As Britain prepares to put African poverty top of the agenda at a summit for the Group of Eight industrialised nations in July, parents in Niger are burying infants who died because they are too poor to feed them.
"Children are dying from hunger today," said Johanne Sekkenes, head of mission for Medecins Sans Frontieres (MSF) in Niger, a West African state on the Sahara's southern fringe.
"The problem is that nobody cares," she said in the capital Niamey on Monday. "The big donors accept this unacceptable situation in Niger."
Ranked as the world's second poorest state according to UN statistics, Niger is a vast, mainly desert country where most of the 12 million inhabitants survive on what they can grow or herd with the little rain that falls.
This year, 3.6 million people need food aid, although for the most part it has yet to arrive.
Drought and swarms of locusts that ravaged crops last year have focused outside attention on Niger, lifting the lid on what aid workers are calling a "chronic emergency" that leaves children severely malnourished even in good years.
About 250 severely malnourished children were being admitted
each week to feeding centres run by MSF in the southern town of Maradi in March, more than three times the number of the previous year, pointing to worse hunger ahead.
Sekkenes said the government and donors should immediately provide free food and healthcare for the most needy people, scattered across the semi-arid south of the country.
"Children are dying from hunger today. The problem is that nobody cares. The big donors accept this unacceptable situation in Niger"
Medecins Sans Frontieres
"The poorest people in the world have to pay for their food and they have to pay for their healthcare," she said. "They need free food distribution now, especially for the worst-affected populations."
Niger's government, one of the poorest in the world, has offered to loan basic staples, such as millet and beans, to families, who must then pay it back after the next harvest. Access to free healthcare is extremely limited.
Sekkenes said Niger, which apart from uranium has precious few resources, had simply failed to attract the kind of sustained food and agricultural aid necessary over the years to drag itself out of a permanent hand-to-mouth existence.
"The donors, the international community, they don't even know where Niger is," she said. "There's no interest in investing or putting in more donations."
Conflict has rendered hundreds of thousands of Africans dependent on food aid in otherwise fertile areas in places such as northern Uganda, Liberia, eastern Democratic Republic of Congo, and southern Sudan.
Niger is the world's second
In Niger, it is the sheer harshness of the environment and lack of development that has caused much of the problem.
The Niger river that flows through the capital is the only reliable source of water, while surging population growth rates mean mothers often have eight mouths to feed.
Roughly one in four children dies before its fifth birthday.