2.6 million people are in need of humanitarian assistance. Combined effects of consecutive seasons of failed or poor rainfall, continuing conflict, rising inflation, massive displacement, and diarrheal disease outbreaks have severely exacerbated food security situation and resulted in an increase in acute malnutrition rates. The poor performance of the 2008 seasonal rains has significantly reduced access to clean water, resulting in an increase in water-related diseases in drought-affected areas. An outbreak of AWD was reported in Barghaal District, Bari Region, in Puntland.