A severely malnourished child from the South Sudanese town of Leer receives treatment at the inpatient ward run by International Medical Corps at the Protection of Civilians site in Juba, South Sudan's capital, on March 22, 2016
Lynsey Addario—Getty Images Reportage for TIME
March 3, 2017 1:00 PM EST

The declaration of famine in parts of South Sudan on Feb. 20, the first announcement of its kind in almost six years, is but the beginning of a cascade of similar pronouncements to come. Yemen, northern Nigeria and Somalia are also on the brink of famine, warns the Famine Early Warning Systems Network. According to the International Federation of Red Cross in Africa, another 32 million people in southern Africa face extreme food insecurity. If nothing is done, officials at the U.N. World Food Programme have warned, some 20 million people could starve to death during the next six months.

That is the least of the devastation, however. Famine doesn’t just kill; it leaves debilitating scars on a nation’s development that endure for decades, perpetuating a cycle of poverty and aid dependency. Yet the call to prevent famine is never as widely shouted, nor as eagerly answered, as the urgent demands to bring it to a halt. It’s time to change the stakes.

Famine, in technical terms, doesn’t just mean people are going hungry. It means they are already starving to death—two adults or four children a day per every 10,000 people. So by the time famine is formally declared, millions have already been suffering, perhaps for years: humanitarian agencies like Oxfam first warned about a looming famine in South Sudan back in March 2015. The last time famine was formally declared, in Somalia in 2011, most of the 260,000 victims had already died.

By the time the inevitable photos of emaciated bodies and wizened children with extended bellies appear in the media, it is almost always too late. The extended periods of mal­nutrition leading up to famine can result in catastrophic developmental stunting in children. When children are chronically malnourished, their brains don’t develop properly, says Adeiza Ben Adinoyi, head of the International Federation of Red Cross and Red Crescent Societies’ health unit for Africa. As a result, they may suffer permanently impaired brain function alongside the more visible effects of stunted growth. The impact on countries afflicted by food shortages is generational; scores unable to reach their full potential, resulting in lost incomes and fewer opportunities.

Spread across a wide enough swath of the population, it could mean an entire generation afflicted by lower-than-average IQ, poor cognition and reduced earnings. The World Bank estimates that productivity and economic growth lost to malnutrition could be worth 11% of annual GDP in sub-Saharan Africa and Asia. This can lead to desperate choices, according to Adinoyi. Some suffering from the ­developmental legacy of malnutrition may join criminal gangs out of a lack of options; others could be drawn to militias, like the ones in South Sudan, which suffered its own famine in 1998, before it gained independence from Sudan. Those are the militias that are largely responsible for today’s famine, because the ongoing civil war has prevented farmers from growing crops for the past several seasons. “Famine just keeps the poverty cycle going,” says Adinoyi.

UNICEF has now released an appeal to the international community for urgent aid to help 1.4 million children severely malnourished in Somalia, Yemen, Nigeria and South Sudan. But in a time of seemingly unprecedented global suffering—the Rohingya in Myanmar, the war in Syria, Islamic extremism in West Africa—it’s hard to break through. If empathy is stretched thin, maybe it’s time to start appealing to global self-interest instead. Famine drives people in afflicted areas to seek opportunities elsewhere, fueling the refugee crisis in Europe and across the globe. “Ultimately the consequences of malnutrition—hunger, war, poverty—these are the push factors of migration,” Adinoyi says.

Last year, 4,581 people died trying to cross the hazardous stretch of the Mediterranean Sea from Libya to Italy, according to the U.N.—a route popular with migrants from many of the countries descending into famine. The European Union has recently backed a $212 million agreement between Italy, Libya, Tunisia and Nigeria to fund better policing to deter migrants from traveling to Europe. If that kind of money had been spent a generation ago on preventing malnutrition, then perhaps some of those people might not have left their countries in the first place.

Baker is TIME’s Africa bureau chief

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