The suffering of 139 million people in acute humanitarian need is avoidable and in many cases deliberately inflicted. This sobering assessment was delivered to the United Nations Security Council by Mark Lowcroft, the Undersecretary General for Humanitarian Affairs.
Aid is blocked or withheld from civilians in the crossfire of conflicts - weaponised in effect - by warring parties.
The proliferation of arms, sold by countries without due regard for how they will be used or where they will end up is compounding the problem, the Red Cross told the Security Council.
The Council’s five permanent members - the US, Russia, China, Britain and France - are in the top six arms dealers in the world. Germany, the other member of the top six arms dealers, also has a seat on the council.
Wars have driven 70 million people to flee from their homes. One conflict alone accounts for a huge percentage of that.
In Syria up to seven million people have been internally displaced by the conflict according to the United Nations High Commissioner for Refugees (UNHCR). Around six million more people have fled the country.
The most recent UN report on the country found evidence of widespread human rights abuses by all parties to the conflict, with kidnapping, murder, torture and the targeting of medical personnel and facilities among the examples cited.
Those seeking to deliver aid are being blocked and slowed down, which in turn drives up the cost of delivery and reduces the value donors get from their donations.
The message to the Security Council was that perpetrators need to be held accountable where humanitarian law is breached and all parties to the conflict have to be aware of the rules of engagement and obligations to civilians.
"Let us not forget that accountability is required by international law," Mr Lowcroft told the audience. States need to hold individuals to account when they commit crimes.
Evidence of combatants being held accountable is not encouraging. A recent report by the UN peacekeeping mission in South Sudan identified a former militia leader, who now occupies the rank of lieutenant general in the South Sudan Defence Forces as a suspect in "the use of rape as a weapon of war against women and girls".
By contrast, a report by the South Sudanese government into allegations of sexual violence in the country’s northern Unity state found they were "unfounded and baseless".
The challenges around preventing aid from being weaponised, ensuring humanitarian workers are protected and holding perpetrators accountable are many. Getting agreement at the Security Council to weigh in behind decisive action is one.
The last session saw a robust exchange break out between Russia and the United States over the White Helmets civil defence group in Syria. Russia accused them of aiding terrorists, with the US expressing concern at the charges. The UK intervened to accuse the Russians of a disinformation campaign against the group and highlighting the record of the Syrian government in the war. This is not the stuff of future co-operation.
Another of the challenges, as the Ivory Coast representative pointed out, is the phenomenon of militias operating across borders. The means to hold militias accountable for their actions is limited. The offensives against such militias can also be problematic as civilians in their hinterland can be targeted by counter-terrorism assaults.
Some Security Council members, like Indonesia, want to see national governments take the lead on holding perpetrators accountable. Others want a multilateral approach through the UN.
While the arguments over process and blame are ventilated among Security Council members, humanitarian workers and the 139 million people who need them must try to take solace from expressions of concern for their situation.