Physicians for Human Rights says in the report that the Syrian government consistently exploited a new UN aid delivery system, depriving millions of Syrians unable to leave their towns and cities of critically needed food and medicine. The group called that a war crime.
The New York-based advocacy group said a new two-step approval process for aid convoys that Syrian and UN officials agreed to in April 2016 "fell abysmally short" of its aim of ensuring access to all Syrians in need because the government in Damascus retained "unilateral authority" over who received assistance.
"Still others bleed to death from war-related injuries or die in childbirth, or from other preventable causes because their besiegers refuse to allow the sick and injured to be evacuated to medical care," the rights group said.
The report called on the United Nations to carry out deliveries to the most difficult areas without prior government approval, and to document and quickly report attempts to restrict or block convoys.
PHP cited data from the UN Office for the Coordination of Humanitarian Affairs saying that by early December 2016, 4.9 million Syrians lived in besieged and hard-to-reach areas, "including about 975,000 under active siege, most of them, about 850,000, by Syrian government forces.
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