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Sep 27, 3:58 PM EDT

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WASHINGTON (AP) -- The United States on Tuesday provided another $364 million in humanitarian aid to Syrians at a time their nation's civil war appears to be getting worse.

The announcement means the U.S. has now given $5.9 billion in assistance to the Arab country since the conflict started in 2011. The money will help the U.N. and independent charities offer food, shelter, safe drinking water and medical care. Millions in Syria need relief. And almost 5 million have fled as refugees to nearby countries.

"Getting help to people who desperately need it requires access," Anne Richard, the State Department's refugee chief, told reporters.

She criticized Syrian President Bashar Assad's government and its allies, Russia and Iran, for "bombing humanitarian convoys, hospitals and first responders trying desperately to keep people alive."

Syrian government forces have advanced in Aleppo, the country's largest city, since the latest U.S.-Russian engineered cease-fire collapsed last week. The military has vowed to wipe out insurgents and more than 200 people have been killed in the latest offensive.

The U.S. had contributed limited military assistance to some rebel groups fighting Assad, but has focused in recent months on securing a long-term truce.

Last week, the U.S. accused Russia of bombing a humanitarian convoy on its way into Aleppo. Twenty civilians were killed. Russia denied responsibility.

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