By Mark Doyle
BBC World Affairs correspondent
An international aid agency reports a massive continuing death toll from war and the related humanitarian crisis in the Democratic Republic of Congo.
Life in eastern DR Congo is a daily struggle
The International Rescue Committee says 45,000 people are dying every month in the central African state - a total of 5.4 million dead over the past decade.
This death toll surpasses any conflict since World War II, it says.
These shocking figures follow a scientific, nationwide survey across DR Congo's 11 provinces.
The IRC has concluded that there are 45,000 more deaths, every month, than would be expected from the average, already poor conditions in the rest of sub-Saharan Africa.
And because DR Congo's population is large - the country stretches across the whole of the centre of the continent - it's a worse humanitarian crisis even than that caused by other African wars.
One of the report's authors, Dr Richard Brennan, says a number of other countries like Sierra Leone, South Sudan and Angola have seen sustained elevations of mortality for a number of years after conflict.
"What is different about Congo is the scale. There are just so many more people living in Congo than there are in these other countries."
And so many more are dying there, from easily preventable conditions like malaria, pneumonia and malnutrition.
The report's authors say the Congolese government has the greatest responsibility to address the crisis, while international aid also has a vital role to play.
But the authors add that DR Congo's crisis continues to be overlooked, with funding inadequate compared to the enormity of the need.