War, conflict and persecution have forced about 60 million people worldwide to flee their homes, overwhelming the global humanitarian aid system designed to help them and exposing its shortcomings.

Haphazard organization, inefficient spending and a lack of coordination in delivering aid are among the problems, according to critics who charge that now, more than ever, the structure for helping the world's most vulnerable people needs to be overhauled.

“It's definitely the case that the way in which we respond to humanitarian crises needs to be reformed,” said Jodi Nelson, senior vice president for policy and practice at the International Rescue Committee. “It's not just the humanitarian organizations, it's the development organizations. It's really about reforming the entire humanitarian aid system.”

How to better coordinate, fund and organize humanitarian aid are among the topics the World Humanitarian Summit will explore when it opens Monday in Istanbul. The two-day event, the first United Nations conference of its kind, was expected to bring together global leaders from government, business, aid organizations, affected communities and youth, among other groups.

Jens Laerke, deputy spokesman for the U.N. Office for the Coordination of Humanitarian Affairs, said world leaders were expected to commit to advancing action in key areas. These include reaffirming the political and financial pledge to help ensure that 130 million people across 40 countries who are “in need of life-saving assistance and protection” have access to humanitarian aid and protection.

The leaders would also “respond to the widespread call ... for a ‘new way of working' to address today's crises, which are increasingly urban, protracted, and complex,” Laerke said in an email.

The problems of the system are endemic, critics charge, not least among them the delivery of aid.

“They have a massive problem with coordination,” said Elizabeth Cullen Dunn, a geographer at Indiana University at Bloomington who spent 16 months between 2009 and 2013 conducting research in camps for displaced people in the former Soviet republic of Georgia. “There is no one who is in charge. We see a lot of duplication of aid and gaps in delivery.”

Dunn and other advocates for refugees also criticize the length of time that displaced people fleeing conflict and other trauma are generally left to languish in camps. The average is 17 years, Dunn said.

U.N. officials cite a gap in humanitarian funding as exacerbating the challenges to the humanitarian aid system.

“The sheer scale of the global crisis is something we've never seen before,” Brian Hansford, a spokesman for the U.N. High Commissioner for Refugees, said in written comments. “But the whole humanitarian system is faced with a critical dilemma because the funds available are not keeping up with the rapidly expanding needs.”

According to Laerke, U.N.-led appeals to donors that include governments, intergovernmental institutions and the private sector have grown from $3.4 billion in 2003 to nearly $21 billion today. “But the gap between the assessed needs and the resources available to meet them is getting wider and wider,” he said.

Theodore Talbot, a senior policy analyst at the Washington-based Center for Global Development, said the funding crisis could be helped through various measures, such as keeping a reservoir of money to help aid agencies respond to on-going problems.

Another way to alleviate the funding shortfall would be to create an insurance contract so that governments could be insured against disasters and get an immediate payout and would not have to depend on donor money, Talbot said.

Humanitarian aid specialists say it's not just about the amount of cash but how the allotted funds are used.

“There's no doubt that the need is outpacing the resources available,” Nelson said. But “it's not just about needing more aid, it's about needing better aid.”

Advocates for reforming the humanitarian aid system call for giving a larger share of funding to local and national aid providers, along with greater power to make decisions about how that money is spent. Now, about half a dozen large nongovernmental organizations receive as much as 90 percent of all funding from the U.N., according to data from aid experts.

“Local actors are often best-placed to respond,” said Shannon Scribner, humanitarian policy manager for Oxfam America. “They understand the culture. They understand the language. They understand what's going on locally more than people coming in. We need to start trusting them more. We can no longer design a program in another capital, not working with local actors and then use (them) as subcontractors. It doesn't work.”

ann.simmons@tribpub.com