The UN launched an urgent appeal Tuesday for more helicopters to deliver aid to those people reachable only by air, after floods triggered by a torrent of monsoon rains washed away bridges and vital access roads.

"As monsoon floods continue to displace millions in southern Pakistan, an estimated 800,000 people in need across the country are only accessible by air," the UN Office for the Coordination of Humanitarian Affairs (OCHA) said.

Pakistan's worst humanitarian catastrophe has affected more than 17 million people, while officials warn that millions are at risk from disease and food shortages.

Around 1,500 people have been confirmed dead by Pakistani authorities, but UN officials have suggested the death toll could prove higher.

"These unprecedented floods pose unprecedented logistical challenges, and this requires an extraordinary effort by the international community," said John Holmes, UN Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator.

Global pledges have topped 700 million dollars, but Pakistani and international relief officials have raised concerns about the slow pace of aid and Islamabad has warned that total losses could reach 43 billion dollars.

Some 4.5 million people remain in urgent need of shelter, the International Organization for Migration (IOM) said Wednesday.

Another two million left homeless by the floods were due to have received shelter materials such as tents and plastic sheets within the next couple of days, the IOM said.

Officials warned yet more Pakistanis could be affected in the fertile southern plains of Sindh province, which face the risk of further flooding in the next few days as the major Indus river threatens to burst its banks.

"Hyderabad and large surrounding districts are still facing a threat," Sindh's irrigation minister Jam Saifullah Dharejo told AFP.

"We are working on a war footing. This is an extraordinary flood and we are at war with the extraordinary floods."

Tens of thousands of people have been evacuated from flood-threatened areas close to Hyderabad, on the lower reaches of the Indus, where more than 40 nearby villages have been swept away.

The minister said Tuesday that thousands of irrigation officials had been sent to build up river barriers at high-risk spots, but a full moon this week would speed up water flows and increase the risk of floods.

Barkaat Rizvi, spokesman for the Hyderabad district administration, told AFP that residents were still leaving vulnerable areas, adding: "Danger is still there."

In Kotri, a western suburb of Hyderabad, the river had swelled from its normal width of 200 to 300 metres (yards) to almost 3.5 kilometres (two miles), local army spokesman Asad Ahmad Jalili told AFP.

Water lapped at a road in Jamshoro district that is normally six or seven kilometres from the river, an AFP correspondent witnessed.

Three hundred miles (480 kilometres) further north, authorities were also battling to save the city of Shahdadkot from surging waters after most of its 100,000 residents had been moved to safety.

Authorities safely evacuated people from the nearby flooded town of Qubo Saeed Khan and there were no reports of any casualties, an official told AFP on Wendesday.

Administrative official Yaseen Shar said 90 percent of the town had been evacuated, but 3,000 people were still stranded.

Prime Minister Yousuf Raza Gilani said Tuesday that more than 3.5 million children were at risk from disease.

"As human misery continues to mount, we are seriously concerned about the spread of epidemic diseases," he said.

Millions who have seen their homes wiped out in the month since the disaster first struck are surviving on aid handouts.

Marcus Prior of the World Food Programme (WFP) said at least 40 extra heavy-lift helicopters were needed "to reach the huge numbers of increasingly desperate people with life-saving relief", according to the OCHA statement.

The WFP's Pakistan chief, Wolfgang Herbinger, said that at least 30 airlifts by large transport aircraft would be needed over the next two months to ensure specialist foods such as high-energy biscuits reached flood victims.

Prior said the floods had now affected an estimated 17.2 million people, of whom at least eight million are believed to need life-saving humanitarian assistance.

Pakistan officials are in talks with the International Monetary Fund in Washington amid reports Islamabad is asking the fund to ease the terms of a loan worth nearly 11 billion dollars.

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