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Abstract Introduction Aid harmonisation is a key component of donor efforts to make aid more effective by improving coordination and simplifying and sharing information to avoid duplication. This study evaluates the harmonisation of health and humanitarian aid in Syria during acute humanitarian and health crises from 2011 to 2019. Methods Data on humanitarian and health aid for Syria between 2011 and 2019 was collected from the OECD’s Creditor Reporting System (CRS) to assess the harmonisation of aid. The data was linked to four key indicators of the conflict: the number of IDPs; the number of people in need of humanitarian assistance; the number or frequency of internal movements (displacements) by individuals; and the decline in Syria’s population between 2011 and 2019. This was compared to data from highly fragile states and stable low- and middle-income countries. Four focus group discussions and four key informants’ interviews with humanitarian practitioners were also conducted. Results The findings suggest that overall aid harmonisation did not occur and importantly did not correlate with increased humanitarian needs. During the first five years, humanitarian and health pooled funds (which endorse aid harmonisation) in Syria were nearly entirely absent, far less than those in low- and middle-income countries and highly fragile states. However, from 2016 to 2019, a visible surge in humanitarian pooled funds indicated an increase in the harmonisation of donors’ efforts largely influenced by adopting the Whole-of-Syria approach in 2015 as a positive result of the cross-border UN Security Council resolution in 2014. Conclusion Harmonisation of aid within the Syrian crisis was found to have little correlation with the crisis parameters and population needs, instead aligning more with donor policies. Assessing fragmentation solely at the donor level is also insufficient. Aid effectiveness should be assessed with the inclusion of community engagement and aid beneficiary perspectives. Harmonisation mechanisms must be disentangled from international politics to improve aid effectiveness. In Syria, this study calls for finding and supporting alternative humanitarian coordination and funding mechanisms that are not dependent on the persistent limitations of the UN Security Council. Key Messages What is already known on this topic Leading aid agencies must coordinate their policies to manage complex humanitarian and health needs. Yet, the impact of crisis-relevant indicators such as internal displacement trends, and population needs assessments remain underexplored, particularly in the Eastern Mediterranean Region (EMR). What this study adds Harmonisation of aid in the Syrian crisis did not align with crisis indicators or population needs, but rather with donor policies, creating challenges in the transition from conflict to early recovery. In addition, the applicability of the Paris Declaration on Aid Effectiveness is less relevant in conflict-affected areas, given that it supposes the existence of a legitimate government and leading aid agencies should collaborate to achieve development goals. However, in complex conflicts, governments may have limited control over resources and legitimacy is subsequently questionable. How this study might affect research, practice or policy This study highlights the need for continuous UN cross-border coordination mechanisms, finding another model than ‘the consent model’ for cross-border humanitarian aid for northwest Syria to protect local communities from ‘aid weaponisation’, and support the newly established Aid Fund for Northern Syria (AFNS), expand its coverage to include northeast Syria and improve its policy to include more development health aid and localisation agenda.
Alkhalil et al. (Fri,) studied this question.