This piece forms part of a TLS Special Feature, our primer on the complex politics and religions of the Middle East

The War on Terror must be one of the most self-defeating strategies in history. Fifteen years after 9/11, violent extremist Islamism is thriving and there is a greater threat of terror in the West than ever before – and all with a price tag of $1.7 trillion (a conservative estimate: some say $5 trillion). Today We Drop Bombs, Tomorrow We Build Bridges focuses on another victim of the War on Terror, that of humanitarian aid: both its principles and its work in relieving the suffering of the most needy in the world.

At the heart of the story is the concept, importance and abandonment of neutrality: the principle of engaging with each side of a conflict as and when necessary to supply humanitarian aid to those suffering – whatever the geopolitical situation and whatever the tactics and views of those in control. Many claim that neutrality is now impossible to achieve, and some speak of it with derision, dismissing it as “quaint” (the Bush administration), part of a past which only the “nostalgic” (according to the Rand Corporation think tank) cling on to. But Peter Gill shows with shocking clarity that a lack of neutrality on the part of aid organizations is giving rise to “A fateful confusion . . . between Western military boots on the ground and Western aid workers”.

The resulting suspicion towards aid agencies has led to a spiral of violence against them. Having a Red Cross painted on your vehicle used to be a source of protection but “today the Red Cross is more like the cross hairs”, one worker told Gill. And this distrust is understandable (though it has nothing to do with the admirable Red Cross). Gill reports the use of white jeeps by the military in Afghanistan, cynically mimicking the appearance of a humanitarian vehicle, with tiny stripes of khaki painted on to escape accusations that soldiers were using the appearance of aid given as cover; blankets handed out in Afghanistan (by an unknown organization) with a number to call with any information on Osama bin Laden’s whereabouts, a tactic that paid no regard to the safety of the recipients, as well as one that blatantly abandoned any pretence of neutrality. Most egregious of all, Gill describes the cover of a vaccination campaign in Pakistan to collect DNA evidence for the CIA in the same manhunt for Bin Laden, using a doctor who had already carried out vaccination programmes in the name of humanitarian aid (and with international funding to do so). It didn’t work, but that detail didn’t prevent Western humanitarian aid from being tarnished in the region – perhaps irrevocably. Save the Children, despite having nothing to do with the doctor who carried out the operation, was expelled from Pakistan, together with its $100m budget funding food, education and health programmes.

The blurring of boundaries between military and humanitarian operations can be traced back to the allied invasion of Afghanistan in 2001, epitomized in the phrase “integrated missions”, a tactic with an eerie overtone of “embedded journalism”. There is a certain logic in the approach: the military mission is not an end in itself, the argument goes, but to relieve the suffering of the population, and so the delivery of humanitarian aid alongside the “liberation” from tyranny and terror is laudable, winning hearts and minds through the delivery of essentials and development in the form of schooling, micro-loans, expertise and so on. But it is not as if the governments are doing this work themselves. The huge aid budgets seen in Afghanistan and Iraq were – and are – farmed out to outside organizations on a tender system, and those best placed to supply what the governments demand for are those already in the field: humanitarian NGOs. The governments may feel this is an integrated mission, or as Colin Powell revealingly put it, a “force multiplier”, but what is clearly sacrificed is neutrality. All Western aid agencies are under suspicion of being political.

Ironically, the same agencies are under constant suspicion from their own same governments. The War on Terror has brought other pressures, including the burden of proof on agencies that not one bowl of rice or piece of bread has fallen into the hands of jihadis, with laws designed to cut off sources of funding to terrorist groups. Of course, a humanitarian agency working as a cover to deliver money to illegal groups is hardly an unlikely scenario, but the effect of blanket suspicion is that aid organizations are now effectively unable to enter many spaces where terrorists are known to operate – a bowl of rice for a child could be eaten by her elder brother fighting the Americans. Many agencies have been quite literally criminalized under this feature of the War on Terror, and so those living under the horror of, for example, Al-Shabaab are deprived of any outside help as well.

Médecins Sans Frontières and the Red Cross are the two untainted organizations in the book, clinging to neutrality through loss of life (as the book went to press the Red Cross had lost forty workers in Syria alone); loss of income (refusing funding that comes with demands not to work with terrorists); and loss of reputation (reports damning them as outdated). These are the two organizations currently most able to work in some of the most unstable states of all – but for how long will they be able to separate their image from the aid industry as a whole? Even the UN is struggling to resist pressure to drop neutrality; indeed, according to a recent report from the Syria Campaign, it is miserably failing to do so: “The United Nations (UN) in Syria is in serious breach of the humanitarian principles of impartiality, independence and neutrality”, is their grim opening to an equally grim account of how the UN only operates within narrow boundaries set by the Syrian government – a government that is manipulating the delivery of aid as yet another weapon in their arsenal. A popular idea is now to replace the UN’s “neutrality” with the anaemically indefinable “integrity”. The UK’s Department for International Development, apparently one of Tony Blair’s proudest legacies, knows what has been lost: “There was nothing really about poverty reduction”, Gill quotes a former DFID official saying of the post-invasion reconstruction of Afghanistan: “Everything was focused on the ‘stabilisation agenda.’” Seen like this, aid is just another tool in the War on Terror, the relief of suffering merely a happy by-product, and the choice of which populations might be most deserving of help is a ­luxury of the past.