The conflict in Syria, triggered by a grassroots uprising in 2011 against the repressive regime of Bashar al-Assad, is usually referred to as a civil war. But this description bears scant relation to what is happening there now. Syria has become an international battleground pitting the great powers, regional neighbours and supranational ethnic and religious forces against each other in a fight for strategic influence, territory and power. After last week’s unveiling of plans for deeper US engagement, this struggle may be about to enter a new, even more dangerous phase. The battle for Syria has produced no clear winners as yet. But there is no doubt who are the losers. Up to half a million Syrians have died, more than 5.4 million are refugees, and 6.1 million are internally displaced. Every day, more death and destruction rains down. In the past week, tens of thousands of civilians in the north-western Idlib province have been uprooted, many of them for a second or third time, by Russian and Syrian airstrikes and shelling. In total, more than 200,000 people have fled. Aid organisations and activists say hospitals and schools have been repeatedly targeted and supply routes blocked.

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Who is to blame for the unending Syrian catastrophe? The short answer is: almost everybody. Some, like Vladimir Putin, are more culpable than others. Since the Russian president intervened in Syria in 2015 to prop up Assad and secure strategic bases on the Mediterranean, he has shown a callous disregard for civilian lives matched only by his host. In his aerial bombing of rebel-held Syrian towns and cities, as in the siege of Aleppo in 2016, and in Russia’s alleged complicity in the regime’s illegal use of chemical weapons, Putin, like Assad, may be responsible for war crimes.

To pin the blame wholly on Russia or even Assad would be facile. Idlib is the last, biggest stronghold of Hayat Tahrir al-Sham (HTS), a 14,000-strong multinational Islamist group closely associated with al-Qaida and its former Syrian incarnation, the al-Nusra Front. The HTS presence in Idlib, and its reported ambition to use Syria as a base for the eventual creation of an Isis-style caliphate, has undoubtedly placed civilians at dire risk. As has been the case since the conflict began, the regime’s “starve and surrender” tactics are justified in the name of rooting out “foreign terrorists”, while supposedly fearless jihadists in Raqqa and now Idlib hide behind children, the elderly and the infirm.

Blame can also be attached to the failure of Assad’s more mainstream political opponents to form a united front. But their splits and differences reflect in turn the shifting rivalries of their neighbourhood sponsors, be they Iran, Turkey, Saudi Arabia or Qatar, all of which have conflicting agendas. Members of the pro-western Free Syrian Army were in Washington last week, pleading for help from the Trump administration. But as Rex Tillerson, the US secretary of state, made plain in a speech in California, repulsing Iran and crushing a resurgent al-Qaida in Syria are Trump priorities. A tidy political settlement and post-Assad elections would be nice, but it is not the White House’s focus.

Turkey, too, has contributed to Syria’s bottomless misery, even as it has borne the brunt of the refugee exodus. After years of meddling, Recep Tayyip Erdoğan, the volatile Turkish president, has reduced his policy to one essential aim: suppressing Syria’s Kurds. For Erdoğan, it seems all Kurds – Turkish, Iraqi, Syrian – are terrorists. Now he is threatening to invade Afrin, close to Idlib, and is accusing Washington, which supports the Syrian Kurdish YPG militia that controls it, of backing a “terror force” on Turkey’s border. Assad’s regime says it will retaliate if the Turks overstep.

The list of people to blame goes on and on. Why has the UN security council proved so weak and ineffective? As David Miliband, the former foreign secretary, said last week, Britain as a permanent council member should be much more engaged. The anti-war movement, perhaps overwhelmed by the complexity of the issue, perhaps lacking a clearly identifiable western target for its protests, is largely silent despite the horrific death toll. What is the EU doing in the face of a possible new surge of would-be migrants? And what about Syria’s supposed peace process? Talks will resume under UN auspices in Vienna this week. But expectations are zero. Meanwhile, Iran’s Revolutionary Guards and Shia mercenaries exploit every opportunity on the ground. And Putin, in cahoots with Tehran and the Turks, continues to promote a rival settlement that would keep Assad in power.

Many in the west blame the Americans, more than anybody, for a lack of leadership over Syria during the Obama years and for supine acquiescence in Putin’s machinations under Trump. That may change in 2018. In his speech, Tillerson pledged open-ended US military commitment, more support for refugees and the internally displaced and new efforts to expand stabilisation initiatives. He called on Russia to help create a de-escalation (or ceasefire) zone in Idlib, akin to that which has worked well in south-western Syria.

Perhaps this is the best that can be hoped for – piece by piece, province by province ad hoc fixes for a fragmented country split asunder by myriad external pressures. Because if the current dynamic does not improve soon, the next phase in this unending tragedy, hinted at by Tillerson, could be more anarchic still. It is the de facto designation of Syria as the no-man’s-land venue for the coming international showdown between the US and Iran – with Israel, the Saudis, Qatar, Hezbollah, Hamas, Putin, Assad, Erdoğan, al-Qaida and the Kurds all shooting randomly from the sidelines.