U.N. deputy emergency relief coordinator Catherine Bragg appealed to the international community for $1.3 billion needed urgently to save lives.
"Every day counts," she told the U.N. Security Council. "We believe that tens of thousands have already died. Hundreds of thousands face imminent starvation and death. We can act to prevent further loss of life and ensure the survival of those who are on the brink of death."
Bragg's office, which coordinates U.N. humanitarian efforts, said the famine is expected to spread to all regions of south Somalia in the next four to six weeks unless further aid can be delivered. The global body says it has received $1.1 billion, just 46 percent of the $2.4 billion requested from donor countries.
Bragg's appeal came as a U.N. food agency official warned that the number of people fleeing famine-hit areas of Somalia is likely to rise dramatically and could overwhelm international aid efforts in the Horn of Africa.
Luca Alinovi, the Food and Agriculture Organization's representative in Kenya, warned that the situation could become "simply unbearable" in the coming weeks if Somalis continue to abandon their homes in southern and central parts of the country — which are mainly under control of al-Shabab Islamist extremists — in search of food.
The United Nations estimates over 11 million people across East Africa need food aid because of a long-running drought exacerbated by al-Shabab's refusal to allow many humanitarian organizations to deliver aid in areas it controls, including the U.N. World Food Program, the world's major aid provider.
According to the U.N.'s Food Security and Nutrition Analysis Unit, Bragg said, "the current situation represents the most severe humanitarian crisis in the world today and Africa's worst food security crisis since Somalia's 1991-92 famine."
"We have not yet seen the peak of the crisis," she warned, citing high levels of severe malnutrition and deaths of children under age 5, combined with increasing cereal prices and a dry harvest season.
The Food and Agriculture Organization reported Wednesday that cereal prices in East Africa reached new peaks in several countries last month, worsening the already dramatic situation for millions of hungry people. The FAO said prices of milk also were at record or very high levels in most of the region.
Food prices have been driven higher by drought-plagued harvests and sharp increases in fuel and transport costs, according to the Rome-based agency.
In the past two months some 220,000 people have fled toward the Somali capital of Mogadishu and across the borders to Kenya and Ethiopia, where refugee camps are straining under the pressure of new arrivals. Almost 1 million people are displaced elsewhere in Somalia, the U.N. estimates.
"The possibility is basically having everybody who lives in that (famine) area moving out, which would be a disaster," FAO's Alinovi said, adding that transportation costs have doubled in recent months — evidence that there is growing pressure to leave.
Alinovi said FAO was working to prevent Somalis from abandoning their drought-stricken farms by paying them cash for small jobs, thus allowing people to remain. Once people leave their farms, they become dependent on aid for a very long time, he said.
Cash payments have been controversial in Somalia, because of the possibility that money might end up in the hands of militant groups like al-Shabab, who are fighting the weak central government in Mogadishu.
"It is a risk that can be handled," Alinovi said of the cash payments, warning that the alternative could be a sharp rise in the number fleeing. "If this becomes a massive number, like hundreds of thousands of people moving out, then this simple problem will be very difficult to bear."
Bragg told the Security Council that in areas under control of al-Shabab, the U.N. and its partners continue to negotiate for access.
In recent weeks, she said, some progress was made to scale up emergency operations by the International Committee of the Red Cross in central and southern Somalia. It is the only organization allowed to conduct food distribution in al-Shabab areas.
The U.N. children's agency, UNICEF, is also boosting its supplies for feeding centers, she said.
Since July, Bragg said, food is also being delivered to two newly accessible areas in the Gedo region.
But she said 3.7 million Somalis "are in crisis," 2.8 million of them in south central Somalia, and 3.2 million need "immediate, lifesaving assistance" including 1.25 million children.
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Associated Press Writer Frank Jordans contributed to this report from Geneva