The twin baby boys lay on a bed of woven palm leaves in a remote camp for displaced people in Yemen’s north, their collar bones and ribs visible. They cried loudly, twisting as if in pain, not from disease but from the hunger gnawing away at them.

Here, U.N. officials’ increasingly dire warnings that a hunger crisis is growing around the world are becoming reality, reports AP.

U.N. agencies have warned that some 250 million people in 20 countries are threatened with sharply spiking malnutrition or even famine in coming months.

The United Nations humanitarian office this week released $100 million in emergency funding to seven countries most at risk of famine — Yemen, Afghanistan, South Sudan, Ethiopia, Nigeria, Congo, and Burkina Faso.

But David Beasley, head of the World Food Program, says billions in new aid are needed. Without it, “we are going to have famines of biblical proportions in 2021,” he said in an Associated Press interview last week.

In multiple countries, the coronavirus pandemic has added a new burden on top of the impact of ongoing wars, pushing more people into poverty, unable to afford food. At the same time, international aid funding has fallen short, weakening a safety net that keeps people alive.

In Afghanistan’s capital Kabul, Zemaray Hakimi said he can only give his children one meal a day, usually hard, black bread dunked in tea. He lost his work as a taxi driver after contracting COVID-19 and now waits daily on the street for day laborer work that rarely comes.

When his children complain of hunger, he said, “I tell them to bear it. One day maybe we can get something better.”

South Sudan may be closer than any other country to famine, as crisis after crisis wears on a population depleted by five years of civil war. The U.N. projected earlier this year that a quarter of the population of Jonglei State, home to more than 1.2 million, would reach the brink of famine.

Now cut off from much of the world by flooding that has affected some 1 million people, many South Sudanese have seen farming and other food routines ripped apart. The challenges are so numerous that “plastic sheets are not available, as they had largely been used for the previous flood response,” the U.N. humanitarian agency said this week.

COVID-19 has restricted trade and travel. Food prices rose. Post-war unrest remains deadly; gunmen recently fired on WFP boats carrying supplies.

“The convergence of conflict, macroeconomic crisis, recurrent flooding as well as the indirect impacts of COVID create a ‘perfect storm,’” the country director for the CARE aid group, Rosalind Crowther, said in an email. “Flooding and violence have led to massive displacement, low crop production and loss of livelihoods and livestock.”

In the Arabian peninsula, Yemen is on a “countdown to catastrophe,” Beasley, of the WFP, warned the Security Council last week.

“Famine is truly a real and dangerous possibility and the warning lights are ... flashing red — as red can be,” he said.

For years, Yemen has been the center of the world’s worst food crisis, driven by the destructive civil war between Iranian-backed Houthi rebels who took over the north and the capital, Sanaa, in 2014 and a Saudi-led coalition backing the government in the south.

International aid pulled it from the edge of famine two years ago. But the threat has surged back this year, fueled by increasing violence and a currency collapse that put food out of reach for growing numbers of people.

Donors have been wary of new funding because of corruption and restrictions that Houthis have put on humanitarian workers. The U.N. had to cut in half the rations it gives to 9 million people — and faces possible cuts to another 6 million in January.

The 18-month-old twins, Mohammed and Ali, weigh only about 3 kilograms, or 6.6 pounds, less than a third of the weight they should be, according to their doctor.

Their father, Hassan al-Jamai, was a farmer in northern Hajjah province near the border with Saudi Arabia. Soon after their birth, the family had to flee fighting to a displaced camp in the district of Abs.

“We are struggling to treat them,” said Mariam Hassam, the twins’ grandmother. “Their father took them everywhere.”

Two-thirds of Yemen’s population of about 28 million people are hungry. In the south, U.N. data from recent surveys show cases of severe acute malnutrition rose 15.5% this year, and at least 98,000 children under five could die of it.

By the end of the year, 41% of the south’s 8 million people are expected to have significant gaps in food consumption, up from 25%.

The situation could be worse in Sanaa and the north, home to more than 20 million people. The U.N. is currently conducting a similar survey there.

Sanaa’s main hospital, al-Sabeen, received over 180 cases of malnutrition and acute malnutrition the past three months, well over its capacities, according Amin al-Eizari, a nurse.

At least five children died at the hospital during that period, with more dying outside, he said.

In Afghanistan — like Yemen, crippled by war — the pandemic has meant further losses of jobs and mounting food prices. The poverty rate is expected to leap this year from 54% of the population of some 36 million to as high as 72%, according to World Bank projections.

Some 700,000 Afghan workers returned from Iran and Pakistan this year, fleeing coronavirus outbreaks. That halted millions of dollars in remittances, a key income for families in Afghanistan, and returnees flooded the ranks of those needing work.

Markets in Kabul seem full of food items. But shop owners say fewer customers can afford anything. More people are experiencing major gaps in their food — expected to rise to 42% of the population by the end of the year, from 25%, according to U.N. figures.

In the Bagrami displaced camp in the mountains surrounding Kabul, Gul Makai sat beside her mud-brick hut. She had spent the night shoveling out water and mud after the roof leaked in a recent snow. With early snows this year, temperatures have dropped below freezing.

Her 12 children, all 10 or younger, sat with her, hungry and shivering in the cold breeze. They were all thin. One daughter, Neamat, around 4, had the withered look that suggests malnutrition.

Makai fled seven months ago from her home in southern Helmand province after husband was killed in a crossfire between government forces and the Taliban. By begging, she scrounges up enough rice or hard bread to give her kids one meal a day. She eats every other day.

“The weather in winter will get colder,” she said. “If I don’t get help, my children may get sick, or God forbid I may lose any of them. We are in a bad condition.”

Also read:Public Development Banks for greater commitment to tackle global hunger, poverty

Eastern Congo marked an official end Thursday to the second deadliest Ebola outbreak in history, which killed 2,280 people over nearly two years, as armed rebels and community mistrust undermined the promise of new vaccines.

Thursday’s milestone was overshadowed, though, by the enormous health challenges still facing Congo: the world’s largest measles epidemic, the rising threat of COVID-19 and another new Ebola outbreak in the north.

“We are extremely proud to have been able to be victorious over an epidemic that lasted such a long time,” said Dr. Jean-Jacques Muyembe, who coordinated the national Ebola response and whose team also developed a new treatment for the once incurable hemorrhagic disease.

The announcement initially was set for April but another case emerged just three days before the Ebola-free declaration was expected. That restarted the 42-day waiting period required before such a proclamation can be made.

The epidemic, which began in August 2018, presented an unprecedented challenge for the World Health Organization, Congo’s Health Ministry and international aid groups because it was the first Ebola epidemic in a conflict zone.

Armed groups posed such a risk that vaccinations sometimes could only be carried out by small teams arriving by helicopter.

Only a few years earlier, West Africa’s Ebola epidemic killed more than 11,000, as at that time there was no licensed vaccine or treatment.

The COVID-19 outbreak in the region has been minimal so far, but the challenges of Ebola underscore how fraught it could be to test and treat those in areas under the control of armed rebels.

 “Ebola has changed our culture,” said Esaie Ngalya, whose grandmother died from the virus. “Now I go to see my uncle but we don’t shake hands. In our culture that is considered disrespectful but now we have no choice because health comes first.

As Africa braces for a surge in coronavirus cases, its countries are dangerously behind in the global race for scarce medical equipment. Ten nations have no ventilators at all.

Outbid by richer countries, and not receiving medical gear from top aid donor the United States, African officials scramble for solutions as virus cases climb past 25,000. Even in the best scenario, the United Nations says 74 million test kits and 30,000 ventilators will be needed by the continent's 1.3 billion people this year. Very few are in hand.

"We are competing with the developed world," said John Nkengasong, director of the Africa Centers for Disease Control and Prevention. "The very future of the continent will depend on how this matter is handled."

Politicians instinctively try to protect their own people and "we know that sometimes the worst in human behavior comes out," said Simon Missiri, Africa director with the International Federation of Red Cross and Red Crescent Societies, urging an equitable approach to help developing nations.

The crisis has jolted African nations into creating a pooled purchasing platform under the African Union to improve negotiating power. Within days of its formation, the AU landed more than 100,000 test kits from a German source. The World Health Organization is pitching in, approaching manufacturers for supplies.

Africa also benefits from the U.N.'s largest emergency humanitarian operation in decades, with medical cargo including hundreds of ventilators arriving in Ethiopia this month and sent to all countries across the continent. Another shipment from the Jack Ma Foundation is on the way.

But Africa isn't holding out a begging bowl, Nkengasong said. Instead, it's asking for a fair crack at markets — and approaching China for "not donations. Quotas that Africa as a continent can purchase."

Such efforts are a response to a global thicket of protectionism: More than 70 countries have restricted exports of medical items, putting Africa in a "perilous position," the U.N. says. New travel bans have closed borders and airports, badly wrenching supply chains.

"It's like people hoarding toilet paper, which I still don't understand," Amer Daoudi, the U.N. World Food Program's senior director of operations, told The Associated Press. "Countries in Europe and North America are paying attention to their own internal needs, but we think that will ease off very soon."

While nations that are traditionally the world's top humanitarian donors are distracted, the WFP, the U.N.'s logistics leader, heaved the emergency operation into place with unprecedented reach. Normally in about 80 countries, this effort involves almost 120, Daoudi said.

The WFP seeks $350 million to keep the operation running for Africa and elsewhere, delivering aid for the pandemic and other crises like HIV and cholera that need drugs and vaccines to keep flowing. Africa imports as much as 94% of its pharmaceuticals, the U.N. says.

"I've never been involved in anything like this before. I don't think any of us have," said Stephen Cahill, WFP's director of logistics. "We're seeing countries taking measures we think aren't always rational. When you start closing borders, we start to get very nervous."

Some African nations, after securing medical equipment, have complicated delivery by causing cargo to stall at ports; 43 have closed their borders.

The global supply crisis is so pressing that the U.N. General Assembly this week approved a resolution urging countries to immediately end "speculation and undue stockpiling." Separately, China said it won't restrict exports of needed medical goods.

Developing regions are taking different approaches. China is the main source of help in Southeast Asia. In South Asia, several countries have committed to India's proposed COVID-19 Emergency Fund. Small South Pacific island nations have teamed up to get equipment. And some Latin American nations are trying to free equipment stuck in U.S. ports or making supplies themselves.

But the global disruptions are especially felt across Africa, where governments that have historically underfunded health systems are partnering in an effort that's been compared to going to war.

"Where a product cost, for example, a dollar before, it's now gone up a hundred-fold," said the Africa CDC deputy director, Ahmed Ogwell. While many African nations have money on hand, the trading companies they use face extreme challenges: "Country X can go and say, 'I'll pay you double what you're offered.'"

In the United States, the Trump administration has said coronavirus aid to at-risk countries would not include key medical equipment, to meet demand at home.

"I've heard no situation yet in any of our countries where the U.S. has made any medical supplies available anywhere," said Charles Franzen, director of humanitarian and disaster response for World Relief.

When asked how many ventilators and test kits have been sent to Africa, a senior U.S. administration official said aid has focused on water, sanitation and messaging: "We're also looking at the PPE and ventilator needs and will be making those decisions very quickly."

In response, African public and private health sectors have teamed up as never before. "Irresponsible behavior by richer countries" will not solve the pandemic, said Amit Thakker, president of the Africa Healthcare Federation, criticizing "any country that diverts supplies for the sake of their own citizens" at developing countries' expense.

In South Africa, Business for South Africa works closely with the health ministry to get supplies. With better-resourced countries more likely to score deals, "that's not great for Africa. ... Ventilators are like trying to spot a dodo bird at the moment, literally," said Stavros Nicolaou, who leads BSA's efforts.

But South Africa has used relationships with economic allies to obtain drugs from India and protective gear from China.

And yet, South Africa has only about four weeks' worth of protective gear, Nicolaou said. With the pandemic arriving in Africa later than elsewhere, "we have entered the fray quite late when the supply chain is highly, highly constrained."

Global powers must share, especially as the pandemic hits countries at different times, said one of Africa's most prominent philanthropists, Sudanese-born billionaire Mo Ibrahim. "This is the time for everybody to act together, not to compete."

Africa, which has been predicted to be hit hard by coronavirus, has recorded more than 1,000 deaths so far, the Africa Centers for Disease Control and Prevention said Saturday.

The victims include the Nigerian president's chief of staff.

A total of 52 of the continent's 54 countries have reported the coronavirus, with the overall number of cases more than 19,800.

Nigeria's government said Abba Kyari, chief of staff to President MuhammaduBuhari, died Friday of COVID-19. "May God accept his soul," the statement said.

Kyari had been considered by some as Nigeria's most powerful government figure, His infection had been one of the highest-profile in Africa. Several government ministers and a U.S. ambassador were infected with the virus earlier in Burkina Faso.

Kyari announced his illness last month, saying that "I have made my own care arrangements to avoid further burdening the public health system, which faces so many pressures."

He was reported to have been infected during a visit to Germany. He was criticized for not isolating upon his return to Nigeria and accused of infecting other top government officials.

Nigeria currently has nearly 500 cases of the virus.

The World Health Organization on Friday noted a 51% increase in cases in Africa and a 60% jump in deaths in the past week. But the WHO chief warned that because of a shortage of testing "it's likely the real numbers are higher than reported."

The Africa CDC has said more than 1 million test kits will be rolled out starting next week.

Under the best-case scenario, Africa could see 300,000 deaths from coronavirus, according to a new report by the UN Economic Commission Africa that cites modeling by the Imperial College London.

Under the worst-case scenario with no interventions against the virus, Africa could see 3.3 million deaths and 1.2 billion infections, it says.

Even with "intense social distancing" under the best-case scenario the continent could see more than 122 million infections, the report says.

Any of the scenarios would overwhelm Africa's largely fragile and underfunded health systems, experts have warned.

The continent as of Friday had more than 18,000 confirmed virus cases, but experts have said Africa is weeks behind Europe in the pandemic and the rate of increase has looked alarmingly similar.