On Friday, December 18, the UN Security Council passed resolution 2254 by a 15-0 vote, calling for a cease-fire in Syria and political talks to create a transitional government, followed by national elections. This hopeful step reflects a greater international unity on Syria, even while major divisions persist over Bashar al-Assad’s future and the definition of who is a moderate Sunni opposition. By itself, however, passage of the resolution is not likely to spur near-term action and inspire compassion and engagement from the world community to address the immediate mass suffering of Syrians. Other actions are needed to achieve that end.

Syria’s massive human crisis has up to now inspired a paralysis among the world’s major powers and in bodies such as the UN Security Council. Recently, however, shifting geopolitical realities in Syria and beyond may provide an opening for U.S. leadership to create an international alliance, with U.S.-Russian cooperation at its core, committed to expanding access and coverage of humanitarian operations to reach the acutely vulnerable inside Syria as well as in the borderland areas. Actions of this kind are not dependent on a prior comprehensive political framework nor a comprehensive cease-fire. Any such humanitarian initiative can benefit from the lessons learned from the successful U.S.-Russian collaboration in removing and destroying Syrian’s chemical weapons.

Paralysis in the Face of Colossal Tragedy

Since Syria’s internal war began in March 2011, an estimated 300,000 people have been killed, Syria’s population has dropped from 22 million to under 17 million, and half of the citizens who remain are now internally displaced. At least 4 million, and more likely over 5 million Syrians, have been forced into exile in neighboring Turkey, Lebanon, and Jordan. Many more will certainly come that direction as Syria steadily empties. In turn, more than half of the 1.2 million refugees who have flooded in desperation this year into Europe are Syrians. This desperate spiral shows no sign of abatement. Up to now, the Assad government has been wholly willing to destroy its society to survive, backed by Iran’s Quds Revolutionary Guard, Hizballah fighters imported from Lebanon, and Russia’s political, materiel, and (since September) air campaign, directed overwhelmingly against opposition forces.

Rather than galvanize action, Syria’s startling human crisis has engendered a conspicuous international numbness, rooted in several factors. The Iraq and Afghan wars created deep fatigue. Competing geostrategic priorities stole a lot of attention, most notably the Iran nuclear negotiations and the Ukraine crisis. It has been difficult to argue against the common refrain that there are simply no meaningful, realistic options to reach the imperiled populations inside Syria and reverse Syria’s burgeoning human crisis, so long as the Assad government has been willing to use industrial military violence against its own civilians, its health community, and the providers of emergency relief. Further, Syria’s multiple internal conflicts, involving a shifting array of dangerous armed Islamist movements battling Assad and other opposition forces, have stymied access, as has the absence of any agreed political framework to resolve Syria’s war.

The UN Security Council passed resolution 2177 in 2012, demanding humanitarian cooperation from the Assad government and others, but that measure has proved meaningless in the absence of any shared high-level political will to enforce it. Action to rid Syria of chemical weapons in 2014, following the killing of 1,400 Syrians through the government’s use of sarin, was largely successful but had no “humanitarian bounce” as many observers initially had hoped. In the meantime, the internal security environment has grown ever more dangerous, fragmented, chaotic, and violent. International organizations and nongovernmental organizations (NGOs) no longer enjoy any measure of protection, as the respect for their neutrality and impartiality has decayed. Health care in Syria is in complete disarray—40 percent of ambulances have been destroyed, more than half of hospitals have been destroyed or seriously damaged, more than half of Syria’s 30,000 doctors have exited, and child vaccination rates have plunged. Health care, along with food and clean water, have become tools of coercion and targets for violence. Just in the last few weeks, air strikes have hit grain silos, water treatment facilities, hospitals, and bakeries—affecting hundreds of thousands of people.

The United States, to its credit, has been generous in investing over $4.5 billion in humanitarian emergency assistance by international organizations and nongovernmental organizations to answer Syria’s human crisis—fully half of the international response—but funding alone cannot solve the access and security challenges at the heart of the crisis.

ISIS’s arrival in mid-2014 in Raqqa, Syria, and Mosul and Falluja in Iraq, changed the security landscape profoundly while at the same time suddenly enlarging the human crisis. As it fed off the chaos of Syria’s internal war and deep Sunni discontent in Iraq, and as it instituted its rein of pathological terror, ISIS rapidly displaced an estimated 3 million people, brought under the caliphate’s roof 8–10 million people, and effectively erased the Syrian-Iraqi border. In control of nearly a third of Iraqi and Syrian territory, ISIS controls delivery of essential services in these territories and has broadened access to scientists, funds, and materials to support its own weapons ambitions.

A Shifting Geopolitical Environment

The geostrategic environment has shifted in important ways, possibly creating the opportunity for renewed U.S. leadership on the humanitarian front, even as countering the ISIS security threat and pushing for a negotiated political resolution to Syria’s internal war have come to dominate the headlines. Humanitarian crises sometimes reach a tipping point at which the international community can look away no longer and the status quo is more dangerous than the options to change it. Such a moment may be at hand in Syria, in terms of expanding access to and coverage of humanitarian operations. In Washington, the mounting pressure from many political directions to “do something” is reflected in the unresolved debate “ over whether to deploy American military forces to establish no-fly zones and safe havens in Syria to protect civilians caught in its grinding civil war .” In reality, that debate may be a red herring that distracts us from the far more practical discussion of feasible humanitarian initiatives that would not entail additional U.S. military involvement on the ground.

Geopolitically, we see four big changes that taken together favor taking another look at what is possible on the humanitarian front.

First, the explosion in refugees, and the resulting political, financial, and ethical havoc, have brought the Syrian crisis directly to Europe’s door. With the winter months bearing down, the conflict is escalating, conditions are worsening, and the political and economic pressures of refugee outflows continue to grow for receiving nations. While resettlement is an essential component of the international response, the motor force behind this surge of desperate migrants into Europe lies inside Syria and Iraq. Now that the crisis has arrived directly in Europe’s backyard, the pressure to stem the crisis at its source has risen steeply.

Second, the dramatic expansion of ISIS-inspired terrorist attacks outside of Syria/Iraq—the killings in Paris, Beirut, Sousse (Tunisia), Ankara, over the Sinai, and now San Bernardino—convey a similar message: the security threat ISIS poses has considerable reach and cannot be simply contained. As outlined in the UN Security Council Resolution 2249 passed unanimously on November 20, 2015, this threat must now be confronted through heightened, concerted international action—including in the humanitarian sphere—by the United States, Russia, and others. ISIS is both creating and encouraging this flight of humanity and also seeking to leverage it to export terror and intimidation. Arresting and mitigating humanitarian conditions on the ground are essential elements of any campaign to defeat ISIS.

Third, since September, Russia has expanded its presence on the ground and in the air over Syria, deepening Russian involvement in the crisis and its expansive armed intervention, including attacks in opposition territories and targeting of hospitals and clinics. This shift has only worsened, not lessened , the human crisis. But also, the stakes for Russia have climbed. Russia now bears increasing responsibility for conditions inside Syria that drive this international crisis. Three months of aerial bombing have not materially changed the military situation on the ground in Syria but has resulted in loss of Russian lives and a dangerous clash with Turkey. Increasingly, Russia now faces the specter of a quagmire. That begs the question: might it be possible to persuade President Vladimir Putin to compel the Assad government to take certain actions that dampen the crisis and create the conditions necessary for a negotiated resolution? Could Russia use both its presence and its influence on the ground to expand access to essential humanitarian services?

Fourth, here at home, the Paris and San Bernardino killings have generated fear, political opposition, and in some cases active bigotry, an ugly American face to the outside world. Political opposition and even hostility toward Syrian refugees have escalated: governors of more than 23 U.S. states have stated their opposition to the resettlement of any Syrian refugees in their states. These developments raise the issue of whether there are active measures the White House might take to reinforce America’s image as a compassionate and generous nation and achieve concrete humanitarian results, short of committing U.S. ground forces and airpower to enforce safe havens and no-fly zones inside Syria. If a moment for action may be approaching, how might U.S. leadership be best channeled?

A Possible Way Forward?

We see two broad, and not mutually exclusive, options.

The United States has the immediate opportunity to significantly enlarge U.S. humanitarian investments in Syria’s borderlands with Turkey, Lebanon, and Jordan, by expanding existing operations that are under way by UN agencies, other international organizations, and nongovernmental groups. In addition, support and assistance must be directed to both the refugee and the host communities to reduce resentments, build more sustainable and enduring capacities, and encourage better host-nation cooperation with cross-border assistance—to include facilitating inspection and accelerating bureaucratic processes and paperwork. Too little has been done to support those countries sharing the front lines of this conflict, and existing assistance efforts suffer from a lack of coordination and deconfliction. Expanding assistance and improving the coordination process to better synchronize assistance through multiple international and nongovernmental organizations are steps that can and should be taken right away. These efforts should be matched by intensified diplomacy to leverage higher commitments from other wealthy donors.

Potentially as part of this effort, the United States and European partners can leverage the Global Health Security Agenda (GHSA) to direct resources and attention to the refugee crisis and promote investment in the borderland states to better protect refugee populations and create stronger capacities there to prevent, detect, and respond to infectious outbreaks. That mobilization under a GHSA flag can feature in discussions at the G7 Summit in Japan in May 2016 and at the GHSA summit in the Netherlands in the fall of 2016.

The United States also has the option to press the Russians and others to join with the United States to expand access and coverage in specific zones inside Syria: particularly those under government control; under the Syrian Free Army; and under Syrian Kurds. It might be possible to move ahead incrementally without the precondition that Vienna talks first achieve a political framework—and without committing U.S. military assets. A humanitarian initiative would likely require the ad hoc creation of an international relief commission of some sort, blessed by the UN Security Council. It would call for actively exploiting any openings created by local cease-fires, as seen in Homs. It would require compelling the Assad government to accept cross-border relief operations and to cease attacks on humanitarian operations. It might feature an expeditionary team of monitors and inspectors, comprising Russians, Americans, and others, that reports to the commission and focuses on cross-border and other delivery channels. Similarly, it would require the Russians cease attacks on moderate Sunni opposition, as well as commitments to humanitarian principles by the Syrian Free Army and the Syrian Kurds. And it would require very close interaction with the likes of the International Committee of the Red Cross, Doctors Without Borders, UN agencies, international NGOs, and the Syrian Red Crescent to address their security concerns and win their agreement to expand on-the-ground relief operations.

If successful, an international humanitarian initiative might provide an important parallel track that brings relief to populations in these three zones, opens roadways and air access for the flow of commodities and relief personnel, improves civilian security, and staunches the human outflow. It might strengthen incentives for a negotiated settlement, while demonstrating U.S.-Russian common resolve.

Learning from Success

There can be no cookie cutter solutions to a crisis this expansive and complex, but neither can “it’s impossible” be the excuse to do nothing. Any international humanitarian initiative in Syria, with U.S.-Russian cooperation at its core, could also draw lessons from the one relatively successful instance of international cooperation in this bloody conflict: the elimination of Syria’s chemical weapons program following the tragic Sarin attacks in East Ghouta in August of 2014.

Under threat of U.S. missile strikes against the Assad government, the United States and Russia negotiated a bilateral framework agreement for the elimination of the vast majority of one of the largest known, active chemical weapons programs in the world—a program including more than 23 sites spread across an active war zone during a catastrophic humanitarian disaster. This included the removal and safe destruction of more than 1,200 metric tons of dangerous chemicals and precursors in bulk form. With the full support of the UN Security Council and the Organization for the Prohibition of Chemical Weapons, partner states banded together in a sizeable coalition committed to implementation of the plan.

The successful removal and destruction of chemical weapons proves that with sufficient coercive pressure and robust international cooperation, resources, and expertise, coordinated international action to achieve a specific, near-term objective in Syria is indeed feasible. Yes, the situation has only grown more complex over the last year. Yes, in the chemical weapons instance Assad was the single culprit and the threat of violent retaliation against continued violations was credible; whereas, in the humanitarian sphere there are numerous bad actors, and it is far from clear how to enforce compliance and punish violators. Nonetheless, a few key lessons from that experience can inform any humanitarian initiative to mitigate suffering on the ground and reassure suffering populations and overburdened neighboring countries that the United States and the world have not forgotten them.

(1) Elevate stabilizing the humanitarian situation to a top-line priority. If everything is a priority, then nothing is a priority. The United States can most profitably lead by winning Russia and others’ consent to a declaration that improved protection of Syria’s displaced, besieged, and refugee populations is an urgent priority, essential both to any plan to defeat ISIS and any transition process to restore peace and governance in Syria.

(2) Any humanitarian compact with Russia has to be clearly grounded in mutual interests. Military interventions are not realistic or effective options, for either the United States or Russia. Both countries have a powerful stake in quelling rather than exacerbating the burgeoning refugee crisis. As with the chemical weapons removal and destruction effort, a core argument has to be that it is in the mutual self-interest of Russia and the United States to devise a bilateral (or even trilateral with Iran) framework agreement for the rapid expansion of humanitarian aid and protection of civilians and humanitarian workers. A bilateral framework outlining the concepts, goals, and targets between the United States and Russia could provide the essential foundation for a humanitarian initiative. With an agreement in place, Russia could then wield its political influence in Syria and compel cooperation, at the same time that the United States could galvanize the international community and assemble the coalition to execute critical tasks. All parties would need to agree to modify airstrikes and refuse to target humanitarian facilities providing food, health care, and sanitation.

Such an agreement need not undercut the longer-term agreement currently under negotiation. In fact it should be separate and independent, focusing on saving lives and improving conditions in the immediate term. In the medium to longer term, it could be a confidence-building measure that contributes in support of a negotiated political settlement.

(3) Most critical is to define the mission in concrete, realistic terms, with specific targets and timelines and practical approaches. Targets might encompass full approval and support for humanitarian convoy requests; acceptance of joint monitoring and inspection teams; increased access to essential health care and nutrition for besieged populations by a concrete percentage; and expansion of health and education services in bordering refugee facilities by a quantifiable measure. These would not be contingent on no-fly zones or safe havens, although perhaps small joint U.S.-Russia inspection teams could provide assurances that the convoys are strictly humanitarian. Regardless, the operational experts on the ground should be charged with defining and shaping creative implementation strategies, and both the United Nations and contributing nations should support and encourage “out of the box” thinking.

(4) Avoid unrealistic preconditions. Rigid preconditions will only invite delays and “kick the can down the road.” It is most critical to focus on what is truly essential to accomplish the task, not what is desirable or preferable. The focus should not be on requiring a viable comprehensive cease-fire to initiate such an effort, rather it should involve acting swiftly to take full advantage of localized shifts in security conditions to enlarge humanitarian access and coverage.

(5) No business as usual. We cannot expect to meet unprecedented challenges with business-as-usual approaches and a traditional tool kit. Addressing a catastrophe this complex, spread over multiple countries and regions, and in an environment of extreme violence and instability requires technical, operational, political, and bureaucratic innovation, as well as the expertise and participation of multiple UN entities and NGOs. The trick will be to devise a unified, flexible mechanism and coordinating body that can convene multidisciplinary expertise from across the international system and navigate the highly complex operational and political terrain.

(6) Remove excuses with a clear mandate. A large, complex mission will ultimately need the blessing of the Security Council to ensure that Syria has an obligation to comply and that donor nations have an obligation to support. An initiative of this magnitude needs a robust international mandate to provide authority, resources, and we hope, ultimately accountability. The Security Council must call this crisis what it is—a threat to peace and security in the region and beyond—and call for the support of all nations in carrying out measures to address it. This is essential to building a viable coalition, generating in kind and financial contributions, and establishing an expectation that noncompliance could result in additional consequences.

A Way Forward?

It may be possible to graduate out of numbness and take action to expand humanitarian access and coverage to the millions of vulnerable, underserved Syrians. It will rest on U.S. leadership to clearly define and ruthlessly prioritize a humanitarian mission that has specific measures and limited objectives. It will rest on a political framework with Russia to guide the effort and bind both of our nations to the outcome. And it will rely on the establishment, in conjunction with a clear international mandate, of an “on the ground” multilaterally empowered entity to bridge the political and operational minefields and synchronize operational efforts. In combination, these steps might make the “impossible” seem just a little more doable.

It’s worth a try.

Rebecca Herman is a senior adviser with the International Security Program at the Center for Strategic and International Studies (CSIS) in Washington, D.C. J. Stephen Morrison is a senior vice president and director of the CSIS Global Health Policy Center.

Commentary is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues. Its research is nonpartisan and nonproprietary. CSIS does not take specific policy positions. Accordingly, all views, positions, and conclusions expressed in this publication should be understood to be solely those of the author(s).

© 2015 by the Center for Strategic and International Studies. All rights reserved.

Rebecca Hersman