The UN Security Council on Thursday approved a one-year extension of humanitarian aid deliveries across war-scarred Syria, expressing "outrage" at the continuing violence in the country and "grave distress" at the devastating humanitarian situation.
The resolution, sponsored by Kuwait and Sweden, was adopted by a vote of 13-0, with Syria's main council ally Russia abstaining along with China.
UN humanitarian chief Mark Lowcock thanked the council for approving the resolution, saying that "cross-border aid provides a critical lifeline for millions of Syrians who cannot be supported through other means."
"You have done your part; we will now do ours to sustain aid in a way that is as effective and accountable as possible," he said.
Lowcock said the situation is especially "very challenging" in northwestern Syria, where some 3 million people remain dependent on cross-border aid.
More than 4.3 million people need aid in areas not controlled by the government, according to the United Nations.
That figure includes more than three million people who can only be reached via cross-border operations.
While a pause in airstrikes has been positive, he said, shelling and fighting continues in and around the demilitarized zone and recent hostilities forced nearly 15,000 people to flee their homes to neighboring villages.
Lowcock also warned that Idlib, the last major rebel stronghold in Syria, "remains on the edge of a humanitarian disaster."
He said a further escalation of violence "would quickly overwhelm the ability of humanitarian agencies to respond." He urged the warring parties to end the violence and head of the "humanitarian catastrophe" that Secretary-General Antonio Guterres has warned about.
Russia's ambassador, Vassily Nebenzia, said Moscow abstained because "the new realities in Syria" require that the program for cross-border deliveries be fine-tuned "with the ultimate goal here being to gradually but inevitably wrap it up," but this was not included in the resolution.
"We decided not to block the decision because of humanitarian considerations and also taking into account appeals from our partners in the region," Nebenzia said.
The authorization allows humanitarian organizations to cross borders after simply notifying the government. The council again warned that "it will take further measures" - UN language for sanctions - against those violating the resolution.
The US believes there is no credible alternative to such deliveries, and has accused the regime of distributing aid unequally at the expense of communities considered less loyal to Damascus during the eight-year conflict.
The first resolution on cross-border aid was adopted unanimously in 2014.
Aid operations in Syria, the UN's largest relief effort, have continued despite little progress by UN diplomats to end the war.
Syria's war has so far killed more than 360,000 people and displaced millions.