In Madagascar, extreme poverty, recurrent natural disasters and a political crisis have created a potent recipe for crisis. The suspension of most external assistance to the country has resulted in reduced capacity of the Government of Madagascar to respond to emergencies. Food insecurity has become a daily reality for many. In fact, unless food insecurity in the southern areas of Androy, Anosy and Atsimo Andrefana is addressed immediately, it is very likely that the nutritional status of 136,000 children-at-risk under age 5 will deteriorate – requiring an emergency intervention during the first three months of 2011. This will be a crucial year for UNICEF in its efforts to improve the welfare of Madagascar’s women and children.