The United Nations is calling on Canada to increase its efforts to help starving people in northeast Nigeria, victims of the fallout from Boko Haram's Islamist insurgency, warning hundreds of thousands could die if nothing is done.

The world body's assistant secretary general in the Sahel region of West Africa, Toby Lanzer, told CBC News that international action is needed immediately to prevent an already acute human tragedy from getting worse.

More than 50,000 people are already in a state of famine, Lanzer said, a fact acknowledged by Nigerian government officials as well as UN agencies and other non-governmental organizations working in the region.

'No amount of international assistance, no amount food from local communities — and there really isn't any left — will keep those people alive.' - Toby Lanzer, UN assistant secretary general in the Sahel region, West Africa

"No amount of international assistance, no amount food from local communities — and there really isn't any left — will keep those people alive," Lanzer said.

Another 4.5 million people are "living on the edge," facing chronic food shortages and severe malnutrition, he said. 

"We will see mass deaths in the northeast of Nigeria next year," he said.

The hardest hit are three states in the northeast of the country: Adamawa, Yobe and Borno, the epicentre of the Boko Haram insurgency. The UN's Office for the Coordination of Humanitarian Affairs has said 8.5 million in those three states are in need of "life-saving assistance." 

Seven-year conflict has displaced 2.6M

Boko Haram militants, who want to create an Islamic caliphate in the northeast, have been fighting government forces from Nigeria and surrounding countries for seven years. 

They have killed and kidnapped people at will, destroying towns and villages and seizing territory equivalent in size to Belgium.  

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This woman sought help for her malnourished baby at a public health facility in the Dalaram district of Maiduguri in northeast Nigeria in September. About 450,000 children in northeast Nigeria are facing acute malnutrition. (Stefan Heunis/AFP/Getty Images)

The insurgency has killed 20,000 people, left farmlands ravaged and forced more than 2.6 million from their homes.

In the past 12 months, the Nigerian military has recaptured much of the territory once held by Boko Haram, but fighting continues, and many who fled now fear returning home. 

Nigeria's economy — on paper Africa's biggest — is at the same time in recession, which has ramped up the prices of food and other essential items, hitting hardest those who have fled the violence with little more than the clothes on their backs.

The UN's Lanzer said in an interview with the CBC that there was "no greater need" on the continent than in northeast Nigeria and in neighbouring Cameroon, Chad and Niger, which have also been hit by waves of fighting and suicide bombings.

"There is absolutely no bigger crisis or deeper suffering than that which boys and girls are enduring on a daily basis in the northeast of Nigeria," he said.

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Children gather next to a food truck after it arrives at a camp for internally displaced people in Maiduguri, a city in Borno state that has been at the epicentre of the fighting between Islamist militants and government forces. (Afolabi Sotunde/Reuters)

Earlier this month, a UN appeal, backed by the Nigerian government, was launched, calling for $1.054 billion US to fund humanitarian projects in the northeast over the next 12 months.

Food is the most pressing need, with 450,000 children facing acute malnutrition, according to UNICEF.

Famine declaration came too late for Somalia

But Lanzer said he is still optimistic the declaration of a widespread famine can be avoided even though some areas of the northeast are still inaccessible because of sporadic Boko Haram attacks, and the full picture is not known.

"I do want to avoid what happened a few years back in Somalia. People waited for a famine declaration, and then the scale-up of international solidarity was seen, and in the meantime 300,000 people had died," he said.

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Nigerian soldiers hold up a Boko Haram flag they seized in the town of Damasak in Borno state. Boko Haram has been fighting a seven-year insurgency against the government in hopes of creating an Islamic state. (Emmanuel Braun/Reuters)

Famine Early Warning System (FEWS), a USAID group of development experts who provides analysis of food insecurity, released a report this month that says a famine likely occurred in the towns of Bama and Banki, near the border with Cameroon, where many displaced people ended up, and surrounding areas in northeast Nigeria in 2016.

FEWS says there is an elevated likelihood that famine is ongoing and will continue in the inaccessible areas of Borno state and that the current response is insufficient to meet the very large emergency assistance needs.

Outbreaks of preventable childhood diseases

The conflict in northeast Nigeria has failed to make as much of an impact in the West as the crises in Yemen and South Sudan despite similar issues and greater numbers of people involved.

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A doctor feeds a malnourished child at a feeding centre run by Doctors Without Borders in Maiduguri. Along with malnutrition, the conflict has also compromised the health of the population in northeast Nigeria in other ways, with outbreak of preventable diseases such as measles and polio and inadequate treatment of chronic conditions such as HIV/AIDS. (Sunday Alamba/Associated Press)

As well as food insecurity, there have been outbreaks of preventable childhood diseases, such as measles and polio. Of the more than 100,000 people in Borno state living with HIV/AIDS, only 11,000 are accessing anti-retroviral therapy, according to the UN's Office for the Coordination of Humanitarian Affairs.

In Borno state alone more than 300 health facilities have been damaged or destroyed.

International assistance has been scaled up in recent months, helping tens of thousands of people in camps for the internally displaced or living with friends and family, with essential food supplies, clean water and vital health care.

'We now need to see [international solidarity] from a broader range of countries across the globe standing with the people of Nigeria, and I invite Canada to step up to the plate.' - Toby Lanzer

But Lanzer says it will take a lot more to help those suffering in the northeast of the country.

"There needs to be a very strong signal of international solidarity," he said. "And I think we are seeing this from London, we're seeing it from Washington and from Brussels.

"We now need to see it from a broader range of countries across the globe standing with the people of Nigeria, and I invite Canada to step up to the plate."​