The Strategic Significance of Syria’s M5 Highway

This Monday, Dec. 23, 2019, file photo, civilians ride in a truck as they flee Maaret al-Numan, Syria, ahead of a regime offensive. (AP)
This Monday, Dec. 23, 2019, file photo, civilians ride in a truck as they flee Maaret al-Numan, Syria, ahead of a regime offensive. (AP)
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The Strategic Significance of Syria’s M5 Highway

This Monday, Dec. 23, 2019, file photo, civilians ride in a truck as they flee Maaret al-Numan, Syria, ahead of a regime offensive. (AP)
This Monday, Dec. 23, 2019, file photo, civilians ride in a truck as they flee Maaret al-Numan, Syria, ahead of a regime offensive. (AP)

It is arguably one of the most coveted prizes in Syria’s war, and after eight years of fighting, Syrian regime leader Bashar Assad has got it back.

The Damascus-Aleppo highway, or the M5, is known to Syrians simply as the “International Road.” Cutting through all of Syria's major cities, the motorway is key to who controls the country.

Assad gradually lost control over the motorway from 2012, when various opposition groups fighting to topple him began seizing parts of the country.

Protests against his family's rule had erupted the year before amid a wave of uprisings in the Arab world. This soon turned into a war, following a brutal regime crackdown on dissent and the intervention of foreign powers in the growing conflict.

Historically a bustling trade route, one Syrian analyst, Taleb Ibrahim, called the M5 “the most basic and strategic highway in the Middle East.”

For the Turkey-backed opposition fighting Assad, the motorway was a cornerstone in holding together their territory and keeping regime forces at bay. Its loss marks a heavy blow for opposition fighters whose hold on their last patches of ground in northwestern Syria is looking more and more precarious.

The Associated Press takes a look at the M5, and its place in Syria's nearly nine-year-long conflict:

What is it?

The M5 is a strategic highway that starts in southern Syria, near the border with Jordan, and runs all the way north to the city of Aleppo near the Turkish border.

The 450-kilometer (280-mile) highway links the country's four largest cities and population centers: Damascus, Homs, Hama and Aleppo, cutting through Idlib province.

Before the war, the M5 motorway served as an economic artery for Syria — mainly feeding the country's industrial hub of Aleppo. Experts estimate the road carried business worth $25 million a day at the height of Syria's trade boom before the war.

The highway was a passageway for the crossing of wheat and cotton from the Syrian east and north to the rest of the country. It was also a road used for the exchange of commodities with regional trade partners like Jordan, Saudi Arabia and other Arab states, as well as Turkey.

Recovering control

Regaining control over the highway has been a top priority of the regime since the early days of the war.

Its slow and tortuous recovery, in many ways, traces the arc of the Syrian war, which has killed nearly half a million people and uprooted half the country's pre-war population.

The regime began winning back segments of the highway, starting in 2014. That's when Russia joined the war on the side of Assad, and essentially tipped it in his favor.

Towns and cities located along parts of the highway, including in the Ghouta region and in the suburbs of Damascus, now lie in ruins after long sieges and incessant bombardment forced them into submission. The Russian-backed recapture of Aleppo in December 2016 was another major game-changer.

End of the opposition’s' road

Under a September 2018 agreement between Russia and Turkey, the M5 and M4 highways were supposed to be open for traffic, linking the regime’s stronghold on the coast with Aleppo before the end of that year. That never happened, as the opposition refused to move away and allow joint Russian-Turkish patrols to protect the traffic there.

That eventually led to the latest regime offensive in Idlib, the last opposition-held bastion in the country.

Regime troops backed by Russia carried out several major advances in Idlib, retaking towns and villages on both sides of the motorway. The capture of Khan Sheikhoun was the first major breakthrough, followed by Maaret al-Numan and Saraqeb, located on the intersection between the M4 and M5.

This week, regime troops recaptured the last opposition-controlled section of the highway around Khan al-Assal. That brought the road under the full control of Assad’s forces for the first time since 2012.

Ibrahim, the political analyst, said the highway is so vital because it links the country's two powerhouses — the capital of Damascus with the trading hub of Aleppo.

“In other words it links Syria’s political capital with its economic capital,” he said. It also links up with the M4 highway at the Saraqeb knot, opening up traffic to the regime’s coastal stronghold of Latakia and the port.

Fighting continues in areas near the highway, and much of Idlib province remains in opposition hands.



Doctors and Moms Say Babies in Gaza May Die without More Formula, Blame Israel’s Blockade

 Seham Fawzy Khodeir watches her son, Hisham, who is just days old and was born prematurely, lying in an incubator at the neonatal intensive care unit of Nasser Hospital in Khan Younis, southern Gaza Strip, Thursday, June 19, 2025. (AP)
Seham Fawzy Khodeir watches her son, Hisham, who is just days old and was born prematurely, lying in an incubator at the neonatal intensive care unit of Nasser Hospital in Khan Younis, southern Gaza Strip, Thursday, June 19, 2025. (AP)
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Doctors and Moms Say Babies in Gaza May Die without More Formula, Blame Israel’s Blockade

 Seham Fawzy Khodeir watches her son, Hisham, who is just days old and was born prematurely, lying in an incubator at the neonatal intensive care unit of Nasser Hospital in Khan Younis, southern Gaza Strip, Thursday, June 19, 2025. (AP)
Seham Fawzy Khodeir watches her son, Hisham, who is just days old and was born prematurely, lying in an incubator at the neonatal intensive care unit of Nasser Hospital in Khan Younis, southern Gaza Strip, Thursday, June 19, 2025. (AP)

Seham Fawzy Khodeir watches as her son lies inside a dilapidated incubator and listens to his faint cry, mixed with the muted sound of the equipment.

The mother of six is increasingly concerned about the survival of Hisham al-Lahham, who was just days old, breathing with the help of equipment and being fed through a tube in his tiny nose.

Most alarming is that the medical-grade formula he needs to survive is running out.

"There is no milk," the 24-year-old mother told The Associated Press. He needs it to "to get better, to live and to see life."

Hisham is among 580 premature babies at risk of death from starvation across the war-battered Gaza Strip, according to the Gaza Health Ministry. Khodeir and others blame Israel’s blockade for the plight of their children. Doctors say that although some formula has been delivered, the situation is dire. Their desperation comes as the war in Gaza has been overshadowed by the Israel-Iran war.

"These babies have no time ... and no voice," said Dr. Ahmed al-Farah, head of the pediatrics and obstetrics department at Nasser Hospital, the main medical facility still partially functional in southern Gaza.

'An avoidable disaster'

Khodeir's son is one of 10 babies in incubators at Nasser's neonatal intensive care unit. Last week, al-Farah rang the alarm, saying the hospital’s stock of medical-grade formula was "completely depleted."

He said the tiny babies who relied on it would face "an avoidable disaster" in two to three days.

His pleas were answered, in part, by the delivery of 20 boxes of formula sent over the weekend by a US aid group, Rahma Worldwide. The new delivery is enough to cover the needs for the 10 infants for up to two weeks, al-Farah said.

Al-Farah, however, expressed concern about future deliveries, saying that it wasn’t guaranteed that more formula would be allowed into Gaza.

"This is not enough at all," he said. "It solved the problem temporarily, but what we need is a permeant solution: Lift the siege."

Meanwhile, fortified formula required for newborns is already out of stock at Al-Rantisi Hospital in Gaza City, its director, Dr. Jamil Suliman, said.

"Many mothers are unable to breastfeed due to severe malnutrition," he said, warning of a looming crisis.

Infants are among the hardest hit by Israel’s blockade, which started on March 2 with the complete ban of any food, water, shelter or medication.

Under mounting international pressure and repeated warnings of famine from the United Nations, Israel began allowing what Prime Minister Benjamin Netanyahu called "minimal" aid, starting May 19.

Since then, more than 1,000 tons of baby food, including formula, have entered Gaza, according to COGAT, the Israeli defense agency in charge of aid coordination in the Palestinian territory.

"Food for babies is certainly entering (the Gaza Strip), as the organizations are requesting it, we are approving it, and there is no withholding of food for babies," a COGAT spokesperson said.

But Gaza’s health officials say that for these babies, that aid hasn't included enough critical medicine, formula, medical equipment, and spare parts to keep the existing equipment operational.

The Palestinian Center for Human Rights said in a report Monday that fortified infant formula was nearly depleted from local markets, with several types already completely out of stock.

"Any limited quantities available in some pharmacies are being sold at skyrocketing prices, far beyond the purchasing power of most families," it said.

COGAT said the baby food is being distributed mostly through international organizations — not via the Gaza Humanitarian Foundation, an Israeli-backed private contractor that has drawn criticism from other groups. Palestinian witnesses and health officials say Israeli forces have opened fire on crowds heading to GHF sites. The Israeli military says it has fired warning shots.

Israel has defended its blockade

Israel has said the blockade aims to pressure Hamas into releasing the 50 hostages it still holds from its Oct. 7, 2023, attack on southern Israel that sparked the war. Fewer than half are still believed to be alive.

Israel has accused Hamas of siphoning aid, without providing evidence. The United Nations says there's been no significant diversion of aid.

Gunmen killed around 1,200 people, mostly civilians, and took 251 hostage on Oct. 7. Most of the hostages have been released by ceasefire agreements.

The war has unleashed unrelenting destruction, with more than 56,000 Palestinians killed and more than 131,00 wounded in Israel's offensive, according to Gaza health officials. The officials don't distinguish between combatants and civilians but say more than half the casualties are women and children.

The war and the blockade have sparked a humanitarian crisis, creating shortages of the most basic necessities and pushing Gaza’s health care system to the brink of collapse.

Seventeen of the enclave's 36 hospitals remain partially functioning, providing health care to more than 2 million people amid bombings, rising malnutrition rates and dwindling medical supplies.

"Starvation is increasing," said Jonathan Whittall, head of the UN's humanitarian affairs office for the occupied Palestinian territories. More than 110 children have been admitted for treatment for malnutrition every day since the start of this year, he said.

"Our warehouses stand empty while Israel restricts shipments to minimal quantities of mainly medical supplies and food," Whittall added.

A crisis at Gaza's hospitals

Human Rights Watch said in a recent report that all medical facilities in Gaza are operating in unsanitary and overcrowded conditions and have serious shortages of essential health care goods, including medicine and vaccines.

"Since the start of the hostilities in Gaza, women and girls are going through pregnancy lacking basic health care, sanitation, water, and food," said Belkis Wille, associate crisis, conflict and arms director at Human Rights Watch. "They and their newborns are at constant risk of preventable death."

The Health Ministry has repeatedly warned that medical supplies and fuel were running out at hospitals, which use fuel-powered generators amid crippling power outages.

Whittall said hospitals were forced to ration the little fuel they have "to prevent a complete shutdown of more life-saving services."

"Unless the total blockade on fuel entering Gaza is lifted, we will face more senseless and preventable death," he said.

Nasser Hospital was forced to cut off electricity for some departments, despite the nonstop flow of patients, as part of a plan to save fuel, said Ismail Abu-Nimer, head of engineering and maintenance.

Supplies have been running out amid the influx of wounded people, many coming from areas close to aid distribution centers, said Dr. Mohammad Saqer, Nasser's director of nursing.

"The situation here is terrifying, immoral, and inhumane," he said.