Oxfam has launched an emergency appeal for £9.5m ($15m) to reach millions of starving people in Ethiopia and other East African countries.
The UK-based agency says thousands of animals have already died because of a drought which is the worst in 10 years.
Warning signs indicate that the lives and livelihoods of 23 million people are threatened - twice as many as the last serious crisis in 2006.
Seven countries are affected, with half of those threatened living in Ethiopia.
Other worst affected countries are Kenya, Somalia and Uganda, with Sudan, Djibouti and Tanzania also hit hard.
'Given up'
Oxfam says many infants have fallen ill and the elderly - who traditionally are the last to get food and water - are the worst hit.
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