Equipo Nizkor - UNSC S/2016/460 - Report of the Secretary-General: Implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014) and 2258 (2015) (Apr.16).

United Nations
Security Council

S/2016/460

Distr.: General
19 May 2016
Original: English

Implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014) and 2258 (2015)

Report of the Secretary-General

I. Introduction

1. The present report is the twenty-seventh submitted pursuant to paragraph 17 of Security Council resolution 2139 (2014), paragraph 10 of Council resolution 2165 (2014), paragraph 5 of Council resolution 2191 (2014) and paragraph 5 of Council resolution 2258 (2015), in which the Council requested the Secretary-General to report, every 30 days, on the implementation of the resolutions by all parties to the conflict in the Syrian Arab Republic.

2. The information contained herein is based on the data available to United Nations agencies on the ground, from the Government of the Syrian Arab Republic, other Syrian sources as well as open sources. Data from United Nations agencies on their humanitarian deliveries have been reported for the period from 1 to 30 April 2016. More recent data have been included when available.

II. Major developments

A. Developments on the ground

3. While the cessation of hostilities continued to reduce levels of violence in some areas during the reporting period, the overall increase in fighting resulted in a significant rise in the number of civilian casualties and in the destruction of civilian infrastructure, including hospitals, markets and schools. Cross-line inter-agency convoys provided assistance to 377,750 civilians in besieged, hard-to-reach and priority cross-line areas in April. That included food assistance to 41.9 per cent of those in besieged areas, representing a considerable increase over previous months. The United Nations and its partners reached 781,425 of the approximately 4.6 million civilians in need living in those areas through cross-line inter-agency operations between 1 January and 13 May 2016. Clearly, much more access needs to be granted to reach those in besieged, hard-to-reach and priority cross-line areas.

4. In line with resolution 2258 (2015), the following brief description of developments on the ground contains information on compliance by all parties in the Syrian Arab Republic with resolutions 2139 (2014), 2165 (2014) and 2191 (2014). The information is provided without prejudice to the work of the International Syria Support Group Task Force on the Ceasefire.

5. Based on information received by the Office of the United Nations High Commissioner for Human Rights (OHCHR), the killing of civilians and other abuses and violations of international human rights law and international humanitarian law during the reporting period rose sharply after a period of relative calm the previous month. Much of the violence occurred in the last two weeks of April, particularly in Aleppo, Idlib, Damascus, Rif Dimashq, Dar'a, Homs, Hasakah and Dayr al-Zawr governorates. OHCHR documented attacks by all parties to the conflict, including government forces, non-State armed opposition groups and designated terrorist groups.

6. Aleppo governorate, and Aleppo city in particular, witnessed heavy fighting during the reporting period. OHCHR documented the alleged killing of at least 184 civilians and injury to hundreds more in Aleppo city in April. On 23 April, information collected by OHCHR indicates that 12 civilians, including a child, were killed in an air strike that hit a local market and a residential building in eastern Aleppo. On 25 April, OHCHR reported that at least 12 civilians, including 6 children, were killed and at least another 100 civilians injured when mortars struck the government-held neighbourhoods of western Aleppo city. On 27 April, the Al-Quds hospital located in the non-State armed opposition group-controlled Sukkari neighbourhood was hit, which resulted in the death of at least 22 civilians, including 3 doctors and 2 children. On the same day, the Ibn Rushd hospital in government-held western Aleppo was reportedly damaged by attacks, with no casualties reported. OHCHR received reports that on 28 April air strikes on non-State armed opposition group-controlled areas of east Aleppo city reportedly resulted in the death of at least 31 civilians and more than 50 injured. According to OHCHR, further air strikes on eastern parts of Aleppo city on 29 April allegedly killed at least 48 civilians and injured another 60 civilians.

7. Ongoing fighting in the north of Aleppo governorate resulted in large population movements and a number of civilian deaths. Fighting between Islamic State in Iraq and the Levant (ISIL) and both non-State armed opposition groups and Syrian forces resulted in more than 40,000 people being displaced around the town of I'zaz, near the Turkish border. That included some 35,989 individuals from settlements and surrounding areas, with 7 of the 12 camps in the area abandoned or almost empty. On 25 April, an air strike on Atarib hit a training centre of the non-governmental organization (NGO) Syria Civil Defence, reportedly killing five first responders. Fighting in the south and west of Aleppo between the Government, non-State armed opposition groups and designated terrorist groups, particularly around the town of Khan Tuman, began on 19 April and continued throughout the month.

8. In Idlib governorate, indiscriminate attacks against civilians and civilian infrastructure continued. According to OHCHR, on 5 April a car bomb in Idlib city reportedly killed a woman and injured dozens of other citizens. On 9 April, OHCHR noted that air strikes on the town of Has reportedly killed at least four civilians, including two children. On 19 April air strikes reportedly hit a number of towns in the governorate, causing death and destruction. OHCHR reported that one of the air strikes hit a market, killing at least 44 civilians, including 3 children, another hit a market in Kfar Nubl, killing 9 civilians, including 2 children, and another fell in the vicinity of a school where 50 children were present, although none were harmed. Reported shelling on Khermash camp and other small camps along the Turkish border, as well as in neighbouring villages, forced between 2,000 and 2,500 civilians to flee their homes and tents for safety in the east near Jisr al-Shaghour.

9. Damascus and Rif Dimashq governorates also faced a number of attacks resulting in civilian deaths. On 5 April, following military operations against ISIL in Dumayr area, 5,000 people were forcibly displaced from the northern and eastern neighbourhoods of Dumayr city towards its western and southern neighbourhoods. OHCHR reports that, on 6 April, two civilians were reportedly killed and several others, including children, injured when air strikes hit several areas in Duma town and Al-Marj. On 23 April, OHCHR reported that air strikes and artillery fire hit various areas, including a livestock market in Duma, reportedly killing at least 12 civilians, including 2 children, and injuring at least 30 others. On 25 April OHCHR reported that a car bomb was detonated at a pro-government checkpoint on the outskirts of Damascus city. At least six persons were killed and numerous others were injured in the attack that was later claimed by ISIL.

10. In Dar'a governorate, fighting resulted in civilian casualties and displacement. On 9 April, fighting in the western rural part of Dar'a between the Free Syrian Army and ISIL-affiliated groups reportedly led to the displacement of 2,700 people from Shajarah to Nawa. On 25 April, OHCHR reported that a missile hit the city of Dar'a, killing one civilian and injuring many others. Hostilities allegedly escalated further on 26 April, with reports of intense shelling and aerial bombardment of non-State armed opposition group-controlled areas of Dar'a governorate until the end of the reporting period.

11. In Homs governorate, OHCHR received information of almost daily air strikes and ground attacks against non-State armed opposition group-controlled areas. Non-State armed opposition groups reportedly periodically fired mortars and homemade rockets into the government-held city of Homs. On 2 April, OHCHR reported that a rocket hit a residential building in Wa'r, allegedly killing three civilians and injuring several others, including children. The approximately 75,000 people living in Wa'r had been cut off from aid for more than two months, following reported violations of the local truce agreement between non-State armed opposition groups and the Syrian government forces. On 11 April, OHCHR received reports indicating that multiple air strikes and rocket fire killed at least 6 civilians, including 3 children, and injured at least 10 others in Talbisah. Exchanges of mortar fire between non-State armed opposition groups in Rastan and government forces in neighbouring villages were also reported by OHCHR. On 18 April, OHCHR reported that an air strike on the field hospital in the opposition-held town of Taldu allegedly killed 4 civilians, including 2 children, and injured at least 10. According to OHCHR, on 26 April another attack on Talbisah killed a young girl and injured a number of other people.

12. Attacks and fighting in the north-east continued to cause civilian casualties. In Hasakah governorate, OHCHR reported that fighting between security police (Asayish) and government forces in Qamishli town resulted in the death of at least 26 civilians, with numerous others injured. In Raqqah governorate, OHCHR reported that attacks by non-State armed opposition groups on 5, 10 and 15 April killed 38 civilians, including children, and injured another 59. In Dayr al-Zawr governorate, on 4 April, OHCHR reported that at least 10 civilians, including children, were reportedly killed when ISIL fired mortars on government-held parts of Dayr al-Zawr city. On 5 April, OHCHR reported that air strikes on the village of Hatla reportedly killed at least 8 civilians and injured 15 others. According to OHCHR, on 16 April air strikes on various ISIL -held neighbourhoods of Dayr al-Zawr city reportedly killed at least 18 civilians. OHCHR also reported that on 17 April air strikes allegedly struck Mayadin, killing five civilians, including four children. On 21 April, OHCHR reported that air strikes reportedly killed eight civilians and injured three others.

13. Although the Ministry of Defence of the Russian Federation provided no direct information to OHCHR on operations in April, it did report on 11 April that Russian operations were conducted in conjunction with Syrian troops against the Nusrah Front. The Central Command of the United States of America reported that in April at least 153 air strikes were carried out by the United States-led coalition against ISIL targets in the governorates of Aleppo, Hasakah, Raqqah, Dayr al -Zawr and Idlib. OHCHR received various reports of air strikes, allegedly conducted by international actors, which caused civilian casualties. However, OHCHR was not able to adequately verify the origin of the reported air strikes.

B. Human rights

14. In addition to the incidents reported above, OHCHR documented abuses and violations of international human rights law and international humanitarian law by ISIL during the reporting period. OHCHR reported that on 6 April ISIL allegedly executed two teenagers accused of spying for coalition forces in Raqqah city. On the same day, in Raqqah OHCHR reported that ISIL allegedly sewed the mouth of a civilian together and paraded him around the city for criticizing ISIL for withdrawing from Palmyra. ISIL reportedly arrested three female nurses in Raqqah on 8 April and another civilian on 16 April in Dayr al-Zawr city. The whereabouts of all four remain unknown.

15. OHCHR also reported the detention of two human rights defenders by Syrian authorities. On 1 April, a human rights defender and Executive Director of the Centre for Civil Society and Democracy in Syria was reportedly detained by Syrian authorities at the Syrian-Lebanese border. He was released on 23 April. On 9 April, another Syrian human rights activist was reportedly detained in Damascus and then released on 17 April. Both releases followed protests against their detention.

C. Humanitarian response

16. In April, United Nations humanitarian agencies and partners continued to reach millions of people in need through all modalities from within the Syrian Arab Republic and across borders pursuant to resolutions 2165 (2014), 2191 (2014) and 2258 (2015). NGOs also continued to deliver assistance to people, in line with previous months. The Government of the Syrian Arab Republic continued to provide basic services to areas under its control, as well as in many areas beyond its control.

Table 1
Number of people reached by United Nations system organizations in April 2016

Organization Number of people reached

Food and Agriculture Organization of the United Nations 28 758

International Organization for Migration 19 368

Office of the United Nations High Commissioner for Refugees 279 292

United Nations Children's Fund 1 500 000

United Nations Development Programme 767 080

United Nations Population Fund 212 507

United Nations Relief and Works Agency for Palestine Refugees in the Near East 160 328

World Food Programme 4 100 000

World Health Organization 2 167 962 (treatments)

17. Cross-border deliveries continued during the reporting period. In April, 15 consignments consisting of 387 trucks crossed from Turkey and Jordan to the Syrian Arab Republic under the terms of resolutions 2165 (2014), 2191 (2014) and 2258 (2015), benefiting millions of people (see map in annex for more information on United Nations cross-border convoys in April). Eight of those consignments crossed from Bab al-Hawa (282 trucks), two from Bab al-Salam (16 trucks) and five from Al-Ramtha (89 trucks). That brings the total number of trucks since the beginning of operations to 7,561 (5,391 through Bab al-Hawa, 647 through Bab al-Salam and 1,523 through Al -Ramtha).

18. In line with Security Council resolutions, the United Nations notified the Syrian authorities in advance of each shipment, including content, destination and number of beneficiaries. The United Nations Monitoring Mechanism for the Syrian Arab Republic continued its operations, monitoring 387 trucks in the 15 consignments in April, confirming the humanitarian nature of each and notifying the Syrian authorities after each shipment. The Mechanism continued to benefit from excellent cooperation with the Governments of Jordan and Turkey.

19. In April, inter-agency convoys to the besieged and hard-to-reach locations listed in table 2 below were completed, assisting 377,750 people in need.

Table 2
Inter-agency convoys in April 2016

Date Location Number of beneficiaries Type of assistance

2 April Tayr Ma'lah, Homs 22 000 Delivery of nutrition, health, education, protection and water, sanitation and hygiene supplies and non-food items

3 and 16 April Afrin, Aleppo 50 000 Delivery of food rations, nutrition, health, water, sanitation and hygiene, education and protection supplies and non-food items

16 and 19 April Kafr Batna subdistrict, Rif Dimashq 50 000 Delivery of food, nutrition, health, protection, education, and water, sanitation and hygiene assistance and non-food items

16 April Tall Rif'at, Aleppo 13 250 Delivery of medical, nutrition, and water, sanitation and hygiene supplies and non-food items

21 and 25 April Rastan, Homs 122 500 Delivery of food, nutrition, water, sanitation and hygiene, health, education and protection supplies and non-food items

27 April and 2 May Talbisah, Homs 60 000 Delivery of food, nutrition, health, education and protection supplies and non-food items

30 April Zabadani, Madaya, Rif Dimashq; and Fu'ah and Kafraya, Idlib 60 000 Delivery of food, health, nutrition, water, sanitation and hygiene, education, shelter and agriculture supplies and non-food items

20. In April, United Nations agencies also undertook single-agency deliveries to cross-line and hard-to-reach locations. For example, the World Food Programme (WFP), in coordination with the Syrian Arab Red Crescent, reached 12,500 people through cross-line deliveries in Tall in Rif Dimashq. The United Nations Children's Fund (UNICEF) delivered multisectoral assistance for more than 60,000 people altogether in Afrin, Aleppo, as well as Rastan, Tall Rif'at and Tayr Ma'lah in Homs. In Yalda, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was able to continue with limited health missions until 7 April, with 348 patients receiving health consultations and 39 dental treatments being provided. All operations were subsequently suspended until early May owing to increased fighting in and around Yalda and Yarmuk.

Humanitarian access

21. Despite some real but modest progress on access to besieged and hard-to-reach locations during the reporting period, the delivery of humanitarian assistance to people in need of assistance in the Syrian Arab Republic remained challenging in many areas of the country as a result of deliberate restrictions by the parties on the movement of people and goods, active conflict and shifting conflict lines.

22. Access to the 4.6 million people living in besieged, hard-to-reach and priority cross-line locations as at 30 April remained of critical concern. During the reporting period, the United Nations agencies and partners reached 68 of the 154 besieged, hard-to-reach and priority cross-line locations (44 per cent). Details of assistance in those areas in April are contained in table 3.

Table 3
United Nations deliveries to hard-to-reach, besieged and priority cross-line locations, April 2016

Sector (United Nations delivery only) Number of people reached (as a percentage of 4. 6 million)

Food security 625 500 (13.7)

Health 675 923 (14.8)

Non-food items 168 840 (3.7)

Water, sanitation and hygiene 165 869 (3.6)

23. Deliberate interference and restrictions by the parties also continued to prevent aid delivery. For example, WFP continued to be unable to reach people in need in areas controlled by ISIL owing to the inability to work independently and to monitor activities. That affected assistance delivery in Dayr al-Zawr and Raqqah governorates, parts of rural Aleppo, southern rural Hasakah and north-western rural Hama.

24. As was previously reported, on 17 March the United Nations submitted its inter-agency convoy plan for the month of April, which included 11 besieged, hard -to-reach and priority cross-line locations with 354,000 beneficiaries. On 23 March, the Government of the Syrian Arab Republic approved 6 of the 11 locations. The remaining five locations, which included Darayya, Duma, eastern Harasta, Mu'addamiyah and Zabadani, were not approved on the grounds of security concerns. Verbal indications were, however, later given for Zabadani (as part of the Four Towns agreement) and Mu'addamiyah.

25. On 20 April, the United Nations submitted its inter-agency convoy plan for the month of May, which included requests to reach 904,750 beneficiaries across 35 besieged, hard-to-reach and priority cross-line locations. By 4 May, the Syrian authorities had granted approval in full to 14 locations with 224,000 people. The Syrian authorities granted conditional approval to eight locations with some 306,000 people. For five of those locations, including the besieged towns of Darayya and Duma, the delivery of assistance was limited to milk and school and medical supplies. For the other three conditionally approved locations, the approved delivery quantities would cover only a portion of the people in need in those areas. Planned deliveries to some 375,000 people in 13 locations were not approved. They include the five locations requested in Aleppo; Talbisah and Wa'r in Homs; and Zabadani, Yalda, Babila, Bayt Saham, Tadamun and Hajar al-Aswad in Rif Dimashq. In total, for the month of May, the Government of the Syrian Arab Republic authorized the United Nations to deliver assistance to 24.7 per cent of the planned beneficiaries in full and to 33.8 per cent with conditions. Requests to deliver assistance to 41.5 per cent of the planned beneficiaries were not approved.

26. The resumption of active conflict in several governorates hindered the effective delivery of humanitarian assistance, as well as people's access to essential services. OHCHR reported intense air strikes and shelling in Aleppo, Idlib, Homs, Hama and Rif Dimashq provinces. Markets, schools and medical and other civilian infrastructures were hit, reducing the availability of basic and essential services in critical areas. Local NGO offices were also damaged, rendering some inoperable. In Aleppo, humanitarian partners had to briefly suspend their operations, and about 100 United Nations staff were advised to temporarily work from home for 48 hours. Moreover, early in May, the United Nations decided to suspend shipments through the Bab al-Salam border crossing point for three days owing to recurring shelling on Kilis city in Turkey. On 7 April, intense clashes erupted inside Yarmuk and interrupted UNRWA humanitarian operations in Yalda. Consequently, UNRWA was unable to deliver much-needed aid to the area surrounding Yarmuk from 8 April until the end of the month.

27. The Nusaybin/Qamishli crossing in Hasakah governorate has been temporarily closed by the Turkish authorities owing to security concerns since 27 December 2015. In April, WFP stocks of monthly food rations in Hasakah governorate ran out, preventing further dispatches of general food distribution to 250,000 food-insecure people. At present, WFP has only limited stocks of ready-to-eat rations available in Qamishli warehouses, approximately 3,000 parcels, which are being prioritized to assist newly displaced families and respond to the most critical needs of internally displaced persons in collective shelters. Reports continue to be received that people have adopted negative coping strategies, including eating only one meal per day and drastically reducing the types of food consumed. A mission of the United Nations Monitoring Mechanism for the Syrian Arab Republic was deployed to Iraq from 23 to 26 April to assess whether the Al-Ya'rubiyah border crossing could be used as an alternative for United Nations cross-border assistance to Hasakah governorate; the crossing was found both closed and inaccessible.

28. As at 30 April, a total of 58 visas for United Nations staff from nine agencies had been approved, of which 23 were new visas and 35 were renewals. Some 38 requests remained pending, and 1 had been rejected.

29. A total of 16 international NGOs are authorized to operate in the Syrian Arab Republic; 3 more have applications pending approval by the Government. International NGOs continued to face a series of administrative hurdles and restrictions that affected their ability to operate, including in gaining permission to undertake independent needs assessments.

30. The number of national NGOs authorized to partner with United Nations organizations increased from 143 to 145 in April. The two additional national NGOs are in Hasakah and Rif Dimashq. Authorized national NGOs continued to operate under complex procedures in partnering with United Nations agencies.

Besieged areas

31. Of the 4.6 million people living in hard-to-reach areas in the Syrian Arab Republic, some 517,700 people are besieged in 18 locations. That includes some 377,700 people besieged by the Government of the Syrian Arab Republic in various locations in Rif Dimashq; 10,000 people besieged by the Government and non-State armed opposition groups in Yarmuk, in Damascus; some 110,000 people in Dayr al-Zawr city besieged by ISIL; and some 20,000 people besieged by non-State armed opposition groups and the Nusrah Front in Fu'ah and Kafraya, in Idlib governorate.

32. Humanitarian conditions in besieged areas remain dire. In April, inter-agency convoys assisted 204,250 people in 8 of the 18 besieged areas (41.9 per cent of the previous total besieged population of 486,700). The United Nations stands ready to deliver assistance to all besieged locations as soon as access is granted. The flow of commercial supplies through official routes remained largely blocked, leading to high prices for commodities reaching besieged areas through unofficial and irregular supply lines. Freedom of movement remained heavily restricted, although limited numbers were sporadically allowed to exit and re-enter some besieged areas.

33. In eastern Ghutah, Rif Dimashq, some 285,000 people remain besieged by government forces in the following locations: Duma, eastern Harasta, Irbin, Zamalka, Ayn Tarma, Hammurah, Jisrayn, Kafr Batna, Saqba and Zabadin. As previously reported, the United Nations and the Syrian Arab Red Crescent convoys reached Kafr Batna on 16 and 19 April, delivering multisectoral assistance for some 50,000 people in total. In addition, under the May plan, delivery of assistance was granted to all locations in eastern Ghutah, including to Duma, where the delivery of assistance has, however, been limited to baby milk and school and medical supplies.

34. In Madaya (and Buqayn), in Rif Dimashq governorate, some 43,000 people remain besieged by government forces. United Nations and Syrian Arab Red Crescent convoys delivered multisectoral assistance on 30 April. They are further authorized to deliver assistance to Madaya under the May plan.

35. In Zabadani, in Rif Dimashq governorate, some 700 people remain besieged by government forces. An inter-agency convoy delivered multisectoral assistance to Zabadani on 30 April. A United Nations request to deliver assistance to Zabadani under the May plan has not been approved by the Government of the Syrian Arab Republic.

36. In Darayya, in Rif Dimashq, about 4,000 people remain besieged by government forces. The United Nations has been unable to deliver assistance to Darayya since November 2012. Under the May plan, the Syrian authorities granted conditional approval to Darayya, limiting the delivery of assistance to baby milk and school and medical supplies. The convoy and assessment mission to Darayya, scheduled for 12 May, was aborted because the convoy was refused entry at the last checkpoint by the Fourth Division owing to the presence of medical items and baby milk on board. The conditions imposed by government security personnel are excessive and contrary to earlier guarantees and approvals obtained from the Government of the Syrian Arab Republic.

37. In Fu'ah and Kafraya, in Idlib governorate, some 20,000 people remain besieged by non-State armed opposition groups and the Nusrah Front. United Nations and Syrian Arab Red Crescent convoys delivered multisectoral assistance to Fu'ah and Kafraya on 30 April. They are further authorized to deliver assistance to the two locations under the May plan.

38. On 20 April, more than 515 people, comprising 80 medical cases and their accompanying family members, were evacuated under the Four Towns agreement from Fu'ah, Kafraya, Madaya and Zabadani, making it the largest medical evacuation to date. More than 160 medical cases and 870 family members have been evacuated since December as part of the Four Towns agreement.

39. In Mu'addamiyah al-Sham, in Rif Dimashq, about 45,000 people remain besieged by government forces. Under the May plan, the Syrian authorities granted conditional approval to Mu'addamiyah al-Sham, limiting the delivery of assistance to baby milk and school and medical supplies. An inter-agency convoy was supposed to reach Mu'addamiyah al-Sham on 14 May. It was previously agreed that Fourth Division representatives would proceed to the warehouse to monitor the loading of humanitarian items. The Fourth Division representatives, however, never proceeded to the warehouse, despite constant outreach at various levels. That meant that aid supplies could not be delivered.

40. In Yarmuk, in Damascus, some 10,000 people are besieged by government forces and non-State armed opposition groups. On 7 April, intense clashes erupted inside Yarmuk and interrupted UNRWA humanitarian operations in Yalda. Consequently, UNRWA was unable to deliver much-needed aid to the area surrounding Yarmuk from 8 April until the end of the month. UNRWA resumed operations on 2 May.

41. In the government-controlled western neighbourhoods of Dayr al-Zawr city, some 110,000 people are besieged by ISIL. Since 10 April, WFP, after intense training and dedication and commitment, successfully carried out 29 high-altitude airdrops over the besieged city, dropping a total of 479 metric tons of urgently needed food assistance, distributed by the Syrian Arab Red Crescent to more than 100,000 beneficiaries in the most food-insecure areas of the besieged city.

Attacks on medical facilities and free passage of medical supplies, personnel and equipment

42. In blatant disregard for the special protected status of medical personnel or health-care facilities under international humanitarian law, attacks continued unabated. In April, Physicians for Human Rights documented six attacks on medical facilities. Five attacks occurred in Aleppo city between 28 and 29 April, and the sixth attack occurred in Taldu in northern rural Homs on 18 April. In April, Physicians for Human Rights also documented the deaths of eight medical personnel, of whom six were killed in the line of duty. Three medical personnel were killed in Aleppo and Hama governorates, one in Rif Dimashq and one in Raqqah.

43. The World Health Organization (WHO), UNICEF and other health partners delivered some 2.2 million medical treatments in 11 governorates. WHO and UNICEF have also been supporting the first nationwide routine immunization campaign as part of World Immunization Week. The first round of the nationwide immunization campaign is taking place in two phases. The first phase started on 24 April and will be extended for an additional week to reach areas that were not covered during the first week. The second phase will start on 24 May and should last until early June. Overall, the campaign aims to reach about 2 million children across the country.

44. In 2016, WHO submitted 21 individual requests to the Government of the Syrian Arab Republic to deliver medical supplies to 82 locations in 10 governorates. The Government approved five requests, including one to deliver medical supplies to Duma, in Rif Dimashq. Meanwhile, 16 requests remained unanswered.

45. The removal of life-saving medicines and medical supplies continued, with nearly 47,459 treatments removed from convoys in April intended for locations in Homs, Aleppo and Rif Dimashq governorates. Removed items included surgical supplies, emergency kits, trauma kits, mental health medicines, burn kits and multivitamins. Removals extended to basic items, such as antibacterial soap, which was removed from midwifery kits. Items were also removed from other kits, notably surgical tools and antibacterial soap.

Safety and security of staff and premises

46. A total of 30 United Nations staff members, of whom 28 are UNRWA area staff, 1 is from UNDP and 1 is from UNICEF, continue to be detained or missing. The total number of humanitarian workers killed in the conflict since March 2011 is 87. That includes 17 staff members of the United Nations, 53 staff members and volunteers of the Syrian Arab Red Crescent, 8 volunteers and staff members of the Palestinian Red Crescent Society and 9 staff members of international NGOs. Of that total, two have been killed since 1 January 2016.

III. Observations

47. Increased fighting in April has resulted in widespread human suffering and the senseless death of countless innocent civilians. Attacks on markets, hospitals, schools and other civilian infrastructure take an immediate toll on civilians who lose access to food, medicine and education. They also make the future road to recovery more difficult. Such attacks must end. International humanitarian law clearly lays out the responsibility to protect civilians. Basic norms and principles, such as distinction, proportionality and precautions, must be adhered to. Medical personnel, facilities and transport enjoy special protections. There can be no impunity for attacks that contravene those basic legal tenets. The air strike on 19 April on a busy market in Ma'arrat al-Nu'man (Idlib) that reportedly killed 44 civilians, the shelling of households in west Aleppo on 25 April that reportedly killed 12 civilians and wounded another 100, and the air strike on 27 April on Al-Quds hospital in Aleppo city that reportedly killed 22 civilians are just a few examples of appalling violations that need to be thoroughly investigated.

48. The disregard for humanitarian space cannot be allowed to continue. Security incidents delayed humanitarian convoys twice in April. In one instance, on the 27 April convoy to Rastan, a mortar strike damaged a United Nations-contracted truck, injured the driver and killed a nearby civilian. Hospitals have apparently become a target such that, in Dar'a governorate, protests by civilians concerned about the risk to the neighbourhood were reportedly held outside a damaged hospital in Jacem to prevent its reopening. Civilians already displaced by fighting have had to flee again from their camps owing to military advances around I'zaz, and in Idlib a camp was hit on 5 May, which reportedly resulted in the death of at least 30. I reiterate my call for the situation in the Syrian Arab Republic to be referred to the International Criminal Court.

49. In the face of significant challenges, the United Nations and its partners continued to extend the provision of assistance throughout the country in April. The active engagement of the International Syria Support Group Task Force on Humanitarian Access played an important part in providing additional space for the provision of assistance. Some 46 inter-agency convoys, both cross-line and cross-border, were deployed in April; together with individual agency activity, millions of people were reached as a result. Some 204,250 civilians in besieged areas, 41.9 per cent of the total number of civilians in those areas, were reached. While that is positive, overall progress is small and fragile. We remain far short of consistently meeting the needs of the 13.5 million civilians in need in the Syrian Arab Republic, 4.6 million of whom are in besieged, hard-to-reach and priority cross-line areas.

50. Five years of conflict in the Syrian Arab Republic has shown that there will be no military victory for any side. The result of continued conflict can only be more death and destruction for the State and its people. The infrastructure needed to achieve peace and end human suffering now exists in the political negotiations led by my Special Envoy for Syria, Staffan de Mistura. The second round of negotiations ended on 27 April in Geneva, with all sides presenting their platforms. The International Syria Support Group and individual efforts of Member States have shown what can be done to concretely address the suffering of civilians and keep the process for peace on track. There only needs to be sufficient political will. It is thus imperative for all parties to exert every possible effort to move the process forward to end the conflict.

Annex

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Organization	Number of people reached
Food and Agriculture Organization of the United Nations	28 758
International Organization for Migration	19 368
Office of the United Nations High Commissioner for Refugees	279 292
United Nations Children's Fund	1 500 000
United Nations Development Programme	767 080
United Nations Population Fund	212 507
United Nations Relief and Works Agency for Palestine Refugees in the Near East	160 328
World Food Programme	4 100 000
World Health Organization	2 167 962 (treatments)

Date	Location	Number of beneficiaries	Type of assistance
2 April	Tayr Ma'lah, Homs	22 000	Delivery of nutrition, health, education, protection and water, sanitation and hygiene supplies and non-food items
3 and 16 April	Afrin, Aleppo	50 000	Delivery of food rations, nutrition, health, water, sanitation and hygiene, education and protection supplies and non-food items
16 and 19 April	Kafr Batna subdistrict, Rif Dimashq	50 000	Delivery of food, nutrition, health, protection, education, and water, sanitation and hygiene assistance and non-food items
16 April	Tall Rif'at, Aleppo	13 250	Delivery of medical, nutrition, and water, sanitation and hygiene supplies and non-food items
21 and 25 April	Rastan, Homs	122 500	Delivery of food, nutrition, water, sanitation and hygiene, health, education and protection supplies and non-food items
27 April and 2 May	Talbisah, Homs	60 000	Delivery of food, nutrition, health, education and protection supplies and non-food items
30 April	Zabadani, Madaya, Rif Dimashq; and Fu'ah and Kafraya, Idlib	60 000	Delivery of food, health, nutrition, water, sanitation and hygiene, education, shelter and agriculture supplies and non-food items

Sector (United Nations delivery only)	Number of people reached (as a percentage of 4. 6 million)
Food security	625 500 (13.7)
Health	675 923 (14.8)
Non-food items	168 840 (3.7)
Water, sanitation and hygiene	165 869 (3.6)

19May16

Report of the Secretary-General: Implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014) and 2258 (2015) (Apr.16)

I. Introduction

II. Major developments

III. Observations