The 17 countries agreed "to implement a nationwide cessation of hostilities to begin in a target of one week's time," said US Secretary of State John Kerry after extended talks co-hosted by Russian Foreign Minister Sergei Lavrov.
The International Syria Support Group also agreed that "sustained delivery" of aid will begin this week, with a new UN task force meeting later today in Geneva to start pushing for much greater access to "besieged and hard-to-reach areas".
But Kerry said they were under "no illusions" about the difficulty of implementing the agreement. Analysts were sceptical the deal would stop the bloodshed.
"It is ambitious and yet very tenuous... There are huge question marks," said Julien Barnes-Dacey, of the European Council on Foreign Relations.
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The failure to include al-Nusra was particularly important, Barnes-Dacey said, since the group is active in Aleppo and surrounding regions, and many of the more "moderate" rebels have links with it.
"Talking about Nusra works in Russia's favour as so many rebel groups have ties to Nusra. This effectively gives the green light for the Syrian government and its allies to carry on military action while paying lip service to the agreement."
A senior Russian foreign affairs official appeared to support the doubts, saying he was "not very optimistic" about a ceasefire.
"Despite the agreement, Russia will continue its anti-terrorist military operation," Vladimir Djabarov, vice-president of Russia's foreign affairs commission told the TASS news agency.
Peace talks collapsed earlier this month after troops loyal to Syrian President Bashar al-Assad, backed by Russian bombers and Iranian fighters, launched a major offensive on the key rebel stronghold of Aleppo.
The bombardments have forced at least 50,000 people to flee, left the opposition virtually encircled and killed an estimated 500 people since they began on February 1 -- the latest hellish twist in a war that has claimed more than a quarter-million lives.