After months of refusing to accept offers of humanitarian aid, Venezuelan President Nicolas Maduro announced what some interpreted as an important pivot. In a television broadcast on March 24, Maduro said that he had asked the United Nations to help “regularize the whole medicine issue.” The president added that he trusted the United Nations Development Program (UNDP) to help “recover the productive capacity” of the pharmaceutical industry in Venezuela.

The announcement made no mention of food aid, and fell far short of a full-throated appeal for assistance from international humanitarian agencies. Nonetheless, admitting that the country’s economic crisis requires outside assistance is a shift for Maduro. In September, when a UN Human Rights Council resolution calling for the development of food security protection programs in the country fell short of the necessary votes, the president called its failure “a great victory.”

As the AP reported, “[J]ust acknowledging that Venezuela needs outside help is a telling sign of how far the nation sitting atop the world’s largest petroleum reserves has fallen under Maduro.”

A Shift in Rhetoric Months in the Making

But while Maduro’s shift in tone is noteworthy, the reality is that Venezuela has been seeking to gain access to more affordable medication for several months. In December, Foreign Minister Delcy Rodriguez announced that the government was expanding coordination with UN bodies like the Pan-American Health Organization (PAHO), in order to address shortages of medication. In her remarks Rodriguez mentioned the PAHO Strategic Fund, a regional mechanism that negotiates with suppliers to provide more affordable medicine to participating member states (which include Venezuela).

In the wake of Rodriguez’s announcement, sectors of the Venezuelan opposition that had participated in the dialogue process began to assert that this was a result of the five-point agreement reached on November 12, which included calls for the government to address food and medicine shortages. Sucre Mayor Carlos Ocariz, the Justice First (PJ) party representative in the dialogue, claimed that the government had made an agreement with the United Nations to facilitate international aid into the country through Caritas Venezuela.

However, Caritas Venezuela’s director Janeth Márquez quickly contested this claim, scaling back expectations. In a public statement, Márquez clarified that no agreement had been reached between the Venezuelan government and the UN to open up a channel for humanitarian aid, and said even if one had been established, her organization lacked the capacity to distribute it. As a Church-affiliated organization, and not a UN agency, it is also unclear whether Caritas would even have the mandate to do so. Márquez did say that Venezuelan authorities had cleared the Vatican to provide some aid to Venezuela via Caritas, but that the government saw this as a kind of loan, not as “aid,” per se. “[This] means that if we bring it in, in the future they will give back what we bring in,” said Márquez.

Amid Opportunities, Deep Obstacles

With interest growing in multilateral, regional solutions to Venezuela’s crisis, addressing the economic crisis is bound to be part of the conversation. While the Caritas agreement and Venezuela’s efforts to procure more medication through the PAHO Strategic Fund are extremely limited, there is some promise in the fact that Venezuelan authorities pursued them in the first place. As multilateral efforts move forward, these initiatives should be taken as a starting point to coax Venezuela into accepting aid in the future.

Of course, doing so will not be easy. Venezuela’s government prefers to see the country as a regional actor capable of providing aid to other nations, not one with deep needs of its own. Maduro’s overture to the UNDP came on the same day that the Venezuelan government received criticism for sending aid to victims of Peru’s recent flooding.

Venezuela is not alone in refusing to accept international aid in the face of a crisis, either out of national pride or a refusal to admit an inability to meet citizens’ basic needs. Both Thailand and India refused aid offers following the 2004 tsunami, Chile allowed only limited assistance after its 2010 earthquake, and the United States declined most offers of help from the United Nations and allies after Hurricane Katrina.

Even setting aside the fact that much of the current crisis can be chalked up to the government’s own economic mismanagement, Venezuela stands out from these cases. Each of these countries claimed—with varying degrees of validity—that they were adequately addressing their crises without assistance. In Venezuela, this argument is clearly falling short.

The Case for Humanitarian Aid

The government claims that it is responding to food shortages through its Local Committees for Supply and Production (Comités Locales de Abastecimiento, CLAP) system, which provides packages of food at a subsidized rate on a semi-regular basis to participants in the program. However, as the human rights group PROVEA has documented, the CLAP system operates with little oversight, and is sometimes politicized. The committees themselves are controlled by Chavista affiliated networks and neighborhood organizations, and PROVEA found reports of Venezuelans being denied CLAP bags or receiving less food because of their opposition to the government. Even where the system does work, the bags are too infrequent to come anywhere close to meeting demand.

Meanwhile, the situation is dire. Available statistics on the toll that the economic crisis is taking on everyday Venezuelans are alarming. Shortages of essential medications like antibiotics have contributed to multiple alarming stories of deaths by normally treatable diseases, and even official reports reflect a startling increase in indicators like the infant mortality rate. According to a 2016 report from the Ministry of Health, the percentage of neonatal deaths (deaths of babies under one month old) stands at 2.01%, some 100 times higher than it was in 2012 (0.02%).

The shortage of food is also having a worrisome impact. According to the latest National Survey of Living Conditions (ENCOVI), published in February and carried out by a group of major universities and research institutions, the combination of record-breaking inflation and shortages of economic goods have caused the number of Venezuelans who report eating two meals or less per day to nearly triple—going from 11.3 percent in 2015 to 32.5 percent in 2016. Meanwhile, the survey also found that nearly three-quarters of Venezuelans report losing weight unintentionally, with an average loss of 19 pounds.

The outlook for this year is not promising. Analysts predict the inflation rate in 2017 will be anywhere from between 740 percent to 2,200 percent in 2017. Humanitarian need is certain to grow.