The dramatic rise in world food prices since 2007 has commanded the world’s attention. However, in recent months, world food prices have fallen almost as rapidly as they had risen in late 2007 and early 2008, yet as is demonstrated in this report, domestic food price levels in many eastern and southern African markets are not closely tracking world prices. Fertilizer prices remain at unprecedentedly high levels and may have a critical influence on future food production levels in the region. Against this backdrop, there is an urgent need for information about how the current food situation is unfolding in the region, the immediate policy response options, and the longer-term challenges and opportunities. This study has three objectives: 1) to examine the impact of recent world food price changes on domestic maize and fertilizer prices in the region; 2) to assess possible changes in cropping patterns, national food production, and consumers’ access to food in light of these price movements; and 3) to consider the implications for policy and program response by governments, donors, and the private sector.