Regional powers attending twin security dialogues in India and Pakistan this week are holding the lives of 40 million people in their hands.

Afghans are trapped between a radical Islamist group and a global community apparently content to sit back and let their aid-dependent country plunge into crisis.

There’s a lot at stake at these two meetings. The national security chiefs of the countries in attendance in New Delhi on Wednesday — Russia, Iran, India and the five Central Asia republics — are fearful of instability spilling over their common borders. They’re wary of unmanageable refugee flows, already a problem for Iran, with close to 800,000 Afghan refugees, and Pakistan, home to more than 1.45 million. All hold grave concerns that Afghanistan is again becoming a safe haven for terrorist groups and are watching for an uptick in drug trafficking and production. Close allies and India rivals, China and Pakistan, are notable no-shows.

Those two countries instead are joining the “extended troika” gathering in Islamabad, which includes the new U.S. Special Representative for Afghanistan, Thomas West and officials from Russia. They’ll no doubt share similar concerns. This group will also meet for the first time with the Taliban’s acting Foreign Minister Amir Khan Muttaqi, the Hindu newspaper reported.

The U.S. is particularly worried about Islamic State and al-Qaeda developing the capacity to launch attacks on its soil, while European leaders are keen to avoid a repeat of the 2015 migrant crisis and are watching developments on the Polish-Belarus border with alarm. Meanwhile, the absence of China and Pakistan in one of the two tracks will make developing an urgent plan to deal with the unfolding crisis even more difficult, as Madiha Afzal, a foreign policy fellow at Brookings and the author of “Pakistan Under Siege: Extremism, Society and the State,” told me.

At the very least, there’s the need for a strong multilateral approach to tackle key areas, including terrorism, the humanitarian disaster and the Taliban’s brutal treatment of women and minorities.

The economic meltdown triggered by the chaotic and deadly U.S. troop withdrawal and the Taliban’s sudden surge to power on Aug. 15 has left the nation in free-fall. Western countries have suspended the financial assistance that made up the bulk of the government’s spending, while they’re preventing the Taliban administration from accessing billions of dollars in foreign reserves. Millions of Afghans have gone for months without receiving their salaries, including women forced into unemployment by officials who refuse to let them work. Babies are dying of starvation.

There is a clear moral obligation to prevent even more Afghans sliding into famine conditions in the face of a severe drought and ahead of what is expected to be a harsh winter. Given its failed 20-year military occupation of the country and messy departure that left a young, 21st century population at the mercy of a backward, violent group of men, the U.S. — along with its North Atlantic Treaty Organization allies — should be the first to step up. As a priority they must take in more refugees and urgently deliver humanitarian aid.

The United Nations food agency is already working to provide assistance to almost 23 million Afghans, among them 3.2 million children. World Food Program executive director David Beasley described the situation as “a countdown to catastrophe.” Taliban leaders want the country’s assets released, yet they are unwilling to make any concessions to the U.S. or other powers to improve the lives of the citizens they now control.

That means there are some significant obstacles to overcome, not the least finding the best way to help people without bolstering the Taliban administration, given several of the group’s leaders are still on the U.N. sanctions list and its promises of a more moderate rule have come to nothing. U.S. President Joe Biden wants assistance delivered via international aid agencies rather than directly to the Taliban, and it is difficult to find any other world leader who disagrees.

The health system is close to collapse, with many foreign-funded clinics closing or running out of essential medicines and the staff to administer them. A recent spate of reprisal killings — including a women’s rights activist and others associated with the previous government — have worsened the climate of fear. Girls in secondary schools are still mostly banned from attending class, while Human Right Watch says the Taliban are preventing women from working in most areas of the aid sector, which means assistance is reaching fewer families in need, especially female-led households.

There appears to be little sense of urgency. Neighboring countries are worried, sure, but it looks like the world is sleepwalking into another humanitarian crisis, unable to find the right formula to fuel any real action until temperatures are well below zero and the death toll is suddenly unacceptably high.

None of the countries at Wednesday’s meeting in Delhi have taken the step to recognize a Taliban government. But it is incumbent upon them to recognize the urgent need of the Afghan people and organize help before it is all too late.

Ruth Pollard is a columnist and editor with Bloomberg Opinion.

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