Things are very different in Nigeria. Eight years into the Boko Haram crisis, the momentum of the humanitarian response is finally beginning to build.

But the extent of the problem is huge. Some 5.1 million people are food insecure out of a population of 5.8 million in the three affected northeastern states. But only a fraction – 1.9 million – are being reached.

This is a crisis of both funding and access. Some $1.1 billion is needed this year for humanitarian action, but the response plan has so far received only $160 million. And despite the government’s repeated promise that the insurgency has been broken, the security situation is fluid, limiting the reach of aid workers. That means the humanitarian presence is at its weakest in the areas where it is most urgently needed.

The emergency has been slow to reveal its true scale. Boko Haram was in control of much of the northeast by 2014, effectively locking up the rural population. Those that could escape did, mostly heading to Maiduguri, the capital of Borno State. But little was known of the needs of the many more left behind.

It’s now clear they are substantial. The military’s advance is breaking Boko Haram’s hold, and, as it does, people are emerging, looking for help. “They are hungry and malnourished; some are incoherent; they have clearly been through a lot,” said Malik Samuel, field communications manager for Médecins Sans Frontières.

As the military liberates the last remaining areas of the northeast, along the northern border with Niger, it’s possible that pockets of starving people in localised famines will be found. The aid response is already stretched. Will it be able to cope? Can it be sustained?

The hope is that it will be more effective than last year, when the USAID-funded early warning system, FEWS NET, said that famine had “likely occurred” in Bama and Banki – two towns the military recaptured in 2015.

The army was unable to care for the people arriving from the surrounding countryside. Although Bama is only 74 kilometres from Maiduguri, as many as 2,000 “famine-related deaths” may have occurred. The situation was likely worse outside the town. We don’t know, because the area was deemed too high-risk to venture into by most aid agencies.

Bama is now flooded with aid workers. “The government and NGOs stepped up,” said Samuel. “Across the northeast, the aid response is better.”

It’s certainly more coordinated than it was. There are more skilled staff available, and the at-times tetchy relationship with government authorities has become smoother. But there are still serious gaps. The army nominally controls 23 out of the 27 Local Government Areas in Borno. But its hold is typically restricted to the main town in the area, where the aid operation is based, feeding the displaced who make it out of still-inaccessible rural zones.

“In some [LGAs], there is still not enough food [distributed],” said Adrian Ouvry, regional humanitarian advisor for Mercy Corps. “In some areas, there is not enough fuel wood, so even if you have the food you can’t cook it.”

Food security is also about functioning markets: Farmers need to be able to sell their produce. But those trade links between the towns and the countryside have been severed by the conflict. Boko Haram turned to requisitioning the food it needed, and as a result farmers planted less and less.

The government’s counter-insurgency approach also deepened the isolation of the rural population. Fearful of Boko Haram’s mobility and the threat of infiltration, it banned fuel sales and restricted movement. The closure of the borders – where it could be enforced – also hit agricultural trade, especially the once-thriving livestock business that historically stretched as far as Central African Republic.

Nigeria is in recession as a result of slumping oil prices and the naira’s freefalling exchange rate against the dollar. Year-on-year inflation hit 19 percent in January, pushing up prices of local and imported staples. This is also being felt keenly in neighbouring Sahelian countries that are struggling already and depend on smuggled Nigerian produce.

Some 1.8 million people are displaced in the three northeastern states of Adamawa, Borno, and Yobe. The bulk are in Maiduguri, whose population has doubled to two million. Rather than settling in poorly serviced official camps, more than 80 percent of these victims of the war live with friends and relatives in the community, further straining households.

Nigeria’s northeast had always been food secure and self-sufficient. But for a third consecutive year farmers have been unable to return to the land for the planting season. The Borno State government, possibly as a sign of frustration, has called for IDPs to head back to their homes by 29 May.

This is widely seen as an impossible goal given the insecurity, the lack of government services, and the deliberate destruction of infrastructure by Boko Haram, which, according to the World Bank, includes 30 percent of homes in Borno.

The best that could be achieved would be the return of people to the largest towns in the LGAs, but this only relocates the problem of caring for those in need to strained urban centres.

The Nigerian government has given assurances that nobody will be forced to move against their will. That is not the case with neighbouring Cameroon, which is “deporting Nigerians on a daily basis”, said MSF’s Samuel. This is despite a tripartite agreement, also signed by the UN’s refugee agency (UNHCR), that forbids refoulement. Nigerians are being forced onto trucks and dumped on the border, where they have a long wait – sometimes weeks – before they receive any assistance.

It’s a reminder that this is a regional emergency. Boko Haram attacks have spilled over into Chad, Niger, and Cameroon, all of which are sheltering Nigerian refugees and their own displaced as a result of the violence. And this is a fragile Sahelian zone, also grappling with the growing impact of climate change and endemic poverty.