Hundreds of civilians have been killed and tens of thousands driven from their homes in ethnic violence in Kyrgyzstan, the site of an airfield that serves as a key transit hub supporting the U.S. war effort in Afghanistan.
Tragic as the violence in Kyrgyzstan is, it gives the U.S. and Russia a chance to work together in a country where both have vested interests.
President Kurmanbek Bakiyev was ousted in April and a referendum on a new constitution appeared set for June 27. Interim President Roza Otunbayeva, backed mostly by ethnic Uzbeks, has accused Bakiyev's family of instigating the violence to try to stop the referendum.
She says she has talked to Medvedev about sending in Russian troops but he refused. Russia also has military facilities in the country, where Washington and Moscow have competed for influence following the Soviet collapse.
Civil war threatens, perhaps a broader regional conflict. The Kyrgyz in the south of the one-time Soviet republic have supported Bakiyev. Ethnic Uzbeks, a minority, have backed the interim government.
There already are reports militants from neighboring Tajikistan have been shooting both Uzbeks and Kyrgyz.
In announcing that Obama and Medvedev would meet, White House spokesman Robert Gibbs said the two leaders might explore cooperation in such areas as trade, investment and innovation. Russia is trying to launch its own version of Silicon Valley.
But there is much more to talk about, especially the nuclear programs of Iran and North Korea, and now the threat the already costly conflict in Kyrgyzstan could spread.
The two leaders will go on from Washington to Toronto for G8 and G20 meetings of world leaders that could be an opportunity for wider discussions.
Russia has been drawing closer to the Obama administration, first with an agreement on a new treaty reducing their stockpiles of nuclear weapons and then helping to pass new U.N. sanctions designed to squeeze Iran into agreeing to safeguards against Tehran developing nuclear weapons.
The U.N. sanctions were the result of compromises that produced measured steps.
In a major sign of resolve after passage, Russia pledged to freeze delivery of an $800 million package of S-300 air defense missiles to Tehran, thereby plugging a potential loophole in the eight categories of banned conventional weapons.
Six-party negotiations over North Korea's nuclear weapons program are in indefinite suspension. Russia, a participant, has been aboard with the United States in seeking to end the program and presumably will stay on board if a way can be found to reopen the talks.