Never More Necessary: Overcoming Humanitarian Access Challenges

Report by Jacob Kurtzer

The 2019 CSIS Task Force on Humanitarian Access brought together top experts to provide concrete policy recommendations for how U.S. leaders can improve the delivery of humanitarian aid. This project based on their findings was made possible by the generous support of the U.S. Agency for International Development (USAID).

A worker fights to save food bags from the fire engulfing a World Food Program warehouse in the Houthi-held coastal town of Hodeida, Yemen | ABDO HYDER/AFP/Getty Images

What Is Humanitarian Access?

Humanitarian access is the ability of humanitarian aid to reach the most vulnerable and for the most vulnerable to reach humanitarian aid . ¹ Today nearly 132 million people need emergency humanitarian assistance, but in recent years, there has been a steep escalation in the deliberate, willful obstruction of access to this aid. ²

Denial of humanitarian access takes many forms, from mundane bureaucratic delays to horrific attacks on civilians seeking refuge and aid workers. Access denials like these are not new but have shifted from being an unintended consequence of conflict to a weapon of war used for political or military gain. As a consequence, principled humanitarian action is under attack all around the world.

Access barriers manifest differently depending on the context: 

  • Afghanistan: More than six million people are in acute need of humanitarian assistance, yet the Taliban has banned the World Health Organization from working in crucial areas. 
  • Yemen: Severe movement constraints for humanitarian organizations, aerial bombardments, and restrictions on lifesaving imports including food, fuel, and medicine have left millions teetering on the brink of famine. 
  • Northeast Nigeria: State armed forces coerce civilians into garrison towns in order to access emergency aid. 
  • Syria, South Sudan, and Myanmar: Governments and nonstate actors unapologetically use siege, starvation, and obstruction as military and political tactics, putting millions of their own people at risk while impeding aid agencies from operating. 


Violent conflict in the world has reached record highs. In part because of the increasing length and severity of conflicts, 70.8 million people are considered forcibly displaced by armed conflict.  Humanitarian access is essential to protecting the rights, dignity, and safety of civilians affected by conflict, as established by international humanitarian law. ³ As a global leader in humanitarian assistance, blocked humanitarian access is an urgent crisis which demands action from U.S. leadership.

In 2017, Syrian refugees in the no-man's zone between Syria and Jordan are permitted by Jordanian soldiers to seek medical attention. | JORDAN PIX/Getty Images

Types of Access Constraints 


1. Violence and Insecurity

“Today, I live with the heavy conscience that one year ago we probably made a mistake giving the UN the coordinates of our center. It is clear by now that the very institutions that are supposed to protect us, civilians, have failed us.”

–Rashed al-Ahmad, Pharmacist from Kurnaz, Syria⁴

Violence and insecurity are a tragic reality for aid workers in protracted conflicts and the populations they are trying to help. Between 2014 and 2017, there were more than 660 attacks on aid workers worldwide, 90 percent of which targeted local aid workers. ⁵ There have also been many attacks on vital physical infrastructure that facilitates access, like hospitals and pharmacies.

However, threats impacting access are not limited to direct attacks from armed groups. These range from landmines and unexploded artillery or ordnance to blockades, kidnapping, and arbitrary detention. Aid workers also face the risk of sexual exploitation and abuse. ⁶

Aid Workers Killed, Wounded, or Kidnapped, 2008-2018 graph

Providing the necessary security and protection for aid workers puts financial pressure on humanitarian organizations and donor governments. Such security measures also threaten the perception of humanitarian actors’ neutrality in a conflict. For example, an armed aid escort traveling to a contested area may give the perception it is a proxy of one side, which can create additional security concerns for the aid workers and limit future access.

A UN patrol of the Multidimensional Integrated Stabilisation Mission in the Central African Republic wait under a tree for the arrival of the convoy they will escort along the only supply road to the capital in 2017 | FLORENT VERGNES/AFP/Getty Images

A UN patrol in the Central African Republic wait for the convoy they will escort along the only supply road to the capital


Insecurity also takes a toll on other types of infrastructure that humanitarian access depends on. Roads, highways, and bridges are critical to humanitarian assistance delivery and are therefore at the core of access. In conflict zones, they often become the target of political or strategic control through blockade or checkpoint. ⁷ In Yemen, armed groups use checkpoints as a means of security and control and as a point of taxation for financial gain.

Access constraints in Yemen have become so extreme that it can take four hours to travel a route that normally takes 15 minutes. ⁸ The vulnerability of local civilian populations increases as infrastructure connecting communities and cities like this deteriorates. Aside from access denial, limiting people’s movement or destroying their means of mobility also deepens a population’s isolation and exacerbates underlying causes of conflict, such as economic and political fragility. This can exacerbate existing inequalities for persons with disabilities, LGBTQ individuals, women and girls, and the elderly. ⁹

Violence and insecurity pose serious physical and psychological risks to aid workers, restrict movement, and limit access to critical infrastructure like hospitals and schools. It is one of the most serious and pervasive threats to humanitarian access and creates undue suffering and loss of life.

2. Bureaucratic Constraints

“Humanitarian organizations in South Sudan are striving every day to save lives and alleviate suffering across this country. Yet, they continue to face obstacles and challenges which hamper their efforts. This must stop.”

–Eugene Owusu, Humanitarian Coordinator for South Sudan ¹⁰

Bureaucratic impediments to humanitarian access greatly complicate the ability of people in need to reach basic assistance and impair the ability of aid workers to provide it.¹¹ Governments may seek to harm vulnerable communities or exploit aid organizations through many different bureaucratic tactics, from curbing the import of aid equipment and relief items to targeting aid workers as they attempt to operate in the country.¹²

In some cases, parties have tried to exploit humanitarian action by levying excessive taxes and fees. They also have reduced administrative allowances for organizations to import goods, sometimes requiring permits to move and delaying their issuance. On top of this, onerous reporting and registering processes have been imposed on aid organizations.¹³

States often exploit the visa process to deny humanitarian access to populations in need. The government of Myanmar regularly denied or delayed visas for international aid staff working in Rakhine state in late 2017. The aid professionals who were delayed or denied entry to the country were also denied the chance to help the Rohingya, even as hundreds of thousands of them were being attacked and forced from their homes.¹⁴


Rohingya Muslim refugees wait in line for relief supplies after fleeing burning villages, the army and ethnic Rakhine mobs

Rohingya Muslim refugees wait in line for relief supplies after fleeing burning villages, the army, and ethnic Rakhine mobs


Short of outright denial, state authorities may also impose excessive costs for registration and visas. One outrageous example of humanitarian extortion was the attempt by the government of South Sudan to increase visa fees to $10,000 for humanitarian personnel in 2017.¹⁵

Bureaucratic constraints to humanitarian access are also put in place by donor countries and institutions. While all of these impediments may not generate the same media coverage and outrage as security incidents, they are equally harmful to the health and safety of civilians and equally difficult to overcome.

3. Counterterrorism Regulation

“The unintended consequences of counter-terrorism national security policies…[raise] the cost for the NGOs that are working humanitarian issues, it's putting them at a risk of liability under the U.S. law.” 

–Ambassador Jeff Feltman, CSIS Task Force Member

Counterterrorism and related economic sanctions regimes are designed to prohibit intentional support to terrorist organizations. However, while critical for national security, these same statutes can at times block humanitarian access to the populations suffering because of those terrorist organizations.

Should assistance fall into the hands of sanctioned actors, aid could be criminalized and aid workers carry the risk of prosecution for life-saving humanitarian activity. Domestic legal frameworks crafted in response to legitimate national security concerns do not always account for situations like this, which can put them in tension with state obligations to protect humanitarian assistance under international humanitarian law.¹⁶

Counterterrorism regulation can create a burdensome standard for humanitarian actors and limit their ability to reach the most vulnerable. Some clauses require organizations to vet recipients of assistance, even prohibiting the provision of aid to those who may have been forcibly kidnapped by sanctioned armed groups.¹⁷

Somali women who fled drought and violence wait beneath a bullet scarred wall to collect aid

Somali women who fled drought and violence wait beneath a bullet scarred wall to collect aid


Aid organizations must dedicate substantial time and staff resources toward compliance with ever-evolving reporting regulations. Navigating these legal and regulatory requirements can contribute to financial constraints, which reduces the funds available for aid operations.

In spite of these complications, only in very rare cases have aid organizations and implementing partners turned down funding with stringent counterterrorism requirements. More often, despite strong reservations, the humanitarian imperative compels humanitarian actors to conform to donor requirements, despite the legal risks and compliance hurdles they entail.

These policies have effectively limited humanitarian organizations’ operational footprint and compelled them to engage in humanitarian action only in areas understood to be safe from legal risk. ¹⁸,¹⁹ This runs counter to one of the core principles of humanitarian aid—that assistance be based on need—and leaves many vulnerable populations without lifesaving support. ²⁰

4. Funding

Denial, delay, and diversion of humanitarian aid lead to substantial wasted time for humanitarian organizations who grapple with bureaucratic impediments, sit stuck at checkpoints, or are compelled to take circuitous routes to avoid insecure areas. This adds up to dollars and staff capacity being directed to navigating access constraints instead of being directed to meeting the needs of the most vulnerable. Funding for overcoming these impediments is increasingly hard to come by at a time when restrictions tied to funding are themselves an impediment to getting assistance to those who need it.

A solitary aid worker looks on as people queue for treatment from his mobile clinic during fighting in Iraq in 2017

A solitary aid worker looks on as people queue for treatment from his mobile clinic during fighting in Iraq in 2017

| CARL COURT/Getty Images

Access denial is becoming increasingly acute at a time when humanitarian needs are growing. While the overall number of armed conflicts globally fluctuates, the severity and length of ongoing conflicts have risen. ²¹ In the last four years, the average length of crises with a UN-coordinated response increased from 5.2 years to 9.3 years. ²² This average increase in response duration means 4 more years of aid funding on a global scale.

As a result, the international community is spending more money on humanitarian assistance than ever before, yet the need is growing even faster. In 2018, the total funding received for UN-coordinated appeals was $15.2 billion—a record high. One-third of this funding came from the United States. ²³ However, 2018 also saw a nearly $10 billion shortfall against UN appeal requirements—the largest ever.

Appeal Funding Gap, 2009-2018 graph

Meanwhile, rising populism in donor states fuels skepticism about humanitarianism itself, undermining their willingness to tackle access challenges.

The disparity between funding needs and funding received is driven by the changing nature of crises. The UN Office for the Coordination of Humanitarian Affairs has stated that most of this aid is dedicated to civilians in regions struggling with protracted conflicts. Reducing access challenges is crucial to overcoming growing funding gaps.

In northeast Nigeria, people fleeing or recently escaped from Boko Haram shelter in a devastated town turned military base, awaiting humanitarian aid | STEFAN HEUNIS/AFP/Getty Images

Access Constraints & the United States

Today’s global access crisis is a symptom of broader, connected trends: the massive increase in humanitarian needs, a collective failure to find political solutions to end armed conflicts, and the rapid erosion of humanitarian norms and standards. But access challenges are not only obstacles to assistance; they jeopardize foreign policy objectives writ large.

Since the end of World War II, the United States has been a leader in the humanitarian sector, reflecting moral and ethical considerations and the United States’ interest in global influence and stability. Access challenges undermine those potential gains, but there is much that can be done by the United States and its allies to resolve these issues.

Elevating humanitarian access to be a foreign policy and national security priority is of paramount importance. This includes prioritizing aid funding, training, data sharing, and new technologies that can help aid workers overcome access challenges to reach the most vulnerable. Tensions must also be reconciled between national security and humanitarian interests, including in counterterrorism regulations.

It is the responsibility of U.S. leaders to reverse the steady erosion of humanitarian access and to promote respect for humanitarian law, principles, and action in the future. Failure to resolve these issues will continue to have consequences; millions of vulnerable lives hang in the balance.


Watch the CSIS Humanitarian Access Task Force go deeper into this issue:

One of five IDP (Internally Displaced People) camps outside the town of Pulka, Nigeria, where people come seeking protection from Boko Haram's devastating attacks against military and civilian targets | STEFAN HEUNIS/AFP/Getty Images

About the Author

Jacob Kurtzer

Deputy Director and Senior Fellow, Humanitarian Agenda
Photo of Jacob Kurtzer

Jacob Kurtzer is deputy director and senior fellow with the Humanitarian Agenda, an initiative that leverages the expertise of CSIS programs to explore complex humanitarian challenges. His primary focus is the Task Force on Humanitarian Access, which will look at challenges in access to aid in complex man-made emergencies. Prior to joining CSIS, Mr. Kurtzer spent seven years with the International Committee of the Red Cross (ICRC), most recently as head of communications for the ICRC Delegation in Israel and the occupied territories. Previously, he served as head of public and congressional affairs for the Washington Delegation of the ICRC, representing the ICRC to a broad spectrum of audiences in the United States and Canada. In addition, he has conducted field missions in South Sudan, and Rakhine State, Myanmar and spent nearly three years as a consultant with the ICRC delegation in Pretoria, South Africa. From 2007-2009, he served as the congressional advocate at Refugees International (RI), a humanitarian advocacy organization based in Washington D.C. Mr. Kurtzer began his career as a legislative assistant to Congressman Robert Wexler of Florida covering domestic and foreign policy issues, including managing the Congressional Indonesia Caucus. Mr. Kurtzer earned an M.A. in peace and conflict studies from the University of Queensland in Brisbane, Australia, where he studied as a Rotary Foundation World Peace Fellow. He also holds a B.A. in philosophy from the University of Maryland, College Park, with a citation in religious studies, and is an alumnus of the College Park Scholars Public Leadership program.

Special thanks to:

Emily Mudd, Research Intern, Humanitarian Agenda, CSIS
Sarah Grace, Multimedia Producer, iDeas Lab, CSIS

This project was made possible by the generous support of the U.S. Agency for International Development (USAID)

A product of the Andreas C. Dracopoulos iDeas Lab, the in-house digital, multimedia, and design agency at the Center for Strategic and International Studies.