The president’s Camp David Summit with members of the Gulf Cooperation Council (Saudi Arabia, Bahrain, UAE, Oman, Kuwait, and Qatar) was supposed to reassure some of America’s most important partners in the Middle East that Washington is standing with them during a period of unprecedented tumult. But the pre-summit bombshell -- Saudi Arabia’s King Salman respectfully declined the invitation from the kingdom’s main protector and patron – along with a post-summit communique peppered with platitudes about “a region that is peaceful and prosperous,” and empty words promising “respect for all states’ sovereignty and non-interference in their internal affairs,” and vacuous references to “no military solution to the regions’ armed civil conflicts,” and vague legalisms about how Washington might or might not respond to “an external threat to any GCC state’s territorial integrity that is inconsistent with the UN Charter” suggest that the gathering neither helped the White House make sense of the Middle East mess nor helped the Gulf monarchies feel more secure amidst the storm. As Marwan Muasher, a former Jordanian foreign minister, concluded, “Are the Gulf states going to go back from this meeting feeling reassured? I would say the answer is no.”

In short, it seems both sides are confused: the Gulf states, along with Jordan, Egypt and Israel, are confused about Washington’s response to the region’s metastasizing crises -- the Syrian civil war, the Pandora’s Box of chemical weapons, the erased red lines, the rise of ISIS, the fracturing of Syria, Iraq, Libya, and Yemen along sectarian fault lines, the Sunni-Shiite proxy wars in Syria, Iraq, Bahrain, and Yemen, the expansion of Iranian influence, the Iranian drive for nukes -- and the administration is confused about whom to support, what to do, where to engage, how much to commit.

One way to make sense of how to deal with today’s Middle East is to borrow an example from medicine. Let’s say a patient staggers into the hospital suffering from chest pain, labored breathing, a toothache and abdominal discomfort. The ER docs would triage his symptoms: A heart attack would take immediate priority over lung cancer, lung cancer would have to be addressed more substantively and quickly than an ulcer, and the toothache would be the least of their worries. In the same way, the United States and its allies must address the worst problems first in the Middle East.

Priority #1: Defeating jihadist terror

If President Bush’s “global war on terror” was too broad, we now know President Obama’s war on “core al Qaeda” was far too narrow.

There are 41 jihadist-terror groups in 24 countries today -- up from 21 groups in 18 countries in 2004.

Offshoots of “core al Qaeda” (based in Pakistan) can be found in Yemen, Egypt’s Sinai, Tunisia, Libya, Mali, and Somalia. ISIS (a reconstituted, rebranded strain of al Qaeda in Iraq decimated by the surge) has affiliates in Afghanistan, Libya, Yemen, and Nigeria. ISIS controls an area the size of Costa Rica and reigns over a population of 2 million. ISIS leader Abu Bakr al-Baghdadi calls on his followers to “erupt volcanoes of jihad everywhere” and “destroy the idol of democracy.”

Defense Secretary Ashton Carter describes ISIS as “the most immediate threat to U.S. national interests.” ISIS, the president adds, “threatens American personnel and facilities located in the region” and “if left unchecked… will pose a threat beyond the Middle East, including to the United States.”

Yet Washington’s response is not to destroy the cancer. The numbers reveal this: between August 2014 and March 2015, the anti-ISIS air campaign Operation Inherent Resolve hit 5,547 targets. That’s 23 targets per day. By comparison, the 1999 air campaign over Serbia,though hamstrung by NATO infighting, averaged 138 strike sorties a day. At the start of Operation Iraqi Freedom in 2003, the coalition carried out 1,700 air sorties and missile launches against Saddam Hussein’s regime on a single day. Last fall, the Syrian air force conducted 210 airstrikes in the span of 36 hours.

Max Boot of the Council on Foreign Relations notes that it took 75 days for the U.S. military to topple the Taliban regime in Afghanistan, with U.S. warplanes averaging 86 strike sorties per day. In the first 76 days of Inherent Resolve, the United States averaged eight strike sorties per day.

Priority #2: Ensuring the security of regional allies and checking Iran

The violence in Iraq and Syria has triggered a cascade of crises that affect the security and stability of America’s most important regional allies: Saudi Arabia is building a massive wall along its Iraq border, bombing Yemen and arresting ISIS fighters by the dozens. Overwhelmed by refugees, Jordan has been drawn into a dangerous and destabilizing military campaign. Turkish territory has been violated by Syria. Israel has conducted preemptive strikes into Syria. ISIS nearly overran Baghdad.

Destroying ISIS will help America’s regional allies feel more secure. But any semblance of security gained from an ISIS defeat will be lost if a) the Syrian civil war continues, b) Iran joins the nuclear club and/or c) Iran’s current regime emerges as the regional hegemon.

Syria’s civil war, which served as feedstock for the rise of ISIS, is now on par in length and lethality with the Balkan wars of the 1990s. Bashar Assad should not be permitted to remain in power. But Washington’s “Assad must go” solution to Syria died the moment the president agreed to Moscow’s plan to disarm Assad, which elevated him from an international pariah into an indispensable partner. It’s a grim reality that Washington is looking the other way as these two enemies attack their common enemy. (To add insult to injury, Assad has continued to use chemical weapons.)

Tehran’s expanding reach explains why Sunni Saudi Arabia has signaled it will match whatever Shiite Iran does on the  nuclear front, why the Saudis are hitting back at Tehran in Syria, Yemen, and Bahrain, and why Israel and Saudi Arabia are exploring ways to address a nuclear Iran. This freelancing on the part of longtime U.S. allies is largely a function of U.S. policies: the president drew a red line in Syria but then failed to enforce it. He supported the Mubarak government in Egypt, then the anti-Mubarak protestors, then Morsi’s "democratic" revolution, then Sisi’s autocratic counterrevolution. He put personality and politics ahead of a strategic partnership in Israel. And his nuclear deal with Iran amounted to a surrender of his own position.

“At present our friendship is not valued,” as Churchill once said, “and our enmity is not feared.” That must change.

The administration may believe Iran can be brought in from the cold. But the hard truth is that the Islamic Republic is a revolutionary regime that seeks to upend the regional order. Thus, it uses terror as a tool of statecraft, bankrolls Hizb’allah, supports proxies in Iraq, Yemen, and Bahrain, threatens to close the Strait of Hormuz, engages in piracy, props up Assad, and games the IAEA.

Sooner or later, Tehran’s advance must be checked. Toward that end, the nuclear deal should be scuttled. “Nuclear talks with Iran began as an international effort… to deny Iran the capability to develop a military nuclear option. They are now an essentially bilateral negotiation over the scope of that capability,” as Henry Kissinger observes. “The impact of this approach will be to move from preventing proliferation to managing it.”

Kissinger knows that while a non-nuclear Iran is difficult to handle, a nuclear Iran may be impossible.

Priority #3: Nurturing freedom

In his book Conservative Internationalism, Henry Nau argues that promoting freedom has long been a tenet of American foreign policy, and should remain so. But Nau contends that Washington should use its resources “to spread freedom on the borders of existing freedom.”

Iraq is a democratic state, albeit a fragile one, bordering a democratic state. Iraq’s freedom experiment carries huge symbolic significance (see Baghdadi’s statements and Tehran’s actions). But keeping Iraq within the borders of freedom is only part of the challenge. Washington should encourage freedom-oriented reforms in the region, but in a focused manner.

For example, Iraq’s Kurdish Regional Government is not an independent state, yet it has embraced democratic governance and is committed to building an “economically free area.” That should be a model for the rest of Iraq. And perhaps postwar, post-ISIS Iraq can become a model for postwar, post-ISIS Syria.

Jordan ranks in the top 10 globally on economic freedom and has a growing commitment to the rule of law. Washington should focus on encouraging reform in these areas. The UAE and Qatar are autocratic states. However, both boast high levels of economic freedom. Properly incubated, that can serve as a basis for political freedom.

To be sure, these priorities -- these courses of treatment -- are interlocking, even interchangeable. What’s telling is that none of them are being fully pursued by Washington at the moment.

Alan W. Dowd is a senior fellow with the Sagamore Institute Center for America’s Purpose.