Syria is a republic ruled by the authoritarian regime of President Bashar Asad. The president makes key decisions with counsel from a small number of security advisors, ministers, and senior members of the ruling Baath (Arab Socialist Renaissance) Party. The constitution mandates the primacy of Baath Party leaders in state institutions and society. President Asad and party leaders dominate all three branches of government. A 2007 yes-or-no referendum that was neither free nor fair by international standards confirmed Asad as president for his second seven-year term. Parliamentary elections held in May 2012 were also neither free nor fair by international standards, and several opposition groups boycotted them. The civil war, which started in 2012, continued throughout the year. The regime maintained control over the southern coastal governorates. Fragmented opposition groups maintained control in several northern and central areas, in many cases establishing new or reconstituted governance structures, including irregularly constituted courts. Some areas remained contested, including the northeastern Kurdish-dominant areas. The regime regularly attacked areas under opposition control. Government-controlled regular security forces and irregular militias ("shabiha") associated with the government committed widespread human rights abuses. Opposition armed forces consisted of diverse groups with varying ideology and goals. The political opposition largely coalesced under a new political entity, the National Coalition for Syrian Revolutionary and Opposition Forces. The Asad regime continued to use indiscriminate and deadly force to quell protests and conducted air and ground-based military assaults on cities, residential areas, and civilian infrastructures, including schools and hospitals throughout the country. For example, on August 21, the regime used sarin gas and artillery to target East Ghouta and Moadamiya al-Sham, suburbs of Damascus, and killed over 1,000 persons. In July the United Nations announced that more than 100,000 persons had been killed since the beginning of the crisis in March 2011. In December the Syrian Observatory for Human Rights (SOHR) estimated that more than 125,835 persons had been killed. As the civil war intensified, the humanitarian situation reached crisis proportions. As of September 1, more than 2.2 million refugees had registered with the Office of the UN High Commissioner for Refugees (UNHCR) in neighboring states and North Africa, and more than 6.5 million persons were displaced internally. The figures for internally displaced persons were estimates; actual figures may have been higher. The regime blocked access for humanitarian assistance to reach civilian areas, particularly areas held by opposition groups. The most egregious human rights problems during the year were the regime's widespread and systematic attacks against civilians; systematic and widespread use of torture; and the perpetuation of massacres, forced displacement, and starvation. The government denied citizens the right to change their government peacefully. The government denied citizens the right to practice freedom of speech, mobility, association, access to legal representation, and medical assistance. The government detained tens of thousands of individuals associated with nongovernmental organizations (NGOs), human rights activists, journalists, humanitarian aid providers, and doctors without access to fair trial.