KUWAIT CITY, Kuwait — Secretary of State John Kerry pledged $380 million in new assistance Wednesday to help civilians who are suffering because of the civil war in Syria.
The pledge came as Ban Ki-moon, the UN secretary general who is also chairman of the donors’ conference here, said that $6.5 billion was needed to provide medical care, food, water, and shelter for Syrian refugees and civilians inside the country through 2014.
That is the largest appeal for assistance in UN history. It comes as the number of Syrian refugees has grown and conditions inside the country have dramatically deteriorated.
But as the offers of assistance rolled in, several factors continued to raise concerns.
First, Kerry warned that the new aid would not be sufficient unless President Bashar Assad stopped “using starvation as a weapon of war” and his forces allowed international aid to reach besieged areas, including the Damascus suburb of East Ghouta.
A fear is that the situation in Syria is deteriorating so fast, humanitarian needs seem to outpace the resources.
On Monday, Kerry and his Russian counterpart, Sergey V. Lavrov, said that pressing the Syrian government and the opposition to allow access to besieged areas would be a major objective of a peace conference on Syria that begins Jan. 22 in Switzerland.
“If the regime can allow access to United Nations and international weapon inspectors, surely it can do the same for neutral international humanitarian assistance,” Kerry said.
Kerry said Assad’s foreign minister would visit Moscow soon to consult with the Kremlin on the peace conference. He added that he planned to discuss the issue of humanitarian access again by phone with Lavrov as he flew back Wednesday to Washington.
But Kerry did not identify any punitive measures — economic, diplomatic, or military — that might be taken if the Assad government refused to heed appeals to provide humanitarian access or did so intermittently. Kerry later said the State Department was examining “a whole set of different options” but that they were “not ready for prime time.”
Another concern is that in the past, not all donor nations have followed through on their pledges. Only about 70 percent of the funding sought by the United Nations for Syria in 2013 was actually provided. Amnesty International said earlier this month that the United Arab Emirates, one of the richest Arab countries, “made promises on aid that failed to fully materialize.” Russia, it said, “has only made minimal contributions to the humanitarian effort.”
The $380 million Kerry pledged means that the United States has committed more than $1.7 billion in humanitarian aid since the crisis began, the most of any donor. Kuwait’s emir, Sheikh Sabah al-Ahmed al-Sabah, made the largest pledge at the Wednesday conference: $500 million. Saudi Arabia and Qatar each pledged $60 million.
A final fear is that the situation in Syria is deteriorating so rapidly that the humanitarian needs seem to outpace the resources promised. Some 6.5 million Syrians have been displaced within their own country and more than 2.3 million have fled Syria as refugees.
“Even under the best circumstances, the fighting has set back Syria years, even decades,” Ban said.
In Damascus, a senior Iranian official, Foreign Minister Mohammad Javad Zarif, met Wednesday with Assad to discuss issues including next week’s planned talks, Syrian state media reported, saying that Zarif had offered support “for Syria in its efforts to make the conference a success.”
There is wide disagreement among the sponsors of the talks on whether Iran should attend. While the United Nations and Russia favor the presence of a delegation from Tehran, Kerry has said that Iran should be invited only if it agrees to the establishment of a transitional body in Syria “by mutual consent” that could govern if Assad relinquished power.
Iran is Assad’s regional ally, a crucial player in both Syria and neighboring Lebanon, and a rival of Arab nations led by Saudi Arabia that back rebels seeking Assad’s ouster.
According to the SANA state news agency, Assad warned that Saudi “thinking has become a threat to the entire world and not just the region’s countries.”
“The Syrian people . . . have become aware of this terrorist thinking and that everybody should contribute to confronting and eradicating it,” Assad said. Assad is from an Alawite offshoot of Shi’ite Islam, which dominates in Iran; Saudi Arabia backs the predominantly Sunni insurgency in Syria.