Relief workers say the devastation from AIDS is combining with the effects of poverty, war, bad governance, corruption and erratic weather to cripple the ability of societies in sub-Saharan Africa to recover from famine.
"The stark message is this crisis is not going to go away. We will have a perpetual crisis," said Brenda Barton, the World Food Program spokeswoman in Nairobi, Kenya.
"We are seeing a redefinition of famine, of humanitarian crises as we know them," she said.
Within the United Nations that new definition is known as "new variant famine." It means that despite the best efforts of aid groups and donors, population losses to AIDS are wrecking agriculture, economies and health systems.
Some 29 million people in sub-Saharan Africa are infected with HIV, about 70 percent of the world's total. Overall, 9 percent of adults in the region of 633 million people are infected, but the rate ranges up to nearly 40 percent in some places. In those countries life expectancy has already fallen into the 30s because of the growing pandemic.
In less than 20 years, the United Nations says, AIDS has killed more than 8 million farmworkers in Africa. It has killed the breadwinner in millions of families, devastated poor rural villages, orphaned 4.2 million children.
"It is driving another stake into the heart of the poor. How do you recover when no one is alive to plant the food?" said Barton.
"What you are seeing is the humbling of society," she added. "We have not seen the peak of the HIV statistics. We have not seen the worst of it."
In fertile fields around Chimbombo, 90 kilometers (55 miles) north of Lusaka, Zambia's capital, a U.S.-government sponsored aid group, the Cooperative League of the U.S.A., teaches subsistence farmers techniques for dealing with drought and increasing crop yields.
Behind one ramshackle house a small boy hacks at the reluctant earth with a long-handled hoe. His mother, Freda Sichalwe, walks through tall, uneven rows of healthy corn. She says the new methods have increased the yield from her small plot fivefold. After the harvest, she will no longer need food aid for her family of six and will also have some corn to sell.
Kinston Munkonze, of the Cooperative League, said 500 of the farmers he works with around Chimbombo have shown similar gains. The other 300 have at least doubled their crops, he said.
All over Africa, humanitarian groups work tirelessly to use food aid to pay for agricultural improvements and maintain farm families while they learn new techniques. They also try to introduce new drought-resistent crops in some places, lower trade barriers and improve market conditions.
Despite limited successes, relief efforts are like spitting in the wind, said Renny Nancholas, the Southern Africa food security coordinator for the International Federation of the Red Cross and Red Crescent societies.
"No one organization is ever going to dent such a huge crisis," Nancholas said. "It is really getting out of control."
Brenda Cupper, the program director for the aid group CARE in Zambia, agreed. "We need a unified strategy and we don't have one," she said.
Donor response to the current food crisis has been adequate so far, but aid workers worry that the war in Iraq and humanitarian needs elsewhere may cut into the help coming to Africa.
"We have prevented a catastrophe, but the crisis is far from over," said Barton.
With this crisis, aid groups find they must feed increasing numbers of people in major urban centers who simply can't afford to buy food.
The United Nations says 300 million people in Africa — 51 percent of the sub-Saharan population — struggle to live on less than a dollar a day. The World Bank estimates the number could rise to 345 million by 2015.
Africa is the poorest continent, the only one to have declined since 1960. Bad governance and widespread corruption have contributed to the fall and to the lasting hunger crisis.
In Zimbabwe, for example, aid workers say the government has devastated agriculture by seizing commercial farms in a hasty and violent land reform program. Fertile land now lies fallow, and a country that was a regional breadbasket now has 7 million people in danger of starvation.
Aid workers and Western diplomats say about 200,000 metric tons of government food aid to Zimbabwe is unaccounted for, an amount roughly equal to what the World Food Program delivered to feed 4 million people in February.
The missing food probably was diverted to the black market, they say. There, a sack of corn meal, the staple food, sells for 10 times the official price.
Diplomats and aid workers also say a third of government-produced fertilizer has been sold illegally in neighboring countries.
In Malawi, the government sold off its food reserves in 2001, at a time when the United Nations said food shortages were becoming apparent. The International Monetary Fund says official corruption cost Angola more than the value of its international aid requests.
But the single biggest factor in the persistent hunger is the AIDS pandemic, said Richard Ragan, the World Food Program's country director in Zambia.
"It permeates everything you do in this part of the world," he said.
Ragan said AIDS lowers production, increases poverty and inhibits the ability of agencies to react to crises.
As an example, he noted the World Food Program had trained 40 African road engineers to look at roads and help plan the distribution of food aid. "Only four of them are still alive," he said.
To conquer hunger, the United Nations and African governments must wage an all-out, coordinated campaign against AIDS, Ragan said.
"If they don't, it is going to decimate the entire continent," he said.