The presidents of Iran, Russia and Turkey meet Friday in Tehran for a summit set to decide the future of Idlib province amid fears of a humanitarian disaster in Syria's last major rebel bastion.

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Hundreds of civilians fled the northwestern province Thursday as government forces and their allies readied for what could be the last -- and bloodiest -- major battle of Syria's devastating seven-year civil war.

Seized from government forces in 2015, Idlib and adjacent areas form the final major chunk of Syrian territory still under opposition control, which is home to some three million people -- around half of them displaced from other parts of the country, according to the UN.

Neighbouring Turkey, which has long backed Syrian rebels, fears the assault could prompt an influx of desperate Syrians attempting to find safety on its territory.

Jasper Mortimer: Turkey has US support at Tehran summit on Syria

But regime backers Russia and Iran have sworn to wipe out "terrorists" and Syrian President Bashar al-Assad has declared his determination to retake control of the entire country.

Ankara, Moscow and Tehran are also guarantors of the Astana process, a track of negotiations that has eclipsed the UN-led Geneva process and helped Assad re-assert his authority over the country.

Iran's President Hassan Rouhani hosts his Russian and Turkish counterparts Vladimir Putin and Recep Tayyip Erdogan at Friday’s summit.

While Turkey has backed rebels opposed to the Syrian regime, Moscow has been Assad’s most militarily powerful ally since the start of the uprising.

Friday’s meeting in Tehran is a “crunch summit,” said Nick Holdsworth, reporting from Moscow for FRANCE 24.

“Russia has a very sophisticated foreign policy on Syria. They won’t make war if they don’t have to make war, they will if they need to. They don’t want to see a massive humanitarian crisis, they don’t want to see a massive refugee situation,” explained Holdsworth. “They’ve got very complex relations with Turkey, they don't want to see tens, hundreds of thousands of people flooding into Turkey. They want to see stability in Syria. They also want to have a big foreign policy win. They would like to see this war resolved, they would like to see Assad fully in-charge of his country again and they’d like to see that done without massive bloodshed and a massive refugee crisis. So it all hinges on today’s summit in Tehran and what comes out of that.”

Nick Holdsworth: Russia has a very sophisticated policy on Syria

UN Security Council meeting on Syria

The UN Security Council is also meeting Friday, at Washington's request, to discuss the situation in Idlib.

Both the US and Russia say they are fighting jihadist groups in Syria and there was periodic cooperation between the two countries against the same jihadist groups operating in Idlib until mid-2017.

Idlib is dominated by the jihadist group Hayat Tahrir al-Sham, led by the former al Qaeda branch in Syria.

Neighbouring Turkey has limited sway over the jihadists who control an estimated 60 percent of the province but it backs rebel groups there and has 12 military "observation points" across the province.

On Thursday, the new US envoy for Syria said there was “lots of evidence” that the Syrian government was preparing to use chemical weapons in Idlib.

Speaking to reporters in Washington, Jim Jeffrey, who was named Secretary of State Mike Pompeo's special adviser on Syria cautioned that, "any offensive is to us objectionable as a reckless escalation".

While US President Donald Trump had signaled that he wanted US forces out of Syria, in April he agreed to keep troops there a little longer.

Trump will chair a UN Security Council meeting on Iran during an annual gathering of world leaders in New York later this month, which is expected to focus on Tehran’s nuclear programme and its involvement in the Syrian war.

France has invited the US, Jordan, Egypt, Saudi Arabia, Germany and Britain for talks on the sidelines of the UN meeting to discuss Syria.

Healthcare workers in Idlib prepare to cope

Idlib's population has swelled as the regime chalked up a series of victories in other parts of the country, reaching evacuation deals that saw tens of thousands of people bussed to the northwestern province.

Russia has conducted a massive naval build-up in the Mediterranean near Syria as Assad’s regime forces are amassing around the northeastern province for a likely ground assault.

The timing and scope of any attack remain unclear, but healthcare and aid workers are preparing to cope for the worst.

The UN has warned of a "bloodbath" in the province, fearing that an offensive will cause a humanitarian catastrophe unprecedented since the beginning of the Syrian conflict, which has left more than 350,000 people dead since 2011.

French Foreign Minister Jean-Yves Le Drian warned Thursday of the risk of humanitarian disaster in Idlib, describing the province as a "ticking time bomb, both in humanitarian and security terms".

(FRANCE 24 with AFP and REUTERS)

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