The fractured political and healthcare structures in Syria have left millions deprived of essential needs, including food, water, shelter, and healthcare services. Since 2014, United Nations (UN) cross-border mechanisms have been essential for the delivery of humanitarian aid to areas outside of Syrian government control. Cross-border mechanisms were introduced after Damascus repeatedly blocked aid from areas besieged by their militias and failed to deliver aid to geographical areas outside of its control, instead allocating aid based on loyalty. Because cross-line mechanisms repeatedly failed, cross-border mechanisms became necessary for the UN and other relief organisations to transport aid from neighbouring countries and coordinate programs that support the infrastructure in northwest Syria.

Initially, there were four border crossings: Al-Ramtha to the south on the Syria-Jordan border (closed in January 2020), Al Yaroubieh to the northeast on the Syria-Iraq border (closed in January 2020), Bab al-Salam to the northwest on the Syria-Turkey border (closed in July 2020) and Bab al-Hawa to the northwest on the Syria-Turkey border. Bab al-Hawa is the last remaining open border crossing. It allows for the delivery of essential aid and programs to more than 4 million people in Northwest Syria, more than half of whom are IDPs (internally displaced people) 80% of the IDPs in the area are women and children. According to estimates from UNOCHA, there are 4.1 million people in need, nearly 2 million who live in tents, and 3.1 million who are food insecure in northwest Syria.

Until July 12th, 2022, the UNSC resolution 2642 that protected the Bab al-Hawa border crossing had been subject to annual renewal. However, following a veto from Russia, the renewal was only extended for 6 months with the requirement of a subsequent vote for renewal for the additional six months. For this to pass, a new resolution needs to be issued based on the report of the Secretary-General of the United Nations no later than 10 December 2022. In this brief, we discuss the public health consequences of these decisions.