Overhaul the global relief system now or watch millions more people slide over the edge into destitution, an aid agency says in a report full of warnings to donors, governments and humanitarians alike.
As rocketing food and fuel prices force more people to resort to begging and more children to give up school to work, CARE International says it would be better - and much cheaper - to act now than to try to wade in later with inefficient life-saving aid.
"We've got a choice what to do. Wait until people need emergency response - and that's extremely expensive - or look at new ways of supporting people to feed themselves," says Vanessa Rubin, who co-wrote CARE's report.
The global food crisis has tipped 100 million people into destitution in the last two years, CARE says. And the forecast for the near future is dire.
"The price of food and fuel have shot up - that's not going to change," Rubin says. "We're seeing more and more sudden emergencies - and with climate change that's only going to get worse. And in some of the countries we're talking about, we're seeing population growth accelerating at an alarming rate.
"Those three things are going to push more people over the edge to the point where they can't meet their needs."
The U.N. Food and Agriculture Organisation has just calculated that 75 million more people were added to the ranks of the world's hungry in 2007, taking the global figure to roughly 925 million.
CARE's report quotes a 9-year-old Ethiopian boy, Mohammed, who says families he knows in the capital Addis Ababa are eating in shifts, the oldest on Monday, the second on Tuesday, the third on Wednesday. "If he's lucky there is something for the eldest to eat on Wednesday morning or evening again."
The report recommends a new global fund to deal with the crisis. The fund would involve the United Nations, multilateral organisations, local government, aid agencies, civil society, the private sector and beneficiaries, the agency envisions.
CARE doesn't say how much the fund would need, but British-based aid agency Oxfam estimated in a June report that it would take $14.5 bn to meet the needs of people affected by the food crisis now.
However Rubin says it's not just about more aid, but about the kind of aid.
CARE's report says relief at the moment is too short-term and too focused on responding when an emergency is in full swing instead of protecting the ways people make a living.
This year, as a food emergency in drought-prone Ethiopia stares donors in the face, many are splashing cash around to save lives. And yet, CARE says that just months earlier some of the same donors turned down its requests for funding to avoid a food crisis in the Horn of Africa.
In Niger, too, three years after the country's worst food emergency for decades, CARE says almost 20 percent of the population is again facing hunger as drought and flooding wipe out their dwindling food stocks.
"Instead of just waiting until an emergency reaches its peak, people need long-term, predictable aid so agencies can identify the people who are most vulnerable and help them become more resilient," Rubin says.
CARE says governments all round the world should be putting safety nets in place to help their populations avoid slipping over the edge, and relief agencies need an urgent shake-up too.
"We need to find clever and different ways to use limited resources to change things," she says.
CARE calls for aid agencies to turn down monetised food aid from the U.S. government - food aid sold to raise cash for poverty-raising programmes.
CARE made a dramatic turnaround on this issue several years ago when it began arguing that the U.S. system was inefficient, wasted half of every dollar spent on shipping food across the world, and undermined local markets by competing with local farmers' crops.
Humanitarians also need to get to grips with the reality that many of the people most at risk today are urban poor, and shift their thinking accordingly.
And they should be helping pastoralists to retain their way of life in a changing world. The traditional herding that sustains many people across Africa is viable, CARE says, but many communities could do with a lot more support accessing credit or veterinary expertise or setting up fodder banks to tide them through hard times.
The world's wealthy countries are already falling far short of their pledges under the Millennium Development Goals (MDGS) - approved in 2000 by U.N. member states and the world's top development organisations - to boost development aid and slash poverty by 2015.
By then, CARE estimates, nearly $200 billion will have been spent fighting emergencies, if we carry on with the status quo.
A meeting in New York on Sept. 25 to review progress on the MDGS will confirm everyone is failing to meet their targets.
And unless they make headway with the first goal - halving hunger - CARE says it will be impossible to achieve the rest, such as gender equality and education.
"Doing nothing," Rubin says, "is not an option."
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