A million children in West Africa’s Sahel region could face death or permanent disability from acute malnutrition this year, Voice of America reports.

UNICEF has called for $67 million in emergency donations to buy fortified food products as part of an effort to raise $120 million to stave off a massive famine in the region. So far, the organization has raised just $9 million.

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The Sahel, on the fringes of the Sahara desert, is one of the poorest areas on earth, with a long history of drought, famine and overpopulation.

As many as 23 million people could face a food shortages in Niger, Chad, Mali, Burkina Faso, Mauritania, Senegal, Nigeria and Cameroon this spring, brought on by failed harvests, according to the UN. It is expected to be the worst famine in decades, according to Agence France-Presse.

Momodou Lamin Fye, who represents the International Federation of Red Cross and Red Crescent Societies in the Sahel, said in Mauritania, the crisis has already hit.

"I saw for myself how severe the situation is," he said, according to AFP. "It could quickly develop into a humanitarian disaster if the world does not start paying attention to the plight."

Aid organizations complain that the funding needed to avert famine in East Africa last year did not come through until children were dying, and the crisis became a news story. For many victims, it was already too late.

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Last minute funding also wastes resources that could be used to save lives, UNICEF spokesperson Marixie Mercado told VOA. For example, shipping 100 tons of ready-to-use therapeutic food (RUTF) by sea cost $13,000. If purchased at the last minute and flown into the Sahel by emergency airlift, the same provisions will cost $350,000.

“We need to place orders for RUTF about six months in advance so that they can continue producing the quantities that we need in order to save lives,” she told VOA. “If we do not have the funding immediately available, we cannot start placing orders so that production can continue at the speed and rate that pre-positioning requires.”

The Sahel region is still recovering from a 2010 famine that affected 10 million people. Increasing instability furthers the suffering in the region, according to the UNICEF 2012 Humanitarian Action for Children report:

"There is growing instability in the Sahel region, fuelled by the Arab Spring and increasing activities of Al Qaeda in the Islamic Maghreb and Boko Haram, all compounding the humanitarian needs of children and women in the region.”