In Northeast Syria, US and Russia in Fragile Coexistence

A US military convoy (L) and a Russian patrol are seen in this January picture crossing paths on the key M4 highway in Syria's northeastern Hasakeh province | AFP
A US military convoy (L) and a Russian patrol are seen in this January picture crossing paths on the key M4 highway in Syria's northeastern Hasakeh province | AFP
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In Northeast Syria, US and Russia in Fragile Coexistence

A US military convoy (L) and a Russian patrol are seen in this January picture crossing paths on the key M4 highway in Syria's northeastern Hasakeh province | AFP
A US military convoy (L) and a Russian patrol are seen in this January picture crossing paths on the key M4 highway in Syria's northeastern Hasakeh province | AFP

On a Syrian highway, Hussein Abdel Hamid recently found himself trapped inside his car. A US army patrol had encountered Russian tanks down the road, neither allowing the other passage.

The incident two weeks ago is not a rare sight in war-torn northeastern Syria, where Russian and US forces demonstrate a fragile coexistence despite backing opposite sides in the nine-year conflict.

"We always see US and Russian forces going head-to-head," AFP quoted Abdel Hamid, a 55-year-old Syrian Kurd, as saying.

"Just like taxis," they keep trying to cut each other off on the road, he added.

A staunch opponent of the Syrian regime, Washington first deployed troops in northeast Syria in 2014 as part of a coalition to combat the ISIS group.

Russia, for its part, has militarily backed the government of President Bashar al-Assad since 2015, but did not deploy its forces in the northeast until late last year, following a Turkish invasion against Kurdish fighters.

Turkey's offensive in October was spurred in part by US President Donald Trump who said he was pulling his forces out of border areas in the northeast.

Feeling abandoned by their erstwhile allies in the anti-ISIS battle, the Kurds turned to Damascus and Moscow to prevent a deeper incursion into their region.

Since then, Russian soldiers and American troops have rubbed shoulders in Kurdish-held territories, where their patrols cross paths regularly, flags fluttering simultaneously on opposite sides of the road.

AFP correspondents have often seen soldiers using binoculars to watch each other's movements.

- 'Exceptional situation' -

"I think the joint presence of Russia and the United States in northeastern Syria is an exceptional situation," said Syria researcher Samuel Ramani.

In a video shared on social media in February, a US military vehicle is seen nudging a Russian armored vehicle that was trying to overtake it off the road.

But the presence of Russian troops has also helped US forces avoid a face-off with Syrian regime forces.

In early March, two American armored vehicles found themselves only 50 meters (yards) from a Syrian army position and had to wait for the return of a Russian patrol in order to leave, local sources said.

In February, Moscow said Russia came to the rescue of American troops who came under attack by Assad loyalists who opened fire and tried to block its passage.

Despite all these tensions, Ramani said he thought "the risk of a major confrontation is very limited".

"Russia and the US might not have much experience with close geographical proximity, but they have a history of fighting in tandem on opposite sides in the Syrian civil war," he said.

Charles Thepaut, of the Washington Institute for Near East Policy, agreed that "neither the Russians nor the Americans are interested in direct confrontation".

But these incidents did however "show how fragile the situation is on the ground".

"The concentration of forces hostile to each other... in a small area where everybody has to use the same roads makes things dangerous," he added.

- Competing interests -

Syria is the only country in decades to have seen both American and Russian forces on the ground at the same time.

In February 2018, US-led coalition strikes killed dozens of regime and allied fighters near oil and gas installations in eastern Syria.

Moscow said five Russians were likely among the victims, blaming the incident on a "lack of co-ordination" by the pro-Assad group with Russian command.

But today, deconfliction channels in place since 2015 to prevent any clash between the Russians and the Americans seem to be bearing their fruit.

Any escalation will likely be contained, "unless one of the parties really wants to show strength," Thepaut said.

But long term, both sides have very different goals.

Although Trump in October said he would withdraw US troops from Syria, he later added that at least 500 personnel would remain, including to protect oil installations in the east.

"The goal of Russia is to get all US troops to leave Syria to reinstall the regime in all of Syria, which is impossible with US troops on the ground," Thepaut said.

"Their goal is also to pressure the (Kurdish-led) Syrian Democratic Forces to negotiate with the regime."

Caught between both sides, the SDF find themselves having to deal with both the Russians and the Americans if they want to salvage some of their semi-autonomy in Syria's northeast.

Residents say they hold little hope in either side.

"We no longer trust the Americans or the Russians," said 61-year-old Yaqub Kassar.

"All countries are only looking out for their own interests."



New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
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New Mpox Strain Is Changing Fast; African Scientists Are ‘Working Blind’ to Respond 

Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)
Dr. Robert Musole, medical director of the Kavumu hospital (R) consults an infant suffering from a severe form of mpox at the Kavumu hospital, 30 km north of Bukavu in eastern Democratic Republic of Congo, August 24, 2024. (AFP)

Scientists studying the new mpox strain that has spread out of Democratic Republic of Congo say the virus is changing faster than expected, and often in areas where experts lack the funding and equipment to properly track it.

That means there are numerous unknowns about the virus itself, its severity and how it is transmitting, complicating the response, half a dozen scientists in Africa, Europe and the United States told Reuters.

Mpox, formerly known as monkeypox, has been a public health problem in parts of Africa since 1970, but received little global attention until it surged internationally in 2022, prompting the World Health Organization to declare a global health emergency. That declaration ended 10 months later.

A new strain of the virus, known as clade Ib, has the world's attention again after the WHO declared a new health emergency.

The strain is a mutated version of clade I, a form of mpox spread by contact with infected animals that has been endemic in Congo for decades. Mpox typically causes flu-like symptoms and pus-filled lesions and can kill.

Congo has had more than 18,000 suspected clade I and clade Ib mpox cases and 615 deaths this year, according to the WHO. There have also been 222 confirmed clade Ib cases in four African countries in the last month, plus a case each in Sweden and Thailand in people with a travel history in Africa.

"I worry that in Africa, we are working blindly," said Dr. Dimie Ogoina, an infectious diseases expert at Niger Delta University Hospital in Nigeria who chairs the WHO's mpox emergency committee. He first raised the alarm about potential sexual transmission of mpox in 2017, now an accepted route of spread for the virus.

"We don’t understand our outbreak very well, and if we don't understand our outbreak very well, we will have difficulty addressing the problem in terms of transmission dynamics, the severity of the disease, risk factors of the disease," Ogoina said. "And I worry about the fact that the virus seems to be mutating and producing new strains."

He said it took clade IIb in Nigeria five years or more to evolve enough for sustained spread among humans, sparking the 2022 global outbreak. Clade Ib has done the same thing in less than a year.

MUTATING 'MORE RAPIDLY'

Mpox is an orthopoxvirus, from the family that causes smallpox. Population-wide protection from a global smallpox vaccine campaign 50 years ago has waned, as the vaccinating stopped when the disease was eradicated.

Genetic sequencing of clade Ib infections, which the WHO estimates emerged mid-September 2023, show they carry a mutation known as APOBEC3, a signature of adaptation in humans.

The virus that causes mpox has typically been fairly stable and slow to mutate, but APOBEC-driven mutations can accelerate viral evolution, said Dr. Miguel Paredes, who is studying the evolution of mpox and other viruses at Fred Hutchison Cancer Center in Seattle.

"All the human-to-human cases of mpox have this APOBEC signature of mutations, which means that it's mutating a little bit more rapidly than we would expect," he said.

Paredes and other scientists said a response was complicated by several mpox outbreaks happening at once.

In the past, mpox was predominantly acquired through human contact with infected animals. That is still driving a rise in Congo in clade I cases – also known as clade Ia - likely due in part to deforestation and increased consumption of bushmeat, scientists said.

The mutated versions, clade Ib and IIb, can now essentially be considered a sexually transmitted disease, said Dr. Salim Abdool Karim, a South African epidemiologist and chair of the Africa CDC’s mpox advisory committee. Most of the mutated clade Ib cases are among adults, driven at first by an epidemic among female sex workers in South Kivu, Congo.

The virus also can spread through close contact with an infected person, which is likely how clusters of children have been infected with clade Ib, particularly in Burundi and in eastern Congo’s displacement camps, where crowded living conditions may be contributing.

Children, pregnant women and people with weakened immune systems or other illnesses may be at greater risk of serious mpox disease and death, say the WHO and mpox scientists.

Clade I has typically caused more severe disease, with fatality rates of 4%-11%, compared to around 1% for clade II. Ogoina said data from Congo suggests few have died of the new Ib version, but he feared some data is being mixed up.

More research is urgently needed, but three teams tracking mpox outbreaks in Africa say they cannot even access chemicals needed for diagnostic tests. Clade Ib can also be missed by some diagnostic tests.

Planning a response, including vaccination strategies, without this is difficult, the scientists said.

Karim said around half of cases in eastern Congo, where Ib is particularly prevalent, are only being diagnosed by doctors, with no laboratory confirmation.

Getting samples to labs is difficult because the healthcare system is already under pressure, he said. And around 750,000 people have been displaced amid fighting between the M23 rebel group and the government.

Many African laboratories cannot get the supplies they need, said Dr. Emmanuel Nakoune, an mpox expert at the Institut Pasteur in Bangui, Central African Republic, which also has clade Ia cases.

"This is not a luxury," he said, but necessary to track deadly outbreaks.