Millions of people across East and Southern Africa are at risk of starvation, disease and lack of water as possibly the most powerful El Nino on record strengthens.
Humanitarian agencies have issued warnings of a major food crisis and are making the case for an urgent need to scale up the humanitarian response in countries already in crisis.
According to the Famine Early Warnings System network (FEWS), much of East Africa, including South Sudan, Sudan and Somalia, is already in a place of emergency on the hunger scale.
Ethiopia, struggling with the worst drought in 50 years, has 8.2 million people in need of emergency food aid, according to the UN.
"It's already too late for some regions to avoid a major emergency," write Oxfam in their report, El Nino: The Case for Urgent Action. "It will cost at least $1.4 billion to respond to the emergency in Ethiopia," they add.
The global children's charity Unicef has warned that 11 million children in Eastern and Southern Africa are at risk from hunger and disease as a result of El Nino.
Unicef also said in their report, A Wake Up Call: El Nino's Impact on Children, that the erratic weather phenomenon is likely to cause floods, as well as drought.
Severe flooding is anticipated along the Shebelle and Juma rivers in Somalia, already in the grip of a serious humanitarian situation following decades of conflict.
In Kenya, the government estimated that 2.5 million children may be affected by floods, landslides, mudslides and diseases linked to the El Nino rains.
In southern Africa, Zimbabwe, Malawi, Botswana, Namibia and South Africa have been hit by drought.
In Malawi, where almost half the children are already undernourished, Unicef fears the worst drought in almost a decade could cause a further increase in acute malnutrition.
In Zimbabwe, the number of people in need of food aid was expected to reach 1.5 million by the time the January-March "lean season" sets in, Unicef has said.
According to the Botswana Agricultural Marketing Board, the country is facing food shortage, as maize and cereals are in short supply due to the impact of drought on last year’s harvest.
The drought in South Africa is reported to be the worst since 1982, with at least 2.7 million people facing water and food shortages.
The country has declared five of its main cereal producing regions in a state of drought. Lesotho has issued a drought mitigation plan and Swaziland has implemented water restrictions as reservoir levels have become low.
The Food and Agriculture Organisation has issued an alert for southern Africa, saying that the failing crop output will impact greatly on food security.
In Namibia, water suppliers, NamWater, have warned that towns in the centre of the country, including the capital, Windhoek, will run dry by September 2016 unless rains refill three emptying dams that supply the cities. The persistent drought is also reported to have killed hundreds of cattle in the farming region of Omaheke.
El Niño is a climate pattern linked to the warming of surface waters in the Pacific Ocean, typically causing drought in some regions and severe flooding in others. El Niño events tend to happen every two to seven years, but, according to the Unicef report, scientists believe they may be becoming more intense as a result of climate change. Forecasters say this year’s event could become more powerful than the 1997-98 El Niño, the strongest on record, which was blamed for an estimated 23,000 deaths and $35-45 billion in damages.