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The United Nations has warned of a "looming humanitarian catastrophe" in four besieged towns in Syria, calling for immediate access to deliver aid to some 60,000 residents.

In a statement late on Monday, the UN humanitarian coordinator for Syria, Ali al-Za'atari, warned of dire conditions in the towns of Zabadani, Madaya, Fua and Kafraya.

Civilians in the besieged areas have been the subject of various ceasefire agreements, which have all been loosely referred to as the “Four Towns Agreement”.

But despite the various attempts at achieving temporary calm and pockets of stability, little help has reached civilians and they remain starving victims of war.

"Sixty thousand innocent people are trapped there in a cycle of daily violence and deprivation, where malnutrition and lack of proper medical care prevail," the statement said.

"The situation is a looming humanitarian catastrophe. The principle of free access to people in need must be implemented now and without repeated requests," it added.

Out of the 60,000 besieged, nearly 40,000 of them have been besieged by the Assad regime in Madaya.

Last year, social media activists took to Twitter to raise awareness for the crimes of the Assad regime within the town. However, the photos and videos released were subject to mockery by pro-Assad and pro-Hizballah tweeters:

The remaining three towns are besieged by the al-Qaeda affiliated Jabhat Fateh Al-Sham (formally known as the al-Nusra Front) and its radical allies. During the start of the revolution, the Assad regime was complicit in radicalising its political opposition by releasing extremists from prison to dilute the revolution’s calls for democracy and to divide his political opposition.

In addition to besiegement, civilians in all four towns are routinely subject to daily violence. They are regular victims of shelling, kidnapping and the refusal of medical care when injured or ill.

“The unfair and totally unjustified besiegement is compounded by the tit-for-tat arrangement between the Four Towns, which makes humanitarian access prone to painstaking negotiations that are not based on humanitarian principles,” said Za’atari.

The Syrian conflict began when the Baath regime, in power since 1963 and led by President Bashar al-Assad, responded with military force to peaceful protests demanding democratic reforms during the Arab Spring wave of uprisings, triggering an armed rebellion fuelled by mass defections from the Syrian army.

According to independent monitors, hundreds of thousands of civilians have been killed in the war, mostly by the regime and its powerful allies, and millions have been displaced both inside and outside of Syria.

The brutal tactics pursued mainly by the regime, which have included the use of chemical weapons, sieges, mass executions and torture against civilians have led to war crimes investigations.

The UN says 4.72 million Syrians are in so-called hard-to-reach areas.