Attacks on aid workers reached a new peak last year, with 155 relief staff killed, and danger levels remain high this year.
Afghanistan topped the list of countries where aid workers faced greater risk, with 81 killed in 2013, according to research from the consultancy group Humanitarian Outcomes released on Tuesday.
Worldwide, a total of 155 aid workers were killed, 171 were seriously wounded and 134 were kidnapped in 2013 - with three-quarters of the violence taking place in five countries: Afghanistan, Syria, South Sudan, Pakistan and Sudan.
Overall, this represents a 66 per cent increase in the number of victims from 2012.
The escalating conflicts in Syria and in South Sudan were cited as deadly settings for aid workers, driving up the killings.
Roaming militias killed six aid workers this month in South Sudan, three of them in an ambush, and 11 UN staff were killed in attacks on UN-run shelters in the Gaza Strip.
Three local staff working for the Czech humanitarian aid group People in Need, were killed in a mortar attack in January in the northern Syrian city of Aleppo.
Preliminary figures for this year suggest that danger levels remain high, with 79 aid workers killed from January to mid-August. That is already more relief staff killed than in all of 2012.
The UN Security Council is due to discuss the rise in attacks on aid workers during a meeting on Tuesday for World Humanitarian Day, marking the 2003 attack on the UN compound in Baghdad that killed 22 UN staff.
Non-governmental organisations are facing mounting pressure to deploy staff in war zones to come to the aid of civilians swept up in fighting and often trapped in battlefields.
Over half of all violent incidents in 2013 were either ambushes or roadside attacks, according to Humanitarian Outcomes.
"The advances in security management for aid operations have failed effectively to address this most prevalent form of targeting, and there is a dearth of innovation around how to secure aid workers in transit," said the group's report.
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