LONDON, England — From Sudan to Gaza, civilians are desperate, hospitals are under attack, and the humanitarian aid system cannot keep up, according to a new report in the Lancet medical journal. 

“The humanitarian system is no longer fit for purpose, given the types of emergencies that we have and their magnitude,” report co-author Dr. Paul Spiegel told Fox News. 

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A professor at Johns Hopkins University and co-chair of its Center for Humanitarian Health, Spiegel has decades of experience working in refugee camps and war zones around the world. “I’ve been doing this for well over 30 years,” he said. “We’re in a very dark time.”

Highlighting one of the world’s largest disasters, Sudan’s brutal civil war — where tens of millions of people are in need as hospitals close and famine spreads — the panel of experts behind the report says the world knows how to save lives, but that the system is failing to deliver. The experts’ report, titled ‘Health in a World of Crises and Impunity,’ argues that some agencies are too bureaucratic, and others too slow. The whole system, they say, needs revamping.

The report argues the United Nations is in need of reform, while in the U.S. it highlights the Trump Administration’s shuttering of the United States Agency for International Development (USAID) over suspected fraud and abuse. 

During that restructuring, many of USAID’s most vital programs were folded into the State Department, but the report calls USAID’s closure a “shock” and “sudden,” and part of a chain of decisions in the U.S. and elsewhere which it condemns as “a political and moral failure.”

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“USAID needed to be restructured,” Spiegel told Fox News. “The U.N. needs to be restructured in a very significant way. But it’s how you do that.

“It is the strategy to make sure that you do it in such a way that vulnerable populations across the globe are not going to be hurt, and that it wasn’t done like that.”

The authors are pushing for major global reforms, including overhauling funding, sending aid directly to local communities, greater accountability if governments or armed groups block aid, and upholding healthcare as a basic human right.

“It’s really a complete rebalancing,” Spiegel said, “to make sure that the system actually works for the people it’s intended to help.”