TEL AVIV, Israel (AP) — Aid groups are warning that the war in the Middle East has upended their ability to get food and medicine to millions of people around the world in need, and that the suffering will deepen if the violence continues.
Not only has the conflict cut off vital shipping routes, creating a global energy crisis, it’s also disrupting supply chains for aid groups, forcing them to use costlier, more time-consuming routes.
Key pathways such as the Strait of Hormuz have been effectively shuttered and routes from strategic hubs such as Dubai, Doha and Abu Dhabi have also been impacted. Transport costs have spiked with higher fuel and insurance rates, meaning less supplies can be delivered with the same amount of money.
The World Food Program says it has tens of thousands of metric tons of food heavily delayed in transit. The International Rescue Committee has $130,000 worth of pharmaceuticals intended for war-torn Sudan stranded in Dubai and nearly 670 boxes of therapeutic food meant for severely malnourished children in Somalia stuck in India. The U.N. Population Fund says it's delayed sending equipment to 16 countries.
Steep U.S. cuts to foreign aid already had hobbled many aid groups, who say the war is exacerbating the problem.
The United Nations says this is the most significant supply chain disruption since COVID, with up to a 20% cost increase on shipments and delays as goods are rerouted. And the war is creating new emergencies, such as in Iran, and also in Lebanon where at least one million people have been displaced.
“The war on Iran and disruption to the Strait of Hormuz risk pushing humanitarian operations beyond their limits," said Madiha Raza, associate director for public affairs and communications for Africa for the International Rescue Committee.
Even when the fighting stops, the shock to global supply chains could continue to delay lifesaving aid for months, she said.
The war has forced organizations to find new ways to transport goods, with some bypassing the Strait of Hormuz and the Suez Canal and rerouting vessels around Africa, adding weeks to the delivery.
Others are using a hybrid of methods, including land, sea and air, increasing costs.
Jean-Cedric Meeus, chief of global transport and logistics for UNICEF, said his agency is using a mix of land and air routes to send vaccines to Nigeria and Iran in order to get them there in time for the vaccination campaigns, but the costs have soared.
Before the war, UNICEF sent vaccines to Iran by plane directly from vendors around the world. Now it’s flying the vaccines to Turkey and driving them into Iran, which has increased costs by 20% and has added 10 days to the delivery time, he said.
Save the Children International, which would normally send supplies by ocean freight from Dubai to Port Sudan, will now have to truck the goods from Dubai through Saudi Arabia and then by barge across the Red Sea, it said. The route adds 10 days and increases costs by about 25%, at a time when over 19 million Sudanese face acute food insecurity. The delay puts more than 90 primary health care facilities across Sudan at risk of running out of essential medicines, it said.
The spike in prices also means organizations have to choose what to prioritize.
“In the end, you sacrifice either the number of children that you serve ... or you sacrifice the number of items that you can afford to buy,” said Janti Soeripto, president of Save the Children for the United States. The group said it has stockpiles in countries where it works but some of those could run out within weeks.
Rising costs are also impacting people's ability to seek help within their countries.
Doctors Without Borders said rising fuel prices across Somalia — where some 6.5 million people are experiencing acute food insecurity — have driven up transport and food costs, making it harder for people to get care. In Nigeria, the IRC says fuel prices have surged by 50% and clinics are struggling to power equipment, such as generators and mobile health teams have scaled back operations.
One of the biggest concerns is the impact the war will have on global hunger.
WFP warns that if the conflict continues through June, 45 million more people will be acutely hungry, adding to nearly 320 million people facing hunger around the world.
Some 30% of the world's fertilizer comes through the Strait of Hormuz and with planting season ahead in areas like East Africa and South Asia, small farmers in poor countries will be hard hit. Sudan imports more than half its fertilizer from the Gulf and Kenya approximately 40% from there, aid groups say.
The U.N. secretary-general has established a task force to facilitate fertilizer trade — modeled on the Black Sea Grain Initiative. But aid groups say that won't be enough. If there's no ceasefire, governments need to provide more funding for organizations to respond to the rising costs, they say.
Humanitarian experts say there's been a slower international response to fund aid during this war compared to previous conflicts like Ukraine, which could reflect growing pressure to invest in security over aid at a time when the world is in turmoil.
“They’re making hard choices between defense security and humanitarian aid,” said Sam Vigersky, an international affairs fellow at the Council on Foreign Relations who has written about the war’s impact on aid.
He said when the U.S. goes to war, it normally has provisions for aid, but hasn't been “activating” those provisions. “It’s not a capacity issue, it’s a policy decision,” he said.
Tommy Pigott, principal deputy spokesperson for the U.S. State Department, said that the U.S. has been the “most generous country in the world" when it comes to humanitarian aid.
The department said it's releasing an additional $50 million in emergency assistance to Lebanon, including to the World Food Program and working closely with the United Nations and others to address the humanitarian needs.
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Associated Press writer Edith M. Lederer contributed from the United Nations
FILE - A woman stands beside her food ration after distribution of aid, in Nalemkais Village, Turkana County, Kenya, Feb. 8, 2026. (AP Photo/Patrick Ngugi, File)
TEHRAN, Iran (AP) — U.S. President Donald Trump on Sunday made expletive-laden new threats to escalate strikes on Iran and its infrastructure if it doesn't open the Strait of Hormuz by his deadline, after American forces rescued an aviator whose Iran-downed plane fell behind enemy lines.
A defiant Iran struck infrastructure targets in neighboring Gulf Arab countries, challenged the U.S. account of the rescue and threatened to restrict another heavily used waterway in the region, the Bab el-Mandeb Strait off the Arabian Peninsula.
In a social media post, Trump vowed to hit Iran’s power plants and bridges and said the country would be “living in Hell” if the Strait of Hormuz, crucial for global trade, isn’t opened by Tuesday. He ended with “Praise be to Allah.”
Trump has issued such deadlines before but extended them when mediators have claimed progress toward ending the war, which has killed thousands, shaken global markets and spiked fuel prices in just over five weeks.
“It seems Trump has become a phenomenon that neither Iranians nor Americans are able to fully analyze,” Iranian Culture Minister Sayed Reza Salihi-Amiri told visiting Associated Press journalists in an interview in Tehran, adding that the president “constantly shifts between contradictory positions.”
Both sides have threatened and hit civilian targets like oil fields and desalination plants critical for drinking water. Iran’s U.N. mission on social media called Trump’s threat “clear evidence of intent to commit war crime.”
Iran’s military joint command warned of stepped-up retaliatory attacks on regional oil and civilian infrastructure if the U.S. and Israel attack such targets there, according to state television.
The laws of armed conflict allow attacks on civilian infrastructure only if the military advantage outweighs the civilian harm, legal scholars say. It’s considered a high bar to clear, and causing excessive suffering to civilians can constitute a war crime.
An intense search had followed Friday's crash of the F-15E Strike Eagle, while Iran promised a reward for the “enemy pilot.”
Trump said that the service member was “seriously wounded and really brave” and rescued from “deep inside the mountains" in an operation involving dozens of armed aircraft. He said a second crew member was rescued in “broad daylight” within hours of the crash.
A senior U.S. administration official said that prior to locating the pilot, the CIA spread word inside Iran that U.S. forces had found him and were moving him for exfiltration, confusing Iranian officials. The official spoke on the condition of anonymity to discuss details not yet made public.
The fighter jet was the first known American aircraft to crash in Iranian territory since the U.S. and Israel launched the war with strikes on Iran on Feb. 28.
Iran also shot down another U.S. military plane, demonstrating both the perils of the bombing campaign and the ability of Iran's degraded military to hit back. Neither the status of the A-10 attack aircraft's crew nor where it crashed is known.
On Sunday, Iran’s state television aired a video showing what it claimed were parts of U.S. aircraft shot down by Iranian forces. The broadcaster said that Iran had shot down a transport plane and two helicopters that were part of the rescue operation.
However, a regional intelligence official briefed on the mission told The Associated Press that the U.S. military blew up two transport planes because of a technical malfunction and brought in additional aircraft to complete the rescue. The official spoke on condition of anonymity to discuss the covert mission.
Two Black Hawk helicopters were hit during the rescue but navigated to safe airspace, according to a person familiar with the situation who spoke on condition of anonymity to discuss the sensitive information.
Trump's upcoming deadline centers on growing alarm over Iran's grip on the Strait of Hormuz, critical for shipments of oil and gas from the Persian Gulf to Europe and Asia as well as humanitarian supplies. Some ships have paid Iran for passage.
An Iranian presidential spokesperson, Seyyed Mohammad Mehdi Tabatabaei, said on social media that the strait can reopen only if some transit revenues compensate Iran for war damages.
A top Iranian adviser, Ali Akbar Velayati, warned on social media that Tehran also could disrupt trade on the Bab el-Mandeb, a key waterway to and from the Suez Canal.
Diplomatic efforts continued.
Oman's Foreign Ministry said that deputy foreign ministers and experts from Iran and Oman met to discuss proposals to ensure “smooth transit” through the strait. Oman has often served as a mediator between the U.S. and Iran.
Egypt said that Foreign Minister Badr Abdelatty had spoken with U.S. envoy Steve Witkoff and Iranian Foreign Minister Abbas Araghchi, as well as with Turkish and Pakistani counterparts.
Islamabad has said that it would soon host talks between the U.S. and Iran.
In Kuwait, Iranian drone attacks caused significant damage to power plants and a petrochemical plant. They also put a water desalination station out of service, according to the Ministry of Electricity.
In Bahrain, a drone attack caused a fire at one of the national oil company’s storage facilities and a state-run petrochemical plant, the kingdom’s official news agency said.
In the United Arab Emirates, authorities responded to fires at a petrochemical plant in Ruwais that they said were caused by intercepted debris, halting operations.
The strikes came a day after Israel struck a major petrochemical plant in Iran that Prime Minister Benjamin Netanyahu said generated revenue used to fund the war. The petrochemical industry converts oil and gas into products like plastics and fertilizer.
Meanwhile, more than 1,900 people have been killed in Iran since the war began.
In Gulf Arab states and the occupied West Bank, more than two dozen people have died, while 19 have been reported dead in Israel and 13 U.S. service members have been killed. In Lebanon, more than 1,400 people have been killed and more than 1 million people have been displaced. Ten Israeli soldiers have died there.
Bassem Mroue reported from Tehran, Iran, Sam Metz from Jerusalem and Samy Magdy from Cairo. Jon Gambrell in Dubai, United Arab Emirates; Lisa Mascaro and Seung Min Kim in Washington; Munir Ahmed in Islamabad; and Farnoush Amiri in New York; contributed to this report.
Israeli security forces and rescue teams work amid the rubble of a residential building struck by an Iranian missile in Haifa, Israel, Sunday, April 5, 2026. (AP Photo/Ariel Schalit)
Iran's Minister of Cultural Heritage, Tourism and Handicrafts, Seyed Reza Salehi Amiri, talks during an interview with the Associated Press in Tehran, Iran, Sunday, April 5, 2026. (AP Photo/Francisco Seco)
Yemeni soldiers patrol the strategic Bab el-Mandeb Strait, Yemen, Sunday, April 5, 2026. (AP Photo/Abdulnasser Alseddik)
A cafe attendant sits at the counter as two men sit at a cafe in downtown Tehran, Iran, Sunday, April 5, 2026. (AP Photo/Vahid Salemi)
A woman walks past a poster of the late Iranian Supreme Leader Ayatollah Ali Khamenei in downtown Tehran, Iran, Sunday, April 5, 2026. (AP Photo/Vahid Salemi)
Vehicles and motorcycles move past an anti-U.S. billboard depicting the American aircrafts into the Iranian armed forces fishing net with signs that read in Farsi: "The Strait of Hormuz will remain closed, The entire Persian Gulf is our hunting ground," at the Eqelab-e-Eslami, or Islamic Revolution square in downtown Tehran, Iran, Sunday, April 5, 2026. (AP Photo/Vahid Salemi)
In this image provided by Sepahnews, the Iranian Revolutionary Guard's official website, wreckage is shown at what Iran's state TV claimed was the site of a downed American transport plane and two helicopters involved in a rescue operation, in Isfahan province, Iran, April, 2026. (Sepahnews via AP)
In this image provided by Sepahnews, the Iranian Revolutionary Guard's official website, wreckage is shown at what Iran's state TV claimed was the site of a downed American transport plane and two helicopters involved in a rescue operation, in Isfahan province, Iran, April, 2026. (Sepahnews via AP)
In this image provided by Sepahnews, the Iranian Revolutionary Guard's official website, black smoke rises into the air at what Iran's state TV claimed was the site where an American transport plane and two helicopters involved in a rescue operation were shot down, in Isfahan province, Iran, April, 2026. (Sepahnews via AP)
In this image provided by Sepahnews, the Iranian Revolutionary Guard's official website, wreckage is shown at what Iran's state TV claimed was the site of a downed American transport plane and two helicopters involved in a rescue operation, in Isfahan province, Iran, April, 2026. (Sepahnews via AP)
Members of Lebanon's General Security stand at the Masnaa border crossing in the Bekaa valley, eastern Lebanon, Sunday, April 5, 2026. (AP Photo/Bilal Hussein)
A man, who fled Israeli bombings in southern Lebanon with his family, sleeps in his car used as shelter, along a seaside promenade in downtown Beirut, Lebanon, Sunday, April 5, 2026. (AP Photo/Emilio Morenatti)
Followers of Iraq's Shiite cleric Muqtada al-Sadr chant slogans as they wave national Iraqi flag during a protest against U.S. and Israeli attacks on multiple cities across Iran, in Tahrir Square, Baghdad, Baghdad, Iraq, Saturday, April 4, 2026. (AP Photo/Hadi Mizban)
A bedroom is damaged in a building struck in an Israeli airstrike in the southern port city of Tyre, Lebanon, Saturday, April 4, 2026. (AP Photo/Mohammed Zaatari)
Pedetrians walk by a destroyed building within the Grand Hosseiniyeh, with the mosque visible in the background, which officials at the site say was hit by U.S.-Israeli airstrikes Tuesday, in Zanjan, Iran, Saturday, April 4, 2026. (AP Photo/Francisco Seco)
Police officers and their horses take cover in an underground parking garage as sirens warn of an incoming missile fired from Yemen in Tel Aviv, Israel, Saturday, April 4, 2026. (AP Photo/Maya Levin)
A man looks at a destroyed building within the Grand Hosseiniyeh complex that officials say was hit by U.S.-Israeli airstrikes Tuesday in Zanjan, Iran, Saturday, April 4, 2026. (AP Photo/Francisco Seco)
