Some 180,000 people have been driven from their homes this year, bringing the total number of displaced in the Central African Republic to well over half a million, said Stephen O'Brien.
"The early warning signs of genocide are there," O'Brien told a UN meeting following his recent trip to the Central African Republic and the Democratic Republic of Congo.
"We must act now, not pare down the UN's effort, and pray we don't live to regret it."
UN peacekeeping chief Jean-Pierre Lacroix last week said he was considering sending a request to the UN Security Council for more troops for MINUSCA.
One of the world's poorest nations, CAR was pitched into a war between Muslim and Christian militias in 2013. It was unleashed when President Francois Bozize was overthrown by a coalition of Muslim-majority rebel groups called the Seleka.
They in turn were ousted by a military intervention led by former colonial ruler France. Those events sparked some of the bloodiest sectarian violence in the country's history as mainly Christian militias sought revenge.
The United Nations has 12,350 troops and police on the ground to help protect civilians and support the government of President Faustin-Archange Touadera, who was elected last year.
While Touadera's government remains in control in Bangui, its authority is weak outside of the capital where former Seleka groups and anti-balaka fighters have clashed.
Thirteen MINUSCA peacekeepers have been killed this year-- nine in the southern town of Bangassou alone -- raising alarm that the country is sliding back to the bloodletting that exploded in 2013 following the overthrow of Bozize.
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