Africa is facing a hunger crisis as soaring food costs sparked by the Iran war compound the toll of foreign aid cuts and erratic weather that has already devastated crops.

Clinics treating malnourished children in Somalia have had to cut rations, with almost 500,000 children under five in the country facing severe acute malnutrition, Reuters reported. A pattern of droughts and floods has worsened the toll.

Elsewhere, the World Food Programme has estimated that as many as 45 million more people worldwide could face “acute” levels of hunger due to a global fertilizer crunch and higher transportation and refrigeration costs for food prompted by the Iran war. “We are on borrowed time,” an energy expert told the Financial Times.