Humanitarian groups are increasingly worried about the looming budget cuts in U.S. foreign assistance. They argue that lives are at stake in places like the Horn of Africa, which is suffering its worst drought in decades.
Raising public and private money for that crisis been a challenge in the current economic environment.
Hollywood stars and politicians have resorted to using the F word — in this case "famine" — to get the attention of Americans about the humanitarian emergency in Somalia.
U2's Bono, actor George Clooney and many others are featured in a video campaign to explain that there are solutions if people and governments are willing to give.
So far aid groups have raised about $60 million from private giving in the U.S., according to Samuel Worthington, who runs InterAction, an alliance of 190 nongovernmental aid groups.
"This is sharply lower than the $1.29 billion that our members, InterAction members, raised for Haiti," he says.
Worthington adds that Americans tend to be generous after dramatic events like earthquakes and tsunamis, but it is harder to generate that kind of response to hunger in a complicated region of Africa. Perhaps, he says, people just don't think there's a solution.
"We do know how to save lives during famines," Worthington says. "We do know how to help farmers plant seeds, and we do know that we could really make a difference in the lives of hundreds of thousands of people in the coming months. The reality is, we do not have the resources to be able to do what we should be able to do."
It's not just the slow pace of private giving in these tough economic times that has aid groups worried.
Tom Hart of the aid advocacy group known as the ONE campaign says the way it looks now, budget cuts will hit foreign aid programs disproportionally — even though they amount to less than 1 percent of the federal budget. And that could undercut the things the U.S. has been able to accomplish in recent years, such as promoting food security.
"Ethiopia and Kenya have experienced the same double drought as Somalia did, and because of good investments in agriculture and pre-positioning of food, Ethiopia and Kenya aren't yet experiencing the severe life-threatening famine that Somalia is," Hart says.
The Obama administration's signature aid program, Feed the Future, has already been scaled back by budget cuts.
A top House Appropriations Committee member, Texas Republican Rep. Kay Granger, says in the past, the U.S. has been able to take the long view — knowing that someday what's been planted would bear fruit. But as her panel unveiled its spending proposals over the summer, she said, "Today is a different time, and every dollar counts."
So Robert Zachritz with World Vision has taken a new approach to his lobbying on Capitol Hill.
"We have been emphasizing — you know what, the budget deficit is a moral issue. That's about $55,000 per American. That's a real moral issue. You can't live beyond your means. But then we also raise, it's a moral issue of saving a child's life or responding to a famine," Zachritz says.
While advocates of foreign aid find themselves fighting to preserve existing programs, others say it is possible to do more with less, and Congress could help by streamlining some of the rules governing U.S. aid.