Drought is a recurring event in Africa. The ongoing 2002-03 drought, affecting large swathes of eastern and southern Africa, is not exceptional. For many, drought is associated with food insecurity: rains fail; crops wither; food supplies dwindle; entitlement to food declines and people go hungry. The response, on the part of government and donors, is typically food aid ‘to save lives’. Yet food insecurity is not the only concern during drought, and is not an isolated concern. One of the principal aims of this report – a synthesis of over four years research – is to show how livelihoods are affected by declining access to food and water, with access to both linked in a number of important ways. Implications for policy – to protect livelihoods before lives are threatened – are highlighted.