Since 1980, the number of undernourished people in eastern and southern Africa has more than doubled. Rural development stalled and rural poverty expanded during the 1990s. Population growth remains very high, and declining per-capita agricultural capacity retards progress toward Millennium Development goals. Analyses of in situ station data and satellite observations of precipitation have identified another problematic trend: main growing-season rainfall receipts have diminished by approximately 15% in food-insecure countries clustered along the western rim of the Indian Ocean. Occurring during the main growing seasons in poor countries dependent on rain-fed agriculture, these declines are societally dangerous. Will they persist or intensify? Tracing moisture deficits upstream to an anthropogenically warming Indian Ocean leads us to conclude that further rainfall declines are likely. We present analyses suggesting that warming in the central Indian Ocean disrupts onshore moisture transports, reducing continental rainfall. Thus, late 20th-century anthropogenic Indian Ocean warming has probably already produced societally dangerous climate change by creating drought and social disruption in some of the world's most fragile food economies. We quantify the potential impacts of the observed precipitation and agricultural capacity trends by modeling "millions of undernourished people" as a function of rainfall, population, cultivated area, seed, and fertilizer use. Persistence of current tendencies may result in a 50% increase in undernourished people by 2030. On the other hand, modest increases in per-capita agricultural productivity could more than offset the observed precipitation declines. Investing in agricultural development can help mitigate climate change while decreasing rural poverty and vulnerability.