The West has "completely failed" the people of Somalia and must refocus efforts to give humanitarian workers safer access to desperate civilians, 52 aid agencies said in a statement.
More than 3.2 million people, almost half of the country's population, need immediate help, a 77 per cent rise since the beginning of the year, they said.
But there has never been a more dangerous time for international aid staff to try to deliver assistance as violence has soared, including the assassination or kidnapping of aid workers.
"The international community has completely failed Somali civilians," said the agencies' statement, signed by Oxfam, Merlin, Save The Children and 49 others.
"National and international aid agencies are prevented from responding effectively to the needs of ordinary Somalis because of violence and severely limited access.
"At present, South and Central Somalia is almost entirely off limits to international staff of aid agencies."
Somalia's dire situation - worse than at almost any time in the past, aid workers say - has been driven by the worsening violence, drought following the fourth consecutive failed rains, and hyperinflation caused by record food prices which have risen 1,000 per cent in some areas.
This "toxic cocktail" of factors has driven 870,000 people from their homes since the start of 2007, most of them into makeshift camps with little clean water, shelter or medicine.
The capital, Mogadishu, is fast becoming a ghost town. Almost 40,000 people have fled in the last two weeks alone.
Fighting between the weak transitional government, with its Ethiopian military backers, and an Islamist-led insurgency has worsened throughout 2008.
Privately, diplomats and analysts said that targeted sanctions against known warlords or corrupt officials could be one of the few "sticks" that the international community has to effect any change on the situation.
The United Nations is supporting peace talks between a faction of the country's government and some moderate figures in the Islamist opposition.
But any deal will likely be worthless as it will not have the support of the remaining majority on both sides.
"Despite the ongoing political process we have not witnessed any lessening of the violence that continues to have a horrendous impact on civilians," the statement continued.
"The situation is expected to deteriorate further with ordinary Somalis bearing the brunt of the cost."
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