Northeast Nigeria’s conflict with Islamist insurgencies had killed nearly 350,000 people as of the end of 2020, the United Nations Development Programme (UNDP) said on Thursday.

The toll, given by the U.N. agency in a new study on the war and its impact on livelihoods, is 10 times higher than previous estimates of about 35,000 based only on those killed in fighting in Nigeria since the conflict’s start 12 years ago.

“The full human cost of the war is much greater,” the UNDP said in a report, released with Nigeria’s Ministry of Finance.

“Already, many more have died from the indirect effects of the conflict,” said the UNDP, citing damage to agriculture, water, trade, food and healthcare.

A Nigerian presidential spokesman declined to comment on the death toll.

Nigeria’s war with Islamist insurgencies Boko Haram and Islamic State’s West Africa Province has spawned one of the world’s worst humanitarian crises, with millions of people dependent on aid. The conflict shows little sign of ending.

Children younger than five account for more than nine out of 10 of those killed, with 170 dying every day, the UNDP said.

If the conflict continues to 2030, more than 1.1 million people may die, the agency said.

“Destruction and displacement have set back development in the region by decades, and continued conflict will only further scar the region,” the UNDP said.

Reuters