Syria: Millions of lives at stake if cross-border aid channel closes

From 2014 until early 2020, the Security Council authorized four border crossings for the provision of humanitarian aid into Syria. This was reviewed and renewed annually to maintain the flow of humanitarian aid into areas that are not under the control of the Syrian government. In 2019 and 2020, Russia and China vetoed the full reauthorization of cross-border aid, removing al-Yarubiyah and al-Ramtha and then Bab al-Salam from the list of approved humanitarian border crossing points. As a result, only one border crossing, Bab al-Hawa, remains active in the current configuration under UNSC resolution 2533 as a formal humanitarian crossing point into Syria. On July 10, the cross-border mandate will expire and the last access route into Syria is at risk of being closed.

The failure of the Security Council to reauthorize this cross-border mechanism would further aggravate the already desperate humanitarian situation in northwest Syria. Humanitarian and medical aid would be drastically reduced and delayed. As one of the few remaining medical providers in the area, MSF would face increased challenges in reaching the most vulnerable populations in northwest Syria. Most hospitals and health facilities would lack the necessary medical supplies to operate, and patients' lives would be put at risk. Furthermore, the COVID-19 response and vaccination campaign in the area would be jeopardized by the closure of the last remaining border crossing point, including the flow of personal protective equipment, oxygen tanks, respirators, essential medications, and COVID-19 vaccines.

"After a decade of war, the renewal of the Security Council mechanism is now more critical than ever," said Dr. Faisal Omar, MSF head of mission for Syria. "The lives of millions of people, the majority of whom are women and children, depend on it. While MSF is not an implementing partner of the UN, and does not rely solely on this mechanism permitting the cross-border flow of aid into Syria, our teams will surely feel the burden of any closure immediately and will not be able to fill the void if UN agencies and other organizations sharply reduce their aid in northwest Syria."

Ongoing economic sanctions on Syria, in addition to an economic crisis and currency devaluation in 2021, have already considerably worsened living conditions for communities in all areas. According to UN agencies, food prices are up by more than 220 percent, while 80 percent of the population remains under the poverty line and 90 percent of children now rely on humanitarian aid.

Over the past year, particularly during MSF's response to the COVID-19 pandemic in northeast Syria, MSF has witnessed firsthand how curtailing access to aid affects people’s lives and health. The decision of the UN Security Council not to renew the UN cross-border aid mechanism via the al-Yarubiyah border crossing prevented lifesaving assistance from reaching northeast Syria through Iraq, with dire consequences. This scenario must not be repeated in the northwest this year, MSF said.

MSF calls on permanent and non-permanent members of the UN Security Council to renew the cross-border mechanism, as well as to reinstate the cross-border points of Bab al-Salam crossing to the northwest and al-Yarubiyah crossing to the northeast. Crossing borders remains the only viable humanitarian channel to cover growing needs in northern Syria.

Over the past decade of conflict, MSF has consistently adapted to the changing context in and around Syria to continue responding to growing humanitarian and medical needs in the country. This ranges from trauma and wound care, to maternal and child health services, as well as vaccination campaigns aimed at preventing the spread of deadly diseases.

MSF is currently supporting eight hospitals in northwest Syria, including a burn care center, in addition to 12 primary health care centers and five ambulances for referrals. In addition, MSF supports 14 mobile clinics serving more than 80 camps for internally displaced people. MSF is also running water, sanitation, and hygiene activities in nearly 90 camps across the northwest.

In northeast Syria, MSF is supporting two COVID-19 inpatient facilities and one comprehensive primary health care clinic, which includes an emergency room, and provides treatment for noncommunicable diseases and malnutrition. MSF supports the population of al-Hol camp with water and sanitation, nutrition care, and primary health care, as well as routine vaccination in 12 locations.

Most recently, MSF has guided health care facilities in responding to COVID-19, following an increase in case numbers. Six COVID-19 isolation and treatment centers were opened in northern Syria in the past year along with rapid diagnostic testing services provided through mobile clinics. MSF is also hosting World Health Organization (WHO)-trained COVID-19 vaccination teams at its health facilities in the northwest and assisting with health promotion activities to address COVID-19 prevention and vaccine hesitancy.