces.[5] Another 2.8 million had already fled the country as refugees, while 6.5 million people were internally displaced.[5]

The crisis deepened rapidly in subsequent years. By early 2018, the UN estimated that 13.1 million people needed assistance out of an estimated Syrian population of 18 million, with 6.1 million internally displaced and 5.5 million having fled abroad.[6] In 2022, 90 percent of the population lived below the poverty line and the health system had collapsed.[8] The World Food Programme estimated 1.3 million severely food-insecure Syrians — people skipping meals or going hungry because affordable food was unavailable — and wheat production had fallen to one-quarter of prewar levels.[4]

The February 2023 earthquakes near the Turkish-Syrian border, registering successive magnitudes of 7.8 and 7.5, caused more than 47,000 fatalities across the two countries and added urgent new needs in Syria, with the northwest particularly hard hit.[3] By 2024, the UN estimated that more than 16.7 million Syrians required humanitarian support.[3] As of March 2024, 14 million Syrians were displaced worldwide: 5.5 million were hosted in neighboring countries and 7.2 million were displaced inside Syria, with 70 percent of the Syrian population needing humanitarian assistance and protection.[9]

International efforts to reach Syrian civilians began within months of the conflict's outbreak. In April 2012, the United States announced an additional $8 million in emergency humanitarian assistance, bringing its total Syria-crisis assistance to nearly $33 million at that point.[10] Aid inside Syria in this early phase included food, medical supplies, water, blankets, hygiene kits, and heaters, delivered through international and nongovernmental partners including WFP, UNHCR, NGOs, UNRWA, and the ICRC, and provided on the basis of need rather than political affiliation.[10]

Even in 2012, the reach of relief operations was striking given the scale of violence. In a single two-week period before the April 2012 announcement, the Syrian Arab Red Crescent, with ICRC support, provided food and other essentials to 60,000 people in several governorates.[10] WFP was simultaneously assisting more than 100,000 people in 11 governorates and expected to reach up to 250,000 Syrians that April, though insecurity and government restrictions left some hard-hit areas inaccessible.[10]

As the conflict intensified, the international fundraising apparatus scaled rapidly. In 2014, a Kuwait donor conference opened with pledges of $500 million from Kuwait and $380 million from the United States.[11] The UN's overall appeal that year reached $6.5 billion — its largest request for a single crisis at the time — against reported needs for 9.3 million people inside Syria and 6.5 million driven from their homes.[11] The response plan inside Syria (the Syria Humanitarian Assistance Response Plan, or SHARP) sought nearly $2.3 billion for 2014, while the regional plan sought more than $4.2 billion to address the needs of refugees in neighboring countries.[5] As of mid-June 2014, combined funding from both appeals had reached only about $1.91 billion of roughly $6.54 billion in requirements — approximately 29 percent — with donor pledges not necessarily converting into actual contributions.[5]

By March 2015, the UN was appealing for $8.4 billion in commitments: $2.9 billion for people inside Syria and $5.5 billion for people who had fled to five neighboring countries.[12] The United States pledged $507 million at the 2015 conference, while the UN reported 12.2 million people — just under half of them children — in dire need of aid.[12] Unfulfilled pledges remained a recurring concern: nearly a quarter of the prior year's pledges, amounting to $585 million, had not been paid as of November 2014, though the Secretary-General later indicated that the fulfilled share had risen toward 90 percent.[12]

The central institutional innovation of the Syria humanitarian response was UN Security Council Resolution 2165, adopted in July 2014. The resolution authorized UN humanitarian agencies and their implementing partners to deliver cross-border aid to Syrian civilians with notification to — rather than consent from — the Syrian government.[13] The mechanism created four authorized border crossings from Iraq, Jordan, and Turkey, designed to circumvent the risk that Damascus could restrict or obstruct access to civilians outside its control.[13]

The scale of deliveries through this mechanism was substantial. By December 2019, some 30,000 aid trucks had entered Syria through the four authorized crossings since 2014; roughly 1,000 trucks per month were crossing the Turkish border at that time, and 40 percent of medicine used for NGO operations in northeast Syria arrived through the Iraqi crossing.[13] By 2022, the crossing at Bab al-Hawa from Turkey had become the dominant route into northwest Syria. Security Council Resolution 2642, adopted in July 2022, authorized another six months of cross-border aid through Bab al-Hawa into Idlib; over the preceding year, the mechanism had assisted 2.4 million people per month and accounted for 80 percent of overall assistance to northwest Syria.[14]

Preceding Resolution 2642, the Security Council had been roiled by political conflict over the mechanism's renewal. Russia vetoed a proposed one-year extension shortly before Resolution 2642 passed, and the six-month arrangement reportedly came with concessions to Moscow.[14] Russia linked renewal to sanctions relief and increased aid routed through Damascus.[14] More than 1,000 trucks entered through Bab al-Hawa each month during this period, whereas only two cross-line convoys had reached Idlib in the preceding year — illustrating the enormous gap in scale between the two modalities.[4]

UN General Assembly Resolution 76/228, adopted in December 2021, described cross-border aid as an "essential and life-saving channel" for people whose needs could not be met through operations within Syria.[15] It cited 11.1 million people requiring urgent humanitarian assistance inside Syria, including 6.6 million internally displaced people and more than 5.6 million refugees abroad.[15] The resolution deplored the closure of the Bab al-Salam and Ya'rubiyah crossings and cited UN reporting that humanitarian needs in northeastern Syria had risen 38 percent following the closure of Ya'rubiyah.[15] By January 2020, cross-border authorization had already been reduced from four crossings to two, with Russia and China vetoing renewal of both Turkish crossings and reinstatement of the Iraq crossing in July of that year.[16]

The mandate's final chapter came in July 2023. Russia vetoed the Security Council's reauthorization of cross-border access, after which the mandate that had operated continuously since 2014 expired and deliveries became dependent on Syrian government permission.[17][7]

After the mandate expired, the Syrian government consented to further deliveries from Turkey but imposed conditions that the UN Office for the Coordination of Humanitarian Affairs considered unworkable. In August 2023, the government withdrew most of those conditions while limiting access to a defined period.[17] In July 2024, it extended permission for deliveries through Bab al-Hawa until January 2025.[7]

Persistent funding gaps shadowed every phase of the international response. The 2017 regional appeal sought $5.6 billion and was approximately 54 percent funded by year's end; the Syria Humanitarian Response Plan sought $3.4 billion and was about 51 percent funded.[6] For 2018, the regional appeal sought $4.4 billion and the in-country plan $3.5 billion.[6] In 2021, international donors collectively met only 46 percent of Syria's assessed humanitarian needs — the lowest share since 2015.[4]

For 2022, the Humanitarian Response Plan inside Syria required approximately $4.4 billion, and the Regional Refugee and Resilience Plan supporting refugees and host communities in neighboring countries required approximately $6.1 billion — a combined requirement of roughly $10.5 billion, which UN-backed funding was insufficient to meet.[18]

By early 2018, the United States had provided nearly $7.7 billion in humanitarian assistance since 2011.[6] At the Brussels VIII Conference in May 2024, it announced nearly $593 million in additional humanitarian assistance — bringing total U.S. assistance for Syria and the region to nearly $2 billion since the beginning of fiscal year 2023 and more than $17.8 billion since the start of the crisis.[19] That assistance supported vulnerable refugees, internally displaced people, and host communities, encompassing emergency shelter, food, health care, education, water and sanitation, livelihoods, and protection.[19] The United States also mobilized $251.5 million in FY2023 humanitarian assistance specifically for earthquake-affected populations in Syria following the February 2023 disasters.[3] More than $4.5 billion had also been contributed specifically for refugee assistance, though even these substantial efforts remained insufficient to enable refugees to lead healthy, peaceful, and productive lives.[20]

Reaching civilians proved as difficult as raising funds. Humanitarian operations faced violence and insecurity, administrative obstacles, visa and partnership restrictions, checkpoint interference, fuel and transport shortages, and sieges.[5] UN entities generally had greater access and capacity for large operations — vaccination campaigns, bulk food delivery — than smaller NGOs, but even UN operations faced severe constraints.[5]

In February 2014, Security Council Resolution 2139 demanded rapid, safe, and unhindered humanitarian access and called for access across conflict lines and borders; the situation remained critically constrained, and the resolution was widely assessed as having failed to produce sufficient progress.[5] Resolution 2165 later in the year authorized cross-border delivery and was reported to have produced some improvements, but access to hard-to-reach areas, besieged areas, opposition-held zones, and territory under Islamic State control remained deeply inadequate.[21]

Besieged communities illustrate the most severe cases. In 2017, eastern Ghouta was under siege, restricting all movement of food, medicine, and fuel; UN officials estimated that 94 percent of all people living in besieged areas of Syria were in eastern Ghouta, yet only 100,000 of an estimated 400,000 residents had received food assistance during the entire year.[6] In May 2016, UN Under-Secretary-General for Humanitarian Affairs Stephen O'Brien told the Security Council that 592,700 people were living under siege, approximately 452,700 of them besieged by government forces.[22] That month, the Syrian government fully approved only 14 of the 34 priority locations where the UN had sought access, and conditionally approved eight more — leaving more than 40 percent of the planned target population without access to basic necessities.[22] A convoy to Darayya, where 4,000 civilians had been besieged for years, was aborted after last-minute restrictions; O'Brien reported that government forces removed all basic supplies, including infant nutrition, at the last checkpoint.[22]

Airdrops were assessed as a costly, dangerous, and technically limited last resort. O'Brien described how several weeks of airdrops over Deir-ez-Zor — where about 20,000 people were besieged by nonstate armed groups — delivered 762 metric tons of food, roughly equivalent to the cargo of a single aid convoy.[22] The UN considered airdrops only when all other options were exhausted and would still have required Syrian government approval to conduct them.[22]

The Rukban camp near Jordan presented a particularly severe long-term case. After Jordan closed its border in 2016, thousands of people were stranded in the camp; the last UN delivery there had taken place in 2019.[23] Residents endured shortages of clean water, food, sanitation, medical care, and schooling. A 2023 Syrian Emergency Task Force assessment identified malnutrition, acute diarrhea, respiratory disease, and other health conditions among camp residents.[23] The Syrian Emergency Task Force launched Operation Syrian Oasis in June 2023 — after two years of effort — and facilitated the first humanitarian delivery to Rukban since 2019, using the U.S. government's Denton Humanitarian Assistance Program to transport supplies on military aircraft to al-Tanf for distribution.[23] Six deliveries followed, including irrigation equipment, fertilizer, seeds, baby formula, prenatal vitamins, food baskets, yeast, school supplies, and 16,000 school books.[23]

In September 2016, dozens of aid trucks from Turkey, under UN supervision and carrying food, medicines, blankets, and tents, waited outside Aleppo during a brief U.S.-Russian ceasefire arrangement. The anticipated opportunity to deliver supplies remained contingent on the fragile cessation of hostilities and was not confirmation that the aid reached its recipients.[24]

Parallel to the operation inside Syria, a large-scale international effort supported the millions of Syrians who fled to neighboring countries. UNHCR and UNDP established the Regional Refugee and Resilience Plan as a coordinated response addressing both refugees and the host communities absorbing them.[18] UNHCR assistance in Turkey, Iraq, Jordan, and Egypt encompassed medication, food, drinking water, fuel and heaters, tents, thermal blankets, and winter clothing.[18]

By 2018, the war had created the world's largest refugee population, with the United Nations recording 6.7 million Syrian refugees — nearly 40 percent of Syria's population that year — while most fled to Turkey and other regional countries, with hundreds of thousands finding asylum in Germany, the United States, and Canada.[2] UN agencies and the governments of Jordan, Lebanon, Turkey, and Iraq continued to provide significant assistance throughout the crisis, though the combined efforts remained insufficient to allow refugees to lead healthy, peaceful, and productive lives.[20]

Jewish and interfaith organizations also contributed to the regional response. The Multifaith Alliance for Syrian Refugees, a project of the Tannenbaum Center for Interreligious Understanding launched in 2013 by Georgette Bennett and JDC International CEO Alan Gill, raised funds for organizations providing direct services to people affected by the war and brought together more than 85 participating organizations from multiple religious communities.[25] HIAS provided legal assistance and resettlement support to Syrian refugees, with its staff advocating with U.S. officials and Jewish communities for refugee resettlement; HIAS professionals also provided legal protection to refugees in Greece and the Middle East, and the organization worked with synagogues and more than 2,000 rabbis in 48 countries to encourage the United States to remain open to refugees regardless of religion.[25]

Israel organized a distinctive border-area humanitarian program known as Operation Good Neighbor — an effort that combined relief delivery with acknowledged security objectives along Israel's frontier with Syria.[26] The program's origins trace to early 2013, when seven injured Syrians reached the security fence and pleaded for help; Israel admitted and treated them, with an account noting they otherwise would not have survived.[26] The IDF Northern Command formally established Operation Good Neighbor headquarters in June 2016 to expand the effort, with its first coordinated activities beginning in August 2016.[27]

The main recipients were approximately 200,000 residents of the Hauran region in southwestern Syria, an area also described as the 80 villages and towns in the Syrian Golan held by rebel groups not affiliated with ISIS.[27][28] About one-third of aid recipients were displaced people or refugees, and approximately half were under 18.[27] Israel communicated directly with village leaders, doctors, and local professionals rather than routing aid through the UN or international relief organizations.[28] Supplies were stored at a fortified logistics center near the border and moved to the Syrian side of the security fence, where recipients collected them; the program was funded mainly by foreign donations, with some IDF funding for basic goods and unit staffing.[28]

The documented scale of deliveries, drawn from multiple reporting periods, conveys the program's ambition. During the year preceding July 2017, Israel delivered approximately 500,000 liters of diesel, 360 tons of food, 77 tons of clothing and shoes, and dozens of generators and water-pumping systems.[28] In June 2018, a nighttime delivery at four locations brought approximately 300 tents, 13 tons of food, 15 tons of baby food, three pallets of medicines and medical equipment, and 30 tons of clothing and footwear to Syrian camps near the border.[29]

When the IDF closed its Good Neighbor administration in September 2018 — after the Assad government regained control in southern Syria — it reported that, over two years of the administration's activity, approximately 1,700 tons of food, 1.1 million liters of fuel, 630 tents, 40 vehicles, 20 generators, 26,000 boxes of medical equipment, 49,000 packages of baby food, and approximately 350 tons of clothing had been delivered.[30]

Medical assistance formed a central pillar of the program. Aid boxes carried the inscription: "Your neighbor could be closer to you than your brother."[26] An internationally managed field hospital was established at an Israeli outpost; Israeli hospitals in the north — Ziv in Safed, Galilee Medical Center in Nahariya, and Poriya in Tiberias — treated Syrian patients, with the program's scope expanding from combat wounds to broader medical needs as Syria's health system collapsed.[31] Approximately 5,000 wounded Syrians were treated in Israel over five years.[31] The September 2018 closure report gave figures of approximately 4,900 wounded treated over five years, around 7,000 children treated at a day clinic during its final year, and more than 1,300 children treated at other facilities or through medical-visit operations.[30] By 2017, approximately 3,000 Syrians had been treated in Israel, alongside 1,000 children brought for treatment and respite during the preceding year alone, and insulin had been supplied to about 100 Syrian diabetes patients.[28]

Approximately 200,000 Syrians lived in a 40-kilometer strip between Quneitra and the triple border — an area described as cut off from Damascus — while an unnamed U.S. organization operated a clinic on the Syrian side of the border under Israeli protection and treated 4,000 patients.[31] The IDF said 90 percent of the humanitarian activity came from donations, with approximately NIS 270 million raised, mostly for medical equipment and medicine.[31]

Israeli officials described both humanitarian and strategic motivations for the program. An Israeli officer was quoted stating, "There is a clear operational interest for Israel" in providing the assistance, with stated aims including helping Syrians affected by the war, stabilizing the border area, and limiting hostile groups' influence.[26] Bashan Division commander Yaniv Asor said the program would help local Syrian residents and strengthen Israel's position along the border, while cautioning that it would not guarantee prevention of attacks.[28] Alongside the relief effort, Israel stated that it would not admit Syrian refugees into its territory, a policy maintained throughout the conflict.[29]

During the conflict and its immediate aftermath through January 2025, the U.S. State Department and USAID provided foreign and security assistance focused principally on areas outside the Syrian government's control, while U.S. humanitarian assistance supported relief efforts for internally displaced people in Syria, selected Syrian communities, and Syrian refugees in regional countries.[1]

Beyond emergency relief, U.S. stabilization activities addressed essential services, local governance, civil society, education, demining, agriculture, independent media, community security, livelihoods, and economic growth.[1] These stabilization programs were distinct from the humanitarian assistance stream directed at displaced persons, communities, and refugees.[1]

Recurring concerns accompanied U.S. programming. The CRS report identifies obstacles to humanitarian access, possible diversion of U.S. humanitarian or security assistance by entities inside Syria, and the risk that U.S.-funded programs could benefit entities with which the United States had policy disagreements.[1] Many of these concerns were linked to the antagonistic relationship between the Assad government and the United States, and to what the CRS described as the Assad government's exploitation of international aid and recovery efforts.[1]

Throughout the conflict, the manner in which aid was routed, controlled, and distributed was deeply contested. The Syrian government and Russia argued that aid should be delivered through Damascus rather than across borders, characterizing cross-border deliveries as a violation of Syrian sovereignty.[4] Cross-line operations — delivering aid across front lines within Syria rather than from outside — were proposed as an alternative, but their volume was starkly insufficient: more than 1,000 trucks entered through Bab al-Hawa each month, while only two cross-line convoys had reached Idlib in the preceding year.[4]

UN and U.S. reporting consistently documented restrictions on access from within Syria. The State Department's 2019 Syria report described Syrian government forces frequently blocking access and removing items such as medical supplies from convoys, especially those bound for opposition-held areas; aid projects were selectively approved, organizations were required to work with vetted local partners, and cross-line operations from Damascus were restricted, with only seven humanitarian-assistance convoys reaching hard-to-reach areas during the entire year.[32] The 2020 report documented similar patterns alongside the Security Council's reduction of authorized crossings from four to two in January 2020, with Russia and China vetoing reinstatement of additional crossings.[16]

The 2023 State Department report described 15.3 million Syrians — nearly 70 percent of the population — needing humanitarian assistance by December of that year, while noting that access restrictions were imposed not only by the Syrian government but also by nonstate actors, including interference by the terrorist organization HTS with aid and service delivery.[17] After Russia vetoed cross-border reauthorization in July 2023, the Syrian government consented to further deliveries from Turkey but set conditions that UN OCHA considered unworkable; in August, the government withdrew most conditions while limiting access only for a defined period.[17]

Syria's UN ambassador, Bashar Jaafari, offered a rebuttal to international characterizations of the Syrian government's conduct, accusing Turkey of using humanitarian convoys to deliver weapons to the government's opponents and stating that Syria permitted aid except for items that could be handed to terrorist groups.[22] Russia backed the Syrian government's position throughout the Security Council negotiations, helping reduce the authorized crossing routes from four to one and mandate durations from one year to six months over the course of the conflict.[33] These competing positions — between the Syrian government and its allies on one side, and the UN, the United States, and Western members of the Security Council on the other — shaped every phase of the cross-border mechanism's existence and ultimate termination.