On our last article of “Unsustainability of world humanitarian aid system”, we have addressed humanitarian crises in financial matters and new challenges on emergencies. On this opportunity I would like to tackle other hidden crisis: institutional and on war international regulation (IHL), particularly because of new forms of conflicts . This situation make organizations like ICRC in need of making in-depth changes and urgently enter in an adaptation process. The solutions for both crises get to the same point: an important change on institutional culture, principles and approach.
In this paper we´re going to focus on institutional aspects under the idea that if a humanitarian organization is not able to deliver aid, in addition, significant percentages of loss of life of aid workers, means that is going through an in-depth institutional crisis.
Violence against ICRC health staff represents more than a threat, but an emergency that is transforming current aid in ineffective. For instance, in Syria 40 aid workers have been killed since the beginning of the conflict 
“The report is based on information collected in 2012 and 2013 on 1,809 incidents in 23 countries in which violence was used against patients, health-care personnel, ambulances or medical facilities..”.“…too frequently, health facilities are still being targeted, and patients are being mishandled or even killed.” “Attacks on or within health-care facilities represent 40 per cent of all confirmed incidents…“,”...The indirect consequences of threats against health personnel, which can leave entire communities without any available care, can be at least as serious as any direct use of violence.” 
All violent acts against humanitarian targets ought to be investigated and punished by IHL. Nowadays there is not enough pressure from international organizations to establish a real commitment for not attacking civil population or health care staff. Is in this point where we identify an institutional crisis from humanitarian sector that threat their political legitimacy. To face this crisis the intervention and commitment from international organizations become essential. Just to be adjunct organizations from national governments -as the current role that national societies are holding- is not enough to assure safety to health staff and infrastructure. Mainstreaming political influence in the whole State apparatus and parts in the conflict is the way that humanitarian aid would be delivered effectively.
The world reputation achieved by ICRC based on it´s principle of neutrality and as one of the greatest and successful Mediator on history place them in a very strong position able to be a key part on the political conflict process, so needed in current globalize and tumultuous times. Only by gaining trust and respect from both parts in a conflict is that aid could be effectively delivered with a minimum of lost lives from health staff. Creating common interests and a strong link with the aid organization is that both sides in a conflict could build a relationship based on respect therefore, on legitimation. Middle East conflicts are a clear example that ICRC is not giving the correct message and is being associated with official establishment, loosing legitimation and put on risk the entire infrastructure. Is it here that more involvement and acknowledgment of some legitimacy in the fight of both parts in the conflict, is what would allow to set positions and recover the lost supremacy that aid organizations and particularly ICRC used to hold.