A prominent famine monitor created by the U.S. government has acknowledged that the U.S.-backed war in Yemen has fueled the “largest food security emergency in the world.” And acording to its analysis, the catastrophic situation only continues to get worse.

Since March 2015, the U.S. has supported a Saudi-led coalition that has bombed Yemen, the poorest country in the Middle East. With tens of billions of dollars worth of American and British weapons, more than 1,000 refueling sorties by U.S. planes and intelligence and guidance from the American and British militaries, Saudi Arabia has carried out thousands of airstrikes, at least one-third of which have struck civilian sites.

The Western-backed, Saudi-led coalition has also intentionally targeted food production and the agricultural sector in its bombing campaign in Yemen, in what a leading expert has described as a “scorched-earth strategy.”

In August, the United Nations reported that more than 10,000 Yemenis had been killed, with an average of 13 civilian casualties per day, in a U.S.-fueled war that has gotten little attention in the U.S. media and which received virtually no mention in the entirety of the 2016 presidential campaign.

The war has plunged Yemen into what the U.N. has characterized as one of the world’s worst humanitarian crises. Yemen already suffered from widespread food insecurity before the coalition launched its bombing campaign and implemented a blockade 21 months ago. Since then, the U.N. has repeatedly reported that more than half of Yemen’s population is going hungry and that millions are on the brink of famine.

In a report released in December, the Famine Early Warning Systems Network warned, “Conflict in Yemen is the primary driver of the largest food security emergency in the world.”

The Famine Early Warning Systems Network is a leading monitor of global food insecurity, created by the U.S. Agency for International Development, or USAID, in 1985. The monitor is not officially part of the U.S. government, but works with a variety of government agencies.

According to the group’s report, hunger in Yemen is getting worse. Although there is limited access to data, the food security and nutrition data available from the governorate of al-Hudayda, one of Yemen’s largest urban centers, suggests that hunger is on the rise. The number of children with severe acute malnutrition admitted to treatment programs in the governorate has increased by roughly 40 percent, compared to 2014 and 2015 levels.

The Famine Early Warning Systems Network gauges the severity of a hunger crisis on a five-point scale, in which IPC Phase 5 is “Famine” and IPC Phase 1 is “Minimal.” In Yemen, at least 2 million people are in IPC Phase 4: Emergency. They “face an increased risk of mortality” from hunger, the monitor says. An additional 5 to 8 million Yemenis are classified in IPC Phase 3: Crisis, and “in need of urgent humanitarian assistance.”

The Famine Early Warning Systems Network’s analysis of food insecurity in Yemen in December 2016.

The whole western half of Yemen, the more populated part of the country with the large urban centers, is in IPC Phase 3: Crisis, according to the monitor. A large strip on the western coast, including the major cities al-Hudayda and Taizz, is in IPC Phase 4: Emergency.

In the upcoming months, between February and May, the Famine Early Warning Systems Network estimates that large swaths of the country will also be plunged into emergency status, including the capital, Sanaa, along with the Saada, Hajja and Shabwa governorates.

More than 14 million Yemenis are already food insecure, according to the U.N. Office for the Coordination of Humanitarian Affairs, in a population of 26 million. The World Food Program is providing assistance to an average of 3.5 million Yemenis per month, but the Famine Early Warning Systems Network warns this “is not sufficient to meet Yemen’s current needs.”

War crimes and targeting of civilian areas

Since March 2015, a coalition of Middle Eastern countries led by Saudi Arabia and armed and supported by the U.S. and the U.K., has sought to topple Yemen’s Houthi movement, which seized power in late 2014, and Houthi-allied forces loyal to former Yemeni leader Ali Abdullah Saleh. The coalition has carried out thousands of airstrikes in hopes of restoring to power the former pro-Saudi leader Abd-Rabbu Mansour Hadi, who was ousted by the Houthis. Hadi had been appointed president in 2012, after winning a putative election in which there were no opposition candidates.

Human rights groups have documented a vast array of atrocities committed on both sides of the war. The U.N. has nevertheless repeatedly reported that the Western-backed, Saudi-led coalition is responsible for nearly two-thirds of civilian casualties, whereas the Houthis and allied pro-Saleh militias have been responsible for less than one-fourth. The rest of the atrocities have been committed by extremist groups like al-Qaeda and ISIS, which have been strengthened by the U.S.-backed war.

The U.N., Human Rights Watch and Amnesty International have on several occasions accused the coalition of carrying out apparent war crimes, documenting Saudi-led bombing of a slew of civilian sites, including hospitals, schools, homes, weddings, funerals, and refugee camps. Cluster munitions, which are banned in much of the world, provided by the U.S. and U.K. have also been used in civilian areas.

Research conducted by Martha Mundy, a professor emeritus at the London School of Economics, has shown how the coalition is deliberately bombing targets that are part of the system of food production and agricultural sector in Yemen.

A blockade the coalition imposed in early 2015 has also fueled the humanitarian catastrophe. The blockade was ostensibly created in order to prevent foreign actors from arming the Houthis and pro-Saleh militias. Saudi Arabia and the U.S. have accused Iran of arming the Houthi-Saleh forces. The extent to which Iran is involved in the conflict is debated, nonetheless, and has often been exaggerated.

Before the war began, Yemen imported 90 percent of its food; the blockade has thus plunged the impoverished country into even worse hunger. The U.S. Navy has helped to implement the Saudi-led coalition’s blockade since it was first established.

The war has led to the displacement of more than 3 million Yemenis. Since the summer of 2015, humanitarian groups have warned that more than 80 percent of Yemen’s population has been in desperate need of aid, in the form of food, water, medicine, and oil.

The war has also totally decimated the poorest country in the Middle East’s fragile economy. In November, the New York Times reported that the coalition has been “systematically obliterating Yemen’s already bare-bones economy.”

Health crisis

Growing hunger is an enormous problem in Yemen, but it is by no means the only one. A public health crisis has also taken thousands of lives. The coalition has bombed scores of hospitals and medical facilities in Yemen. The U.N. has repeatedly warned that Yemen’s health-care system is “on the verge of collapse.” Less than one-third of the population has access to medical care, and more than half of Yemen’s health facilities are non-functional.

Every week, more than 1,000 Yemeni children die due to preventable diseases — an average of one child every 10 minutes — according to UNICEF. Thousands are perishing from malnutrition, diarrhea, and respiratory infections. More than 2.2 million Yemeni children need urgent care, and at least 462,000 are suffering from severe acute malnutrition, at risk of starvation, a 200 percent increase since 2014.

“The state of health of children in the Middle East’s poorest country has never been as catastrophic as it is today,” Meritxell Relano, the deputy UNICEF representative in Yemen, warned in December. “Malnutrition in Yemen is at an all-time high and increasing.”

Cholera, which had nearly been eradicated, is also on the rise on Yemen. In its December humanitarian bulletin, the U.N. Office for the Coordination of Humanitarian Affairs reported that it had documented 122 confirmed cases of the disease in 12 governorates, with 7,700 more suspected cases.