Starvation being used as a weapon of war has become the new normal, according to Save the Children. Its analysis shows more than half a million infants in conflict zones could die of malnutrition by the end of the year if they do not receive treatment, the equivalent of one every minute.

The charity makes its own estimates using UN data, and projects that 4.5 million under-fives will need treatment for life-threatening hunger this year in the most dangerous conflict zones – an increase of 20% since 2016. At current rates, only one in three will receive treatment, and 590,000 could die as a result.

The data emerged ahead of Tuesday’s launch of the UN annual report on food security, which last year warned that global hunger was rising for the first time since the turn of the century, fuelled by conflict and climate change.

“The broad story is we’ve seen a drastic increase in the number of children at risk of death as a result of hunger related problems” said Kevin Watkins, the CEO of Save the Children. “Using starvation as a weapon of war has become the new normal, with devastating consequences for children. From Yemen to South Sudan the failure to protect children from hunger is putting children at risk.”

There were chronic shortfalls in donor funding in conflict zones. The charity described as “striking” the example of the Democratic Republic of the Congo, which it estimated had the highest number of infants with life-threatening malnutrition while facing an 8.6% funding shortfall for nutrition.

It estimated 1.9 million infants in the DRC would suffer severe acute malnutrition (SAM) – the most dangerous form of under-nutrition – by the end of 2018. With 1.6 million likely to remain untreated, more than 300,000 children could die, it said.

More than half of the infants at risk from untreated SAM were in the DRC, while Sudan, Afghanistan, Yemen and Somalia were the next four most impacted. On average the nutrition programmes were around a third funded, with the exception of Yemen, which was 60% funded.

“In DRC, where funding is critical in keeping people alive, the nutrition appeals are heavily underfunded,” said Watkins. “The picture is different in Yemen, which is relatively well funded in terms of its nutrition programme. But in Yemen, the real damage of the war is the liquidity crisis which is draining the lifeblood of the economy. You see 400,000 children at risk of malnutrition.”

Previous research by Save the Children found an increasing number of “grave violations” of children’s rights, due to the denial of humanitarian access and attacks on aid workers assisting children, in 2017 – 1,460 cases, up from 1,014 cases in 2016.

Symptoms of SAM include jutting ribs and loose skin, with visible wasting of body tissue or swelling in the ankles or feet. Children with it also have substantially reduced immune systems, and are prone to contract and die of diseases like pneumonia, cholera and malaria.