An escalation of attacks on aid workers and human rights defenders in southern and central Somalia is putting at least 3 million Somalis at even greater risk of malnutrition and disease. Many organizations have suspended programmes and withdrawn staff.

At least 40 humanitarian and human rights workers have been killed so far this year, as highlighted in Fatal Insecurity: Attacks on Aid Workers and HRDs in Somalia, a new report by Amnesty International.

This is at a time when Somalia is in the middle of a humanitarian emergency, with the UN estimating that around 3.25 million Somalis – 43 percent of the population – will require food aid until the end of 2008.

The restrictions on the freedom of humanitarian agencies to deliver emergency humanitarian services – food, shelter and essential medical services – form one of the leading factors contributing to widespread malnutrition and death from starvation or preventable diseases throughout the area.

One humanitarian worker said: "We are not able to start new programmes because our staff can't go in. There is acute malnutrition in Mogadishu, but we're not able to respond quickly enough, we have to work by remote control, and quality suffers."

"These killings, abductions and threats mean that workers and rights defenders no longer enjoy the limited protection they previously held, based on their status in the community as impartial distributors of food and emergency services, or as advocates of peace and human rights," said David Copeman, Amnesty International's Somalia Campaigner.

Many Mogadishu-based human rights defenders and other civil society members have this year been forced to flee Somalia for the first time since the end of the government of former President Mohamed Siad Barre in 1991.

Attacks continue, with UN staff killed by bombing attacks on 29 October, the targeted killing of an UNICEF engineer in the central town of Hudur on 19 October and a women's rights activist killed in Guriel on 25 October.

Where the identity of the attackers is known, the majority of killings have been attributed to members of armed opposition groups, including al-Shabab militias, and the various Alliance for the Re-liberation of Somalia (ARS)-affiliated militias (often also called Islamic Courts).

The remaining killings were attributed to criminal gangs, or in a smaller number of cases, to militias associated with the Transitional Federal Government (TFG) or to the Ethiopian military. Most recent killings have been carried out by one or more gunmen, almost always described as between 15 and 25 years old. Threats are issued by phone, in leaflets and by word of mouth.

Amnesty International is calling on all parties to the conflict in Somalia to stop these illegal attacks on humanitarian workers and civil society.

"International leaders must establish a mechanism, such as an International Commission of Inquiry, to investigate these killings, kidnappings and beatings and bring those responsible to justice," said David Copeman.

"Donor governments and the UN must also increase their efforts to ensure a transparent and clearly demonstrated distinction between apolitical emergency humanitarian relief, and any political or development activities assisting TFG or the peace process."

Amnesty International