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ISTANBUL — In a camp for displaced people in northern Syria on Friday, aid workers handed out cash, one-time payments of $120, to sustain people living on the edge of ruin. Prices of basic goods were soaring, and some families were surviving on bread alone.

Foundering economies in Syria and neighboring Turkey had contributed to the rising prices, and now the war in Ukraine and its accompanying global wheat shortages and spike in oil prices have exacerbated the crisis. Over the last month, hundreds of families have lined up for the payments in $20 bills. Without the cash, “I really think there will be disaster,” Muslem Sayyed Issa, a spokesman for the aid group Syria Relief, said in a text message from Syria’s Idlib province.

He and others said things might be about to get much worse.

Aid agencies are warning of a looming catastrophe in northwest Syria if a U.N. Security Council resolution that allows the passage of relief supplies across the Turkish-Syrian border is not extended for another year, before the mandate expires July 10. The resolution facilitates one of largest humanitarian operations anywhere in the world, aid officials say.

It allows the United Nations to coordinate aid shipments that provide food, medicine and other relief supplies to millions of people in the region, many of them displaced by war. If the corridor were cut off, it would cause “inexcusable suffering,” a group of aid agencies said in a statement released this week, the latest dire warnings from Western diplomats and relief agencies about the consequences of not extending the mandate.

Millions of Syrian civilians at risk if U.S., Russia fail to strike deal on aid deliveries

Russia has in years past threatened to veto the resolution, arguing that aid deliveries from Turkey into rebel-held areas of Syria violate the sovereignty of President Bashar al-Assad’s government, Moscow’s ally. Now, Russia’s invasion of Ukraine and the breakdown of its relations with other Security Council members, including the United States, have cast uncertainty over the future of the aid corridor.

Russian President Vladimir Putin’s government has advocated for aid deliveries from government-held parts of Syria. But people familiar with the relief operations have argued that a number of obstacles, including Syrian government restrictions on aid coming from its territory, mean such deliveries were not sufficient to replace the cross-border aid operation from Turkey.

Russia has not yet said which way it will vote on the resolution, but its deputy ambassador to the United Nations, Dmitry Polyanskiy, said last month that Russia was “absolutely convinced that organization of humanitarian deliveries to all areas of Syria is possible in coordination with Damascus.” He added that aid shipments from government-held areas in Syria “may grow considerably” if the lone border crossing for aid deliveries from Turkey were closed — a prospect that is beyond alarming for relief groups.

Last year, in vastly different circumstances, the Security Council voted unanimously to continue the aid deliveries across the Turkish border. Both the United States and Russia hailed the vote as a success for diplomacy, and the product of a meeting between President Biden and Putin a month earlier in Geneva — the kind of cooperation that is now a distant memory.

“This is a moment when it’s absolutely vital that the people of Syria are not forced to pay the price of geopolitical division from Ukraine and elsewhere, in a way that interferes with vital humanitarian aid that they need now and that they need in increased quantities now,” David Miliband, the president and CEO of the International Rescue Committee, which signed the joint statement, said in a briefing last week.

Roughly 4.5 million people live in northwest Syria, a region controlled by opposition militant groups and riven by war in the years since the 2011 uprising against Assad. Worsening conditions mean 4.1 million of them now require humanitarian assistance, said Mark Cutts, the U.N. deputy regional humanitarian coordinator for the Syria crisis.

“People can’t afford to buy food, can’t afford to buy bread,” he said. Families, he added, were resorting to worrying survival mechanisms, including child labor and adolescent marriages, to cope. Hunger was on the rise, and 1 in 3 people in the region was suffering from undernutrition, he said.

The worsening economic picture is hardly the only challenge. Turkey, which has facilitated the aid deliveries, has at the same time threatened a new military incursion into northern Syria against Kurdish fighters — an operation that aid officials said would exacerbate the humanitarian crisis.

U.N. votes to allow humanitarian aid to keep flowing into Syria across Turkish border

As the need has grown, the U.N. operation has suffered from dwindling access to Syria. When the operation began in 2014, the Security Council authorized aid deliveries through four border crossings into Syria, from Turkey, Iraq and Jordan. Two years ago, three of the crossing points were removed after vetoes by China and Russia, and now the entire operation runs through the Bab al-Hawa border crossing.

Funding shortfalls for humanitarian operations had also decreased the numbers of trucks rolling across the border, Cutts said. In 2020, an average of 1,000 trucks delivering aid crossed the frontier. Over the last two years, the number fell to roughly 800 per month.

“One thinks of this cross-border operation as trucking food and supplies. It’s not just about trucking goods,” Cutts said, adding that the operation facilitated the running of hospitals, provision of clean water to the region’s residents, the assistance of people with disabilities and providing improved shelter to people in camps, among other activities.

In Syria’s war without end, refugee tent camps harden into concrete cities

Issa, the spokesman for Syria Relief, said his main worry was for the vast number of displaced people in northwestern Syria, uprooted by war, some multiple times in recent years. There were 2.8 million displaced people in the region, according to the United Nations, and for them, the recent challenges — the fivefold increase in fuel prices, and surging costs of other goods — were insurmountable.

“Everywhere in Idlib, there are camps,” he said.

In the last year, five aid convoys from government-controlled areas — Russia’s preferred method of delivery — reached northwestern Syria, Martin Griffiths, the U.N. humanitarian relief coordinator, told the Security Council during a briefing last month. “It is no small thing,” he said.

“But we need to face reality,” he added, saying there was “no alternative” to the aid deliveries from Turkey. “The needs of the people of Syria — the Syrian people, who should be our first attention — are rising, with more of them requiring our assistance and our protection.”