Anbar province, the western-most Sunni-majority province in Iraq, is under virtual siege by Muslim extremist groups, including the Al Qaida-affiliated Islamic State in Iraq and the Levant.

Anbar was the site of horrific battles between US troops and extremists in 2004 until the founding of the Sunni Awakening, or Sahwa, movement there in 2006 and its alliance with US forces in 2007.

Ramadi and Fallujah, familiar names to Americans in 2004, are the two key battleground cities in the province. Iraqi Prime Minister Nouri Al Maliki has dispatched thousands of Iraqi troops to repel the extremists and vigorously has sought US aid.

Results so far are mixed.

The US cannot be indifferent to Baghdad’s plight for several reasons.

First, simply stated, Iraq cannot afford to lose Anbar and its estimated 1.5 million citizens. It would further widen the sectarian fissure that divides the nation and lessen prospects for healing.

Under extremist control, Iraqis living there would be condemned to utter despair. An exodus of hundreds of thousands would likely follow. Such a movement would exacerbate political and sectarian pressures in the country that Maliki and his already hard-pressed government do not need.

Second, an Al Qaida-friendly Anbar would exponentially ratchet up the violence in neighboring provinces, Nineveh and Salah Al Din, and in Syria. A base in Anbar would serve as an attractive gathering point for the region’s extremists to continue the withering attacks on Syria and even harass friendly neighboring states such as Jordan.

Closing Anbar to the extremists would deal a significant strategic blow to extremist movements in Syria and make a critical dent in the numbers of Iraqi militants, both Sunni and Shia, traveling from Iraq to participate in the Syria conflict.

Third, Iraq’s national parliamentary elections are scheduled for late April. A conflict in Anbar would mean that voter participation in this all-important province highly problematic, if not impossible. If Iraqis are to experience a peaceful and fair election in which all candidates and voters can fully participate, Anbar must be stabilized and Iraqi government control re-established.

Anything less would hold the election hostage to fear and intimidation, casting grave doubts on Iraq’s still nascent electoral process.

Such a prospect evokes memories of the political predicament in the post-election period of 2010 when the winning candidates were unable to form a government for almost nine months and parliamentary operations were suspended for a nearly equal period.

Fourth, US assistance would significantly strengthen a US-Iraq partnership that has deteriorated since the US troop withdrawal at the end of 2011. Iran has taken advantage of the diminished relationship, replacing the US as Iraq’s most influential interlocutor, creating additional challenges for the US in the region.

Easier Iranian access to Hezbollah in Lebanon and Baghdad’s support for Syrian dictator Bashar Al Assad have increased security threats to Israel.

US assistance would demonstrate to Maliki, and even more importantly to Iraqis, that the US is its best partner and that stronger ties to the US and the West offer Iraq its best future.

Military aid would give the US the leverage it currently lacks to do this. Moreover, it would send a clear signal to Tehran that the US wouldn’t abandon the region, either to extremist Sunnis or to Iran.

Finally, aiding Baghdad would reassure a very skeptical region of America’s continuing engagement in the Middle East and commitment to its stability.

Correctly or not, that confidence has been badly shaken in recent years by the US withdrawal from Iraq, a perceived diffident approach to the Syrian conflict, controversial outreach to Iran and tension with such regional stalwart allies such as Israel and Saudi Arabia.

Fresh aid to Iraq would require Congressional scrutiny. It should include more and higher quality weapons and the training of Iraqi’s to use them effectively.

The US should also consider providing critical intelligence information and support, dispatching US Special Forces to aid in training Iraqi forces and planning operations against the extremists.

This strategy might even offer limited air support to Iraqi forces, including aerial surveillance. Since this is Baghdad’s fight, however, the US should not involve land combat forces. Iraq must now fight its own battles, with friends willing to offer a strong helping hand.

This is an ideological confrontation designed to reverse the poor relationship Maliki’s government currently has with the nation’s Sunnis and eliminate an extremist alternative that the vast majority of Iraqis, both Sunni and Shia, reject. The US must ensure that Baghdad wins this fight.