Leishmaniasis unleashed in Syria.

As Syria prepares to enter its seventh year of war, the tide seems to have turned in favour of the Assad regime. Government forces over-ran Aleppo at the end of 2016, assisted by air support from Russia. President Bashar al-Assad has now regained control of all the major population centres in the country, including the four largest cities. As The Lancet Infectious Diseases went to press, a ceasefire had been agreed. It was intended to act as a prelude to peace talks, but few people expect Assad to give up the fi ght while swathes of the country, including Idlib governorate, are in the hands of the rebels. Besides, 1·4 million Syrians still live under the rule of Islamic State. The so-called caliphate sprawls across the border into Iraq (while the regime was busy besieging Aleppo, Islamic State retook Palmyra). It is inconceivable that any kind of settlement will leave the caliphate intact; ceasefi re or not, 2017 is likely to see a great deal of suff ering in Syria. An estimated 400 000 Syrians have already lost their lives. 4·8 million people have fl ed the country, mostly to neighbouring states. A further 6·3 million are internally displaced. 12·8 million Syrians are in need of health assistance, and more than two-thirds of the population lives on less than US $2 per day. It adds up to what the UN High Commissioner for Refugees, Filippo Grandi, describes as “the biggest humanitarian crisis of our time”.