Children around the world are at the highest risk of violence since 2005, according to a report published by the organization Save the Children on Wednesday.

Wars and conflicts are only getting worse and creating increasingly dangerous situations for children, said the report titled “Stop the War on Children 2020: Gender Matters.”

While fewer children were living in conflict-affected areas, those who do are more vulnerable to serious violence, based on 2018 data. There are currently over 149 million children in high-intensity conflict areas. 

Children living in conflict areas were more likely to be killed or injured, recruited, abducted, sexually abused, to see their schools attacked, or have aid denied to them, according to the report. The number of reported attacks on schools and hospitals increased by 32% from the previous year and 12,125 children were either killed or injured by conflict-related violence in 2018. 

Syria had high numbers of serious violations against children and 99% of all children living in conflict zones. Afghanistan, Somalia, and Nigeria had the highest rate of children who were killed or injured, had survived sexual violence, and had been recruited by armed forces or groups.

“Our analysis shows that boys and girls suffer differently in war,” Janti Soeripto, president and CEO of Save the Children said in a press release. “To meet their specific needs, we must invest larger sums in helping their recovery. Children are best placed to tell us what they need to recover and rebuild their future. For this to happen, we must listen to them.”

Somalia and the Democratic Republic of Congo were the most dangerous countries for girls.

Girls were more likely to be raped, forced into child marriage, or survive other forms of sexual abuse than boys and represented 87% of the verified sexual violence cases, while 1.5% were boys. Gender was not recorded in 11% of the cases. 

There were almost 20,000 verified cases of sexual violence cases against children between 2005 and 2018, but the report authors suspect the actual total is much higher. Sexual abuse often goes underreported due to fear and stigma. 

Read More: 420 Million Children Living in Crisis Don't Have Basic Sanitation: UNICEF

Boys were more likely to be killed in direct warfare and more vulnerable to recruitment by armed forces and groups, according to the report. Girls who were killed or badly injured were more likely the victims of indiscriminate explosive weapons. 

“It’s staggering that the world stands by while children are targeted with impunity,” Soeripto said. 

Without support, conflict-affected children are denied good health, nutrition, water and sanitation, and other necessities to reach their full potential.  

“The senseless destruction of children’s lives will continue, unless all governments and warring parties act now to uphold international norms and standards, and make perpetrators answer for their crimes,” Soeripto said.