The United States and France led international condemnations of the Syria regime and its backers after the latest chemical attack upon its own citizens.

Anti-government rebels in the town of Douma, near the capital Damascus, were bombarded with chlorine and sarin gas shells on Saturday, according to local reports. Photos from journalists in hospitals show patients, including women and children, foaming from the mouth. The number of casualties from various reports are between 50 and 500. The United Nations’ response to the chemical attack has been hampered by the repeated vetoing of draft resolutions by Syria’s ally, Russia.

They had previously vetoed ten proposed UN resolutions to deal with the conflict, branding the latest chemical attack as “fake news.” After one of the most prominent chemical attacks in 2013, which then-US President Obama described as a “red line” being crossed, Russia, under US and UN recommendation, was tasked with removing Syria’s chemical weapons capabilities. This has seemingly not been followed through with. The “red line” was not acted upon and Syria and its allies seem beyond the United Nations control.

The American representative to the UN, Nikki Haley, said that America would act with or without UN action after the latest attack. The US, as the world peacekeeper, has been undermined by its reluctance to engage with the Syrian conflict. Recent changes such as the arming of Kurdish rebels against Islamic state and coordination with Israel in the bombing of Syrian military targets indicate a change in philosophy, but it may be too late to regain control of an extremely volatile and complicated situation.

Earlier this year, French President Emmanuel Macron described any chemical attack as his own “red line.” As of publication, neither the United States or France have acted upon this rhetoric, although President Trump promised a “forceful response” and that Syria, Russia and Iran would have a “big price to play.” Similarly, Macron said any attack would be on chemical weapon facilities. The UK also carried out airstrikes in Syria, which British Prime Minister Theresa May claimed were justified, and effective in degrading Syria’s use of chemical weapons in the future.

On Wednesday, President Trump tweeted out a response to Russian threats to shoot down missiles, implying that strikes on Syrian targets were his preferred option, despite Russian objections. The Syrian civil war has been raging in the country for seven years. What initially began as protests against the autocratic rule of Bashar al-Assad during the liberal revolts of the Arab Spring escalated into an all-out war. Many factions backed by many countries have fought in the conflict, including the notorious Islamic State, which controlled large swathes of Syria and its neighbour Iraq before being defeated earlier this year. More than 350,000 people have been killed and there are more than 5,000,000 people seeking refuge in other countries.