ISTANBUL/SANAA - In 1984 and 1985, about a million people died in Ethiopia in a famine that was widely broadcast on international television.

Eventually, rock stars and royals swooped onto the world stage, raising millions of dollars slated for emergency aid.

Now, decades later, across the Gulf of Aden, a similar tragedy is unfolding in Yemen, only without the rescue efforts championed by the glitterati.

"We see a dramatic degradation of the humanitarian situation," said United Nations Secretary-General Antonio Guterres at a press conference. "And the risk ... of a famine would probably have had no parallel in recent history, except for the famous famine in Ethiopia many decades ago."

The humanitarian crisis in Yemen has been called the "world's worst" for years now, as the country reels from a brutal war, economic collapse, and a barrage of diseases like cholera, dengue fever and malaria. COVID-19 cases are relatively low, but those infected are 10 times more likely to die than people in many other countries.

COVID-19 is the disease caused by the coronavirus. Yemen has recorded a total of 2,114 cases and 609 deaths, according to the Johns Hopkins University.

The U.N. says roughly 80 percent of the population, about 24 million people, are in urgent need of humanitarian aid. And now, millions of people, including hundreds of thousands of children under the age of five, are said to be on the verge of starvation. 

"It is a terrible, agonizing and humiliating death," said the U.N.'s aid chief, Mark Lowcock, in an online conference. "And it's particularly cruel in a world like ours where there is, in fact, more than enough food for everyone."

Pandemic pressure

Abdo Rashedy, a shepherd in the Yemeni capital, Sanaa, was 40 years old when he contracted COVID-19 in June.

A week later, he died.

"So many people were infected with diseases at the hospital," said his brother, Ali Yahya Reshedy, 45, in his Sanaa home six months later. "The hospital just didn't have the supplies."

Hospitals in Yemen have long lacked funding, staff and equipment but in recent years, the health care system has fallen into almost total disrepair, according to Yemeni doctors. Roughly half of all Yemeni health care facilities have been destroyed in nearly six years of war that has killed more than 100,000 people.

"Things are much harder now," said Qaid Rajeh Halboob, a Sanaa doctor and father of 10. "Our hospitals are damaged and no one supports us financially."

International observers say Yemen's COVID statistics may be higher than officially recorded, because of lack of testing, reporting, fear of hospitals and stigma.

The pandemic has also put further pressure on the already-strained system, according to the World Health Organization. And as people become more malnourished combined with other health conditions, the need for health care intensifies, said Altaf Musani, the WHO mission head in Yemen, in an email to VOA.

"When their immune system loses strength, men, women and especially children are likelier to fall sick or die from diseases that they may have otherwise resisted," Musani explained.

The cost of war

When Mohammed Taher, 27, became ill with cholera two years ago, he could not stop vomiting so he went to the hospital. The waiting room was packed with patients, mostly children who appeared to have the same disease. Even back then, the treatment was a financial strain for Taher and his family.

Two years later, the value of Yemeni currency has plummeted, and food prices and unemployment have gone up.

"Now everything is too expensive," said Taher.

Nearly 80 percent of the Yemeni people are impoverished, and the U.N. says if the war doesn't end, Yemen could become the world's poorest country by 2022.

But the war is complex, and deeply tied to a multitude of alliances far beyond Yemen's borders. The ongoing civil war between northern and southern Yemen has attracted international allies and foes on both sides, like Saudi Arabia, the United States, and Iran. Within parts of Yemen there are also breakaway regions in addition to tribal and jihadist militant groups.

Recent reports say the United States is considering adding the Houthi militias, formally known as Ansar Allah, and the de facto northern government, to a list of designated terrorist organizations to pressure Iran, a Houthi ally.

Aid organizations say the designation could derail efforts to stave off famine by limiting their access to impacted regions. It could also further complicate Yemen's shattered economy, driving up food prices and fueling the famine, according to the Reuters news agency.

"Yemen is now in imminent danger of the worst famine the world has seen for decades," said Secretary-General Guterres in a statement on Friday. "In the absence of immediate action, millions of lives may be lost."