Granting or withholding humanitarian access in the Syrian civil war has been politicized, used by different warring parties to advance their military strategies and political objectives. For the regime, withholding access and preventing aid from reaching rebel-held areas is a deliberate strategy to punish and weaken opposition groups and to prevent the creation of an alternative political order. Regulating and distributing basic public goods, from food to electricity, is also used to reward loyalty and further civilian dependency on the regime. At times, aid has even been diverted to support the Syrian army’s war efforts. For the Islamic State (IS), preventing humanitarian access in areas under its control follows a distinct, yet equally political logic: IS wants absolute control and absolute civilian dependency. In this context, humanitarian access is de facto “weaponized.”

Because of this situation, the international community’s approach to delivering aid in Syria has evolved over the past few years, expanding from the initially negotiated response plan—which relied almost entirely on a system of coordination with the central government to carry out humanitarian relief operations in Syria. Unfortunately, when withholding access and distributing aid are seen as key military tools, relief operations quickly became hostage to politics: The regime slows down the process or withholds consent according to its own strategic interests and in turn undermines humanitarian aid’s need to stay neutral and impartial.

Since the initially peaceful political revolution turned violent, sectarian, and militarized, the regime led by Bashar Al-Assad has sought victory both by defeating rebel groups on the battlefield and systematically undermining their attempts to create a political alternative to the regime. In practice, this has meant targeting rebel-held areas to destroy infrastructure and cut opposition supply lines, as well as deliberately attacking civilians and targeting hospitals, schools, or markets—as shown by the horrific devastation in places like Duma and Aleppo. Preventing civilian access to basic goods and services, including humanitarian aid, is another widely employed tactic to ensure either that civilians are forcibly displaced—further isolating the rebels—or that the opposition is eventually forced to surrender both territory and population.

Preventing access to basic goods such as food, water, and electricity has been particularly apparent in Syria’s siege warfare, an especially brutal tool that weakens both active fighters and civilians alike. Infamous examples include the brutal regime sieges of rebel-held areas in eastern and southern Damascus; the Palestinian refugee camp of Yarmouk, and the towns of Madaya and Daraya. With goods prevented from entering the areas, and with civilians forbidden from leaving through the use of military checkpoints or anti-personnel landmines, besieged Syrians have starved to death.

According to the February 2016 report of the UN’s Independent International Commission of Inquiry on the Syrian Arab Republic, over 400,000 civilians were besieged, with an additional 4.5 million located in zones where assistance is scarce and intermittent (and these numbers tend to err highly on the side of caution). Yet despite the widely publicized instances where the regime granted temporary access to besieged areas, the situation has only worsened. As of June 2016, the UN Office for the Coordination of Humanitarian Affairs estimated that around 600,000 people remained trapped in eighteen besieged locations across the country—at the hands of the regime, but also by other warring parties, including IS.

Denying access to medical care and targeting medical personnel and infrastructure has been another heavily used tactic in this campaign against the civilian population. For example, the aforementioned UN International Commission of Inquiry reported that of the 33 hospitals functioning in Aleppo in 2010, fewer than ten were still active in February 2016. That same month, Doctors Without Borders announced its decision to refrain from communicating data about some of its medical facilities to the Syrian and Russian forces, voicing concern that, instead of guaranteeing those facilities’ safety, sharing such data would make them more likely to be targeted.

This weaponization of aid and relief operations, added to the intense fighting and rapidly shifting battle lines, makes the humanitarian space in Syria incredibly constrained and contested. In reaction to these clear problems, the United Nations Security Council (UNSC) passed Resolution 2139 on February 22, 2014, demanding unfettered humanitarian access. Later that year, it authorized cross-border delivery of aid (UNSCRs 2165 and 2191), allowing UN agencies and their inter-governmental and non-governmental partners to bypass Damascus and reach some of the previously inaccessible rebel-held areas directly. Yet cross-border operations alone have not solved the problem. The Syrian government continues to perceive urgently needed aid as a tool by the international community to strengthen the very same opposition it is bent on crushing—and large areas remain under siege as the regime continues to delay or withhold permission for aid agencies to operate. While practical measures like allowing airdrops and facilitating air-bridges can certainly have a positive effect to circumvent the regime’s physical barriers, these alone are insufficient.

Resolving this impasse represents a monumental challenge. As long as humanitarian and aid agencies’ negotiate and coordinate with the government, this allows the regime to grant or withhold access according to standing political and military interests. It leaves many vulnerable Syrians excluded and undermines the credibility of aid organizations’ neutrality and impartiality, making humanitarian workers more likely to be targeted by all sides. However, ignoring or bypassing the power brokers on the ground is also costly. Lack of coordination increases the risks for aid workers because, without explicit permission to operate, they may find themselves directly targeted by the Syrian regime.

This makes the negotiation of humanitarian access an especially divisive and controversial topic within the broader international humanitarian community. While some prominent groups, like Doctors Without Borders, have called to increase cross-border efforts and prevent the regime from politicizing aid, other groups—such as the International Committee of the Red Cross—have been adamant in stressing the need to “work with all parties.” This highlights the real struggle to preserve minimum principles of impartiality and neutrality.

Establishing shared rules of engagement is ever more urgent given the sheer magnitude of the Syrian civil war and the degree to which the regime has relied on granting and denying humanitarian access as part of its war strategy. The international humanitarian community needs to fundamentally rethink existing templates of assistance. One of its top priorities needs to be pressing all parties to the conflict—and especially the regime—to stop weaponizing humanitarian access and to hold those who do accountable. Reaching those in need, regardless of which party controls the inhabited area, is a key precursor to tackling the issue of forced displacement.

This article is reprinted with permission from Sada. It can be accessed online here.

Benedetta Berti is a fellow at the Institute for National Security Studies (INSS), a TED Senior Fellow, and a non-resident Senior Fellow at the Foreign Policy Research Institute (FPRI) and the Modern War Institute.