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Remember the date; on 7 July 2016, the final route out of rebel-held Aleppo was cut off by regime-led forces. After five years of siege tactics in the Syria war we now come to the biggest one yet.

The UN says almost 600,000 people are under siege, mainly by government forces, in 18 locations across Syria. They are now joined by up to 400,000 people cut off in Aleppo. The mother of all sieges may have just begun.

As opposed to a sudden bombing or battle, the effects of siege play out over time like a slow motion car crash. Media coverage, already hugely limited in what is the world's most dangerous country for journalists, finds it hard to access and tell the story. In Madaya, it was only when stories of starvation and pictures of emaciated children emerged that people saw the impacts of siege for what they are; slow death, but death nevertheless.

Rebel commanders claim they have supplies for "months" yet the price of a kilo of tomatoes has already gone up five-fold this week alone. Fuel for generators has been cut and the residents of the siege - who have already got used to hospitals and schools underground - will find themselves more and more in the dark. Aid agencies have previously reported health problems for children who are suffering from a lack of sunlight, and this will surely get worse.

If you could eat rubble, the residents of Aleppo would feast like kings. In reality the UN and its partners in east Aleppo have warned that they only have enough food supplies for 145,000 people for one month. What we don't know is if opposition tunnels exist to bring in supplies or if there are new plans for coping and survival mechanisms that we've not yet seen, after all the imposition of the siege was clearly on the horizon over the previous few months.

The psychological impacts of being isolated are accentuated by the reminders of the physical violence that enforces the siege: Snipers from unseen corners and angles of the city, barrel bombs from above and artillery from everywhere.

The UN and its partners in east Aleppo have warned that they only have enough food supplies for 145,000 people for one month

Anas Alabdah, the president of the Syrian Opposition Coalition, said that "it is a shame that the world in the 21st century is watching an 8,000-year-old city destroyed on the heads of its inhabitants and bombed with 200 air raids and dozens of barrel bombs daily without doing anything."

But what can be done?

Aid access has been a perennial issue since the fighting began. The proliferation of sieges and "hard to reach areas" has made a mockery of humanitarian principles and put the UN and its agencies under huge amounts of pressure to do more. Controls on who can go where with what have been a daily feature of life on the ground for aid agencies.

The International Syria Support Group has criticised the regime in Damascus for having "consistently failed to live up to its commitments under International Humanitarian Law to ensure free, unimpeded access for humanitarian agencies".

The frustrations around aid access led to the international community calling on the World Food Programme (WFP) to carry out humanitarian airdrops to those besieged or hard to reach areas. The threat of more direct actions to provide aid has seen the regime relent somewhat and areas that hadn't seen any aid for years received some in June.

One off deliveries quickly run out and there is a need for a genuine commitment to lifting the sieges

Yet one off deliveries quickly run out and there is a need for a genuine commitment to lifting the sieges, whilst confidence building measures such as re-establishing medical evacuations from east Aleppo are urgently needed.

The siege of Aleppo is also symbolic of the failure of the latest peace initiatives. A western diplomat in The Financial Times that the start of the Aleppo siege was the "last nail in the coffin" of the De Mistura-led peace talks in Geneva.

However, for the residents of Aleppo now living under siege, their most immediate concern is day to day survival and the theatre of international peace talks must seem a world apart.

Tragically, the siege of Aleppo is simply the latest chapter in the terrible descent that people of Syria have faced over the last five years, and things are only likely to get worse.


James Denselow is an author and writer on Middle East politics and security issues. He is a former board member of the Council for Arab-British Understanding (CAABU) and a director of the New Diplomacy Platform. Follow him on Twitter: