(Al Jazeera) Nobody should doubt the tactics that the Syrian regime and its allies will countenance in order to win this war. The horror of Madaya has been told in the pictures of emaciated children and the stories of people forced into eating cats, dogs, grass and whatever else they can find to survive. Starvation can be added to a list that includes chemical weapons, barrel bombs, massacres and indiscriminate artillery use on built-up urban areas.
Madaya had previously seen a single food distribution on October 18 before a stranglehold took place that has now seen huge suffering for an estimated 40,000 residents. In Madaya, 25 miles away from Bashar al-Assad's presidential palace, 23 Syrians, including children, starved to death last month. Others risk landmines and sniper fire to do whatever they can to keep their families alive.
Seen in isolation, the story of Madaya could appear as just another tragic chapter in the story of Syria's bloody civil war. However, the tactics of starvation have both context and history, while lessons can be learned about how media attention and pressure have led to access being promised for aid and desperately needed relief.
Not a new weapon
Starvation is not a new weapon but a tactic from medieval times finding modern applications. Hezbollah's reported role in the siege of Madaya has parallels with the role of militias in the War of the Camps during the Lebanese Civil War.
This conflict within a conflict in the 1980s saw siege tactics applied on Palestinian refugee camps by militias in urban areas, with similar consequences for anything edible.
Pauline Cutting's powerful chronicle of life working as a medic in a camp, Children of the Siege, told of people having to eat insects and even contemplating eating bodies of the fallen in order to survive.
As a tactic, starvation not only weakens your enemy but also places them under increasing pressure to care for civilians within the besieged site. In Syria, it is also an example of collective punishment and the failure of an international responsibility to protect that didn't exist during the time of the Lebanese Civil War.
The international system is haemorrhaging legitimacy and effectiveness every time a civilian dies in a besieged area due to a lack of access to aid. After all, the UN has been pushing for aid to be delivered to civilians for years. The Security Council has passed two resolutions concerning cross-border aid access without permission from Damascus and it has a mandate until January 2017 to do so.
Yet, while Madaya is an extreme example of the effects of siege, other areas are under similar pressures. The UN estimates that 400,000 people in 15 areas are going hungry, while 4.5 million Syrians are living in areas "hard to reach".
Single shipments of aid are not enough and such is the level of malnutrition in Madaya that NGO Doctors without Borders (MSF) is calling for the evacuation of civilians in order to receive life-saving hospitalisation.
While Syrians slowly starve to death, we should be under no illusions as to what this means for the UN system that is seemingly impotent in preventing it.
Syrian children call for the lifting of the siege off towns in Syria in front of the offices of the UN headquarters in Beirut [Reuters]
In the UK, pressure is growing for the military to airdrop aid to support civilians in places such as Madaya. If UN access is continually denied, then the argument is being made that if drops were made for Yazidis in Iraq fleeing the Islamic State of Iraq and the Levant group (ISIL), why not for civilians in Syria?
Others counter by explaining that the regime's air defence is stronger in areas near Damascus, but then, would the Syrian regime shoot down Western aircraft dropping supplies of civilian aid?
The other lesson from Madaya is that media pressure apparently works in changing regime behaviour in the short term. The Syrian regime has said it will allow aid in - showing that it is good at answering questions that it has posed.
However, media attention and the global outrage it sparks is fickle and short-sighted, and the tragedy of Syria's long war is that without a wider resolution to the violence, one-off deliveries can't truly change things.
Syrians are forecast to soon face temperatures below freezing, and fuel will be added to the list of life-saving items for those surviving under siege. This should give urgency to an international system that should be ashamed of how it has failed to stand up for the people of Madaya.
Aid access and the humanitarian crisis in the besieged areas must move up the agenda of the Vienna process and be an issue to address right from the start of the upcoming peace talks. If these fail, then serious consideration must be given to new ways of ensuring that basic human rights and the laws of war are not footnotes in history, but rather real constraints on the actions of armed groups.