The UN has appealed to the major international players in the Syrian conflict to allow aid through to territories still under attack, according to Reuters.
Humanitarian adviser Jan Egeland yesterday called on Russia, Turkey and Iran to de-escalate the fighting, particularly in the Idlib governorate, which he said was "screaming for a ceasefire."
A UN humanitarian taskforce has been unable to make deliveries to besieged areas across the country for over two months, as Syrian President Bashar Al-Assad's government has withheld security guarantees and facilitation letters to aid convoys.
"It's an all-time low in giving us the facilitation letters," Egeland told reporters after meeting senior diplomats in Geneva.
"When we need their ability to influence the parties the most, in this bleak hour for humanitarian work, humanitarian diplomacy seems to be totally impotent. We're getting nowhere at the moment."
Air strikes hit two crowded markets and a hospital in Idlib this week, killing over 33 people including a pregnant woman and an unborn baby.
"I told the members of the humanitarian task force, we cannot have conventional warfare in what is essentially a refugee camp," Egeland said.
Further north, a Turkish offensive in Afrin district has displaced some 15,000 people, Egeland said, adding: "There are also reports … that local authorities have made it hard for people to flee from the Afrin area."
Outside Damascus, in the opposition-held enclave of Eastern Ghouta, almost 400,000 people are under siege and about 750 need urgent medical evacuations he concluded, stressing the need for an immediate pause in the fighting.
"We have indications from both sides that they want it, but it hasn't happened. And it's both sides that have to help us here. There are air raids, fighting from the government side, but there is a barrage of mortars and grenades going from this area going into civilian neighbourhoods in Damascus."
Eastern Ghouta and the province of Idlib are designated de-escalation zones under the Astana negotiations as agreed upon by Russia, Turkey and Iran in an effort to stem the bloodshed in the seven-year conflict. However the agreement is regularly violated by forces allied to the regime, with Idlib province and the suburb of Eastern Ghouta subject to an intensified assault by regime forces in recent months.
Last month the UN Special Adviser on the Prevention of Genocide and the UN Special Adviser on the Responsibility to Protect expressed concerns about the situation in Idlib and Ghouta, calling on their de-escalation statuses to be respected. Such calls have been ignored.