The first World Humanitarian Summit opened Monday in Istanbul, as part of widespread recognition among the United Nations and key donors that the humanitarian aid delivery system is not working well, but the event is facing heavy criticism.

The UN and major donor countries are planning to announce measures meant to tighten up the finances, to ensure more efficient spending of aid money.

Some aid groups have been critical of the event, saying governments themselves are often responsible for blocking aid and attacking schools and hospitals. 

"Today we do not yet have a functioning humanitarian aid system," German Chancellor Angela Merkel said. 

UN agencies and their partners need roughly 20 billion dollars this year but only a fraction has been received.

"Very often pledges are made but the money does not reach where it is most needed," Merkel said. Earlier, the European Union admitted that "donors cannot fully cover the growing humanitarian needs generated by today's emergencies."

Doctors Without Border (MSF) pulled out of the summit, saying it would be a "fig leaf" and fail to address the most acute humanitarian crises, which it warns cannot be fixed through aid alone.

The aid group wants states to do more to end conflicts, protect civilians, deliver assistance and respect international law. Last year, 75 hospitals managed by or supported by MSF were bombed, often by governments who employ airstrikes and heavy weapons.

"In Syria and elsewhere, hospital and medical centres are being bombed, people are losing their lives," said Merkel, the highest ranking official from major donor countries to attend the summit.

Russia and the United States are among key players - both in terms of donations and influence - which have not sent high-level officials. Russia is angry charities have any say at all in the summit, arguing the UN's member states are being sidelined.

The event organized by UN Secretary General Ban Ki-moon, recognizes that 125 million people need aid around the world, a "record number."

Of those, some 60 million people are displaced, a growing number, which points to how conflicts remain unresolved. Turkey, the host country, has more than 2 million Syrian refugees, with no sign of the civil war ending, letting them go home.

Despite often being touted as an example of generosity towards refugees, the country is lately coming under fire from human rights groups, who contradict government claims that it has an open border policy.

The UN should "press Turkey to reopen its border to civilians fleeing the horrors in Syria," Human Rights Watch said, charging there is a "deafening silence on Turkey's abuse of Syrian asylum seekers."

Security is already tight in Istanbul, which has been hit by terrorist attacks this year.

The hope is the summit, and the process leading up to the event, will help ensure better delivery of aid to those in need, and fix problems like the lack of schools for tens of millions of children in conflict zones.

The humanitarian publication IRIN warned summit attendees to be on the lookout for "woolly language" that avoids making concrete promises with strict timeframes, noting that important reforms can simply be kicked down the road.

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