Germany has urged Russia and Iran to pressure the Syrian government to end the "massacre" in a rebel-held Damascus suburb that an independent monitor says has killed at least 250 civilians in two days.
"One has to ask where is Russia, where is Iran, which had pledged in Astana to guarantee a cease-fire also in eastern Ghouta," Steffen Seibert, a spokesman for German Chancellor Angela Merkel, said on February 21, referring to Syria peace talks in the Kazakh capital.
"Without the support of these two allies, [President Bashar al-]Assad's regime would not be where it is today, and undoubtedly, without this support, this regime would have to show more readiness to negotiate in the UN process," he added.
In Paris, French President Emmanuel Macron told a news conference that his country "vigorously" condemned the war activities in eastern Ghouta and called for a "truce" to allow the evacuation of civilians and allow access to humanitarian aid.
Macron said the Syrian "regime and some of its allies have decided to target civilian populations and presumably some of its opponents."
The comments come amid a growing outcry from Western capitals, the United Nations, and humanitarian groups over what they describe as "devastating" attacks and "siege-and-starve tactics" being used by Syrian and Russian warplanes and helicopter gunships against the rebel-held enclave outside the Syrian capital.
The UN human rights office says at least 346 people have been killed in the Damascus suburb since the Syrian government and its allies escalated their offensive on the region on February 4. In a statement on February 21, it said another 878 had been wounded, mostly in air strikes hitting residential areas.
Russia and Iran have given Assad's government crucial support throughout the 7-year-old war in Syria, which began with a government crackdown on protests. Moscow helped turn the tide of the conflict in Assad's favor by a launching a campaign of air strikes in 2015 and stepping up its military presence on the ground.
Russian Foreign Minister Sergei Lavrov defended the assault on the Damascus suburb, saying it was an assault on "terrorism" and not directed at civilians.
"In keeping with the existing agreements, the fight against terrorism cannot be restricted by anything," Lavrov said in Moscow on February 21.
He blamed what he called "armed provocations" by Al-Nusra Front militants for conditions in eastern Ghouta, and said Russia and Syria would draw from their deadly and controversial assault on the northern city of Aleppo in 2016 in the offensive.
The Syrian Foreign Ministry accused militants in Ghouta of targeting Damascus and using people as "human shields."
Kremlin spokesman Dmitry Peskov rejected Western suggestions that Russia was to blame for some of the civilian deaths in Ghouta.
"These are groundless accusations. We don't know what they are based on,” Peskov told a news conference in Moscow.
The allegations "are not backed up with any specific information. We do not agree with them," he added.
Russia's ambassador to the United Nations later called for a Security Council session on February 22 to discuss the violence raging in eastern Ghouta.
Ambassador Vassily Nebenzia told the council that an open meeting was "necessary" to allow all sides to "present their vision, their understanding of the situation, and come up with ways of getting out of this situation."
Meanwhile, UN Secretary-General Antonio Guterres called for an immediate suspension of "all war activities" in the rebel-held Damascus suburb where he said 400,000 people were living "in hell on earth."
Rescuers, monitors, and the UN say the bombs have hit hospitals, apartment blocks, markets, and other civilian targets.
"We no longer have the words to describe children's suffering and our outrage," the UN children's agency said.
"How much cruelty will it take before the international community can speak with one voice to say enough dead children, enough wrecked families, enough violence, and take resolute, concerted action to bring this monstrous campaign of annihilation to an end?" asked UN human rights chief Zeid Ra'ad al-Hussein.
On February 20, U.S. State Department spokeswoman Heather Nauert said the United States was "deeply concerned" about the "siege-and-starve tactics" being used by Russia and Syria and the "ongoing slaughter of trapped civilians and woefully inadequate access for humanitarian actors."
"We call on all parties to commit to the unconditional deescalation of violence. Russia must end its support of the Assad regime and its allies. They are responsible for the attacks, for the dire humanitarian situation in east Ghouta, and for the horrendous civilian death toll," Nauert said.
UN Syria envoy Staffan de Mistura warned that the escalating battle in Ghouta could turn into a repeat of the bloody fight for Aleppo, over which Damascus regained full control in late 2016 after years of fighting.
Factions in Ghouta fired mortars at Damascus on February 20, killing six people and injuring 28, Syrian state TV said.