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U.S. Secretary of State Rex Tillerson talks to reporters during a ceremony at the Sant'Anna di Stazzema memorial, dedicated to the victims of the massacre committed in the village of Sant'Anna di Stazzema by the Nazis in 1944 during World War II.MAX ROSSI/Reuters

The U.S. struggled Monday to explain a hazy Syria strategy that has yet to clarify key questions: whether President Bashar al-Assad must go and when the United States might feel compelled to take further action.

Successive attempts by top officials in President Donald Trump's administration to articulate a plan have only furthered the appearance of a policy still evolving, even after the United States broke with precedent last week by striking Mr. al-Assad's forces in reaction to a chemical-weapons attack that killed more than 80 people.

U.S. Secretary of State Rex Tillerson raised fresh expectations for aggressive U.S. action as he visited Sant'Anna di Stazzema, a Tuscan village where the Nazis massacred more than 500 civilians during the Second World War. As he laid a wreath, he alluded to the Syria chemical attack.

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"We rededicate ourselves to holding to account any and all who commit crimes against the innocents anywhere in the world," Mr. Tillerson said.

The United States has said its Syria strategy centres on persuading Russia – Mr. al-Assad's strongest ally – to stop supporting that regime. On Tuesday evening, Mr. Tillerson will fly to Moscow, the first official visit by a Trump cabinet official to Russia.

New questions were raised about Russia's involvement in the chemical attack.

A drone operated by Russians was flying over a hospital as victims of the attack were rushing to get treatment, a senior U.S. official told the Associated Press on Monday.

Hours after the drone left, a Russian-made fighter jet bombed the hospital in what U.S. officials believe was an attempt to cover up the usage of chemical weapons.

Though comments such as Mr. Tillerson's hint at a more activist U.S. foreign policy focused on preventing humanitarian atrocities, Mr. Trump has consistently suggested he prefers the opposite approach. His young administration has generally played down human-rights concerns while promoting an "America First" strategy de-emphasizing the concerns of foreign nations.

The uncertain view of U.S. objectives prevailed as Mr. Tillerson planned to attend a meeting Tuesday of the "likemindeds" – countries that share a similar approach to resolving Syria's protracted civil war. The session on the sidelines of the Group of 7 summit in Italy was to include Middle East countries including Turkey, Saudi Arabia, Jordan and the United Arab Emirates that share the United States' interest in resolving the conflict and resisting Iran's influence in Syria.

Mr. al-Assad's days as President of Syria are numbered, Prime Minister Justin Trudeau suggested Monday, as more hostile talk from international powers continued to amplify the threat of a military escalation in the Middle East.

The way forward in Syria can't include Mr. al-Assad, whose chemical attack against his own people was abetted by those countries – Russia and Iran – that have allowed him to remain in power, Mr. Trudeau told a news conference during a visit to Juno Beach in France to commemorate those who died in Canada's Second World War.

"There is no question that anyone who is guilty of the types of war crimes against innocents, against children, that Assad and his regime are, needs to be held to account," he said.

No component of Mr. Trump's Syria policy has engendered more confusion than Mr. al-Assad's future – an issue that similarly befuddled the Obama administration, whose once-adamant position that Mr. al-Assad must go softened substantially by the time president Barack Obama left office in January.

Leading up to the U.S. missile attack, Mr. Trump's administration had said Mr. al-Assad's future was up to the Syrian people. Then Mr. Trump, the day after the assault, said his thinking about Mr. al-Assad had changed. Mr. Tillerson answered a question about effecting regime change by saying the United States was organizing a coalition to do just that.

Yet after Mr. Trump's retaliatory strike, the position became less clear. Some officials, such as Mr. Tillerson, said the United States was confident Syrians would choose on their own to push Mr. al-Assad aside, while suggesting the U.S. wouldn't mandate it. UN Ambassador Nikki Haley and others said ousting Mr. al-Assad was indeed a U.S. goal, but only one of several.

At the White House, spokesman Sean Spicer insisted that Mr. Trump wouldn't box himself in by disclosing his actions in advance. But he added further uncertainty to the equation by saying that even barrel bombs – which Mr. al-Assad has used with frequency – would necessitate U.S. action.

Minutes later, the White House rushed to clarify that Mr. Spicer wasn't announcing any new policy on barrel bombs. "Nothing has changed in our posture," a White House official said in a written statement.

On one point, the administration has been consistent: Defeating the Islamic State group in Syria is the first priority. There's less certainty about what comes now.

Mr. Tillerson and other officials have said the next priority is to create "zones of stability" in Syria, where those displaced by civil war can live without fear of violence. They say that entails negotiating ceasefires between Mr. al-Assad's government and rebels, who have been fighting both the Islamic State and the Assad regime. With stability restored, they say, conditions will be ripe for a UN-brokered political transition.

Yet it's unclear why rebel groups would agree to ceasefires with Mr. al-Assad, who would protect the zones, and how.

- With a report from The Canadian Press

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