A new study says 45% of child deaths in Africa is due to insufficient food, and officials from Caritas fear the situation is not getting better.

The report from the African Child Policy Forum says child hunger “is the most extreme form of child deprivation.”

“Hunger kills, often silently and slowly. It affects and damages children’s health, hinders their capacity to learn, and reduces their ability to earn as much as their better-off peers,” it continues. The study says nearly 60 million children in Africa do not have enough food despite the continent’s economic growth in recent years.

“It is completely unacceptable that children are still going hungry in Africa in the 21st century. The statistics are truly alarming. Child hunger is driven by extreme poverty, uneven and unequal economic growth, gender inequality and a broken food system. Although Africa now produces more food than ever, it hasn’t resulted in better diets,” he said.