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Basic services and infrastructure in Syria are near collapse and the economy is at a standstill after three years of conflict, with millions dependent on food and medical supplies that are not reaching the most desperate, the aid agency said.
"The scale of the conflict in Syria is unprecedented, and the stark truth is that there is no end in sight," Robert Mardini, head of Near and Middle East operations at the International Committee of the Red Cross (ICRC), told a news briefing.
"Hundreds of civilians are killed or wounded every day."
In the last few months, President Bashar al-Assad's forces have conducted an aerial bombardment in Aleppo, dropping barrel bombs from helicopters on rebel-held districts. Aleppo is Syria's largest city and was once its business hub.
"Our priority is clearly Aleppo. We have a very substantial plan of response for Aleppo that would include medical and surgical aid but also food, non-food items, not only for Aleppo city but Aleppo province," Mardini said, noting that the ICRC was already helping to provide clean water in the city.
"This would cover needs of civilians in government-controlled but also opposition-controlled areas including besieged areas up north in Nubl and Zahra. For this we are still waiting for the green light of Syrian government," he said.
The ICRC is currently providing food, water and other goods to about 900,000 people in Syria each month, but it has not been able to reach any besieged areas since visiting Barzeh in the Rural Damascus district in February after a local ceasefire, Mardini said.
"Indeed as the crisis is deepening, access is becoming a challenge everywhere in Syria. The number of checkpoints is increasing from point A to point B and this is a constant challenge for our teams," he said.
LARGEST OPERATION WORLDWIDE
The independent agency, which now deploys 240 aid workers in Syria, aims to step up operations in the country - already its largest worldwide - to reach 1 million people monthly in the second half of 2014. It aims to deploy an additional 75 staff.
It appealed on Thursday for a further 76 million Swiss francs ($86.6 million) to bring its budget for Syria this year to 139 million Swiss francs and overall budget for Syria and neighbouring countries hosting 2.7 million refugees to 193 million Swiss francs.
The ICRC is seeking access to Moadamiyah and Douma in Rural Damascus, "where we know there are very acute needs", he said.
Mardini said the ICRC was working to win acceptance for its relief work from Islamic groups such as the Nusra Front and al-Qaeda affiliated ISIS (Islamic State of Iraq) in the north.
"It remains a challenge to engage and to have a meaningful dialogue. Because this is what we aim for at ICRC, not only one-off contact, but one on which you can base our presence. And acceptance for the groups you mentioned, this remains a work in progress," he said.
"For other groups, things are going in the right direction," he said, mentioning the Free Syrian Army.