Hunger is expected to reach emergency levels by the end of the year in drought-hit southern Madagascar, where many families already have been forced to sell their homes or land, or migrate, the World Food Program (WFP) warned Thursday. At least 1 million people need food and cash aid, and about 200,000 pregnant women and children under age five need treatment for acute hunger, the U.N. agency said. Four of the nine districts in the southern tip of the island are likely to fall to emergency hunger levels by year-end, according to preliminary results of a food assessment carried out by WFP and other agencies. The survey also found that three more districts could follow unless rapid action is taken. The districts are currently in phase three of a five-point scale used by food agencies, where five is famine. "The situation is extremely worrying," WFP Director Ertharin Cousin said as she concluded a visit to Madagascar this week. "I met women who told me they had nothing to feed their babies except the fruit of the red cactus growing by the roadside." Overall, 1.2 million people in southern Madagascar are food insecure, with 600,000 severely food insecure, according to an assessment carried out last month by the ministry of agriculture, the WFP, and the U.N. Food and Agriculture Organization (FAO).