"If more Syrians are to be saved, we will have to again consider using force to insure the delivery of goods."

The United States and like-minded countries will soon have to make up their minds on how to keep millions of Syrians going.

In the past three years of civil war the world’s humanitarian efforts have concentrated on helping Syria’s neighbors keep their borders open to refugees and providing support for almost three million, and supplying multi-million dollars of assistance to needy peoples inside Syria. That has been a significant achievement. But the problem keeps growing and has become even more difficult to manage.

Washington is currently focused on working out a political settlement at the Geneva conference beginning January 22, in the hope that Russia and perhaps even Iran can somehow be brought around to produce an agreement. However necessary a political settlement is, it is highly unlikely to be achieved at this time whatever our determined efforts with the Russians. That probable failure makes the deepening humanitarian debacle in Syria an even more pressing concern.

The US and its friends working closely with the UN will continue to try hard to stem Syria’s dismal humanitarian situation internally and externally. Aid monies were aggressively pursued at the second international pledging conference on Syria January 15, but the 2.4 billion dollars promised for both Syrian refugees and internal victims, even if paid, is far less than the 6.5 billion dollars the UN insists it needs for this year. Whether or not a peace settlement is achieved we will seek at Geneva ways of better dealing with the terrible internal humanitarian situation.

International aid goes to the needy in Assad controlled areas where the population is greater and apparently lesser amounts to the non-Assad controlled areas where the need is probably greater but more difficult to deliver. Assad forces and some rebel groups often prevent aid deliveries. The US is leaning now on Russia and through others on Iran to find ways of persuading mostly the Assad regime to allow more goods into encircled areas. There is the belief that the Sochi games and efforts to embarrass the Russians may help prod Moscow to persuade Assad to allow more goods into beleaguered areas. Assad has recently offered Moscow to allow goods into some encircled areas including Aleppo but only if there is a ceasefire. The rebels have looked with justifiable suspicion at the government’s behavior on this score.

Even if Geneva produces increased internal deliveries, it is doubtful they will be permanent or proportionate to the need. Continued fighting will again resume in civilian populated areas and we can expect renewed blockades by Assad and some rebel groups. In short we may well be back to the previous situation, except worse for the non-combatants. The conflict will likely drag on with the tide of war seemingly back and forth. Some knowledgeable American officials think Assad will ultimately crack, but they are obviously uncertain when that hoped for development will take place. In the interim millions will continue to flee to supposedly safer areas in Syria, or to the neighbors who are increasingly fed up with the continuing Syrian influx and whose political stability may be approaching its limits. Many more will certainly die.

If this unfortunately turns out to be what the world faces, will the US and its friends continue its current posture of managing as best they can both the refugee outflow, now reaching incredible proportions in weak neighboring countries except for Turkey, and the further decline of many Syrians who won’t or can’t flee to these countries. We have watched it for well over two years and our domestic political considerations make it likely we will end up watching it some more.

Syrians flee often for safety internally or to neighboring countries. Many remaining inside also need sustenance: they will have to come to the goods abroad or the goods have to come to them. Clearly the latter is preferable to avoid further harm to neighbors and better preserve Syria. If more Syrians are to be saved we will have to again consider a difficult course of action the administration has always rejected and is not politically popular, using force to insure the delivery of goods to Syrians in desperate circumstances on a continuing basis. If we want to significantly improve the humanitarian equation in any short term time frame this course will be essential. Such a response also offers perhaps another way to enhance the possibility of a political settlement. Whether it will all be seen that way here is another matter.

Morton Abramowitz, a senior fellow at The Century Foundation, is a former ambassador to Thailand and Turkey.