The BBC's Orla Guerin: "Families are homeless, hungry, and threatened by disease"
Pakistani Prime Minister Yousuf Raza Gilani has cancelled a trip to next week's UN General Assembly in New York because of floods in Sindh province.
Pakistani leaders were accused of neglecting victims of floods that swept the country last year and are accused of being slow to respond once again.
This year about six million people have been affected so far, with fears some areas will remain submerged for months.
Aid agencies are again warning of a disaster and have launched emergency appeals. At least 269 people are already confirmed to have died.
The authorities are accused of being months behind schedule in repairing dams and embankments damaged by last year's floods.
'We're worried'Mr Gilani has been in Iran in recent days, while President Asif Ali Zardari flew to London last week on a private visit.
The prime minister's office now says he "will visit flood-affected areas from tomorrow and supervise relief efforts".
Foreign Minister Hina Rabbani Khar will address the General Assembly in his place.
President Zardari was heavily criticised for visiting the UK in August 2010 when Pakistan was hit by its worst floods in living memory.
And although he and Mr Gilani visited areas flooded by monsoon rains earlier this month, there is growing criticism that the government is not doing enough.
The destruction in Sindh province is once again on a massive scale.
Thousands of refugees are streaming to Karachi, Hyderabad and other urban areas unaffected by the floods.
More than two million people are suffering from flood-related diseases following the torrential rain, aid officials say. Cases of malaria and diarrhoea are increasing.
At least 7,000 people are being treated for snake bites.
"We have assessed 16 out of 22 districts and roughly 1.8 million people have left their homes and 750,000 are living in temporary sites," a UN children's agency spokesman said on Thursday.
Many others have little or no food or shelter.
People in Sindh have told the BBC they are angry the authorities have not done more in the wake of the disaster of 2010.
They say flood prevention projects and proper drainage systems could have saved homes and lives and an awful lot of misery.
There is also anger that UN aid agencies remain in the forefront of the relief effort - providing health facilities and rations - but government aid is conspicuous by its absence, the BBC's Syed Shoaib Hasan in Hyderabad says.
Many people have been taken into relief camps but many more are fending for themselves as the rains keep coming.
"We're on the road, no-one has given us a tent," one homeless man, Abdul Latif Chandio, told the BBC.
"Our children are already ill and we're worried about the waters rising more."
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