A U.S. official involved in providing humanitarian relief for Afghan refugees says the coming months could see as many as a million more Afghans fleeing to neighboring Pakistan and perhaps as many as 400,000 more crossing the border into Iran. There's concern that famine and the coming winter will lead to the deaths of many.

Pakistan is now host to the largest refugee population on earth, with famine, war and drought driving some three million Afghans into the country.

Bear McConnell, USAID's point man for Central Asia, arrived in Pakistan this week with some 20,000 blankets and other forms of humanitarian aid, all intended to get refugees through the coming winter. "People are going to die in Afghanistan this winter," he said. "Our objective, our first track, is to do what we can do to reduce that rate of death."

But there are many obstacles. He says air strikes, which are being coordinated with relief operations, are nevertheless terrifying people. And, U.S. officials say harassment by the Taleban has forced all foreign aid workers to leave the country. Apart from air drops, it's now left to Afghans themselves distribute relief supplies. "Our objective is to get the food to where the people are," stressed Mr. McConnell.

U.S. officials are hoping Uzbekistan to the north will open an overland route that could be used to bring in fresh relief supplies by land. That would provide a way of getting in as much as 40 percent of what is needed to feed those Afghans most in need. So far, the Uzbek government has kept this route shut, fearing it could also provide an entry for Afghan-based Uzbek rebels.