LAHORE: As many as 12 million children in Pakistan suffer from stunted growth, read a new study by the World Bank. The study, Pakistan Development Update, says under-nutrition is the largest killer of under-five children, and is responsible for the death of 3.1 million children each year. Globally approximately 162 million children under the age of 5 years are stunted, the report adds. At 43.7 percent, Pakistan has the third highest rate of stunting in the world. Pakistan accounts for up to 12 million of this total represent the highest in South Asia too. A growing body of evidence suggests that addressing the nutrition challenge will be essential to ensure a healthy economic future for Pakistan. The report warns that in spite of economic growth of Pakistan and unlike its regional peers, it has made no progress on nutrition indicators in recent decades. Poor nutrition exerts a heavy toll on health outcomes and economic activity-stunted children start school later, are less likely to graduate or undertake higher education and earn significantly less in adulthood. It also affects lifelong health, hindering brain development, intelligence, educability and productivity. Moreover, Pakistan is falling behind in the fight against malnutrition. The global prevalence of stunting is improving at an average annual rate of 2.1 percent per year. However, Pakistan’s stunting rates have barely changed over the last three decades, instead worsening in recent years. Peer countries with a comparable stunting burden a decade ago have improved significantly. Bangladesh, for example, reduced its stunting rates from 42 percent in 2004 to 36 percent in 2014 and Afghanistan reduced stunting from 52 percent in 2004 to 41 percent in 2013. It says that stunting and malnutrition vary across provinces in Pakistan, with Sindh and Balochistan showing the highest prevalence and Punjab exhibiting the lowest rates. Children in urban areas are slightly better off than their peers in rural areas (36.9 percent urban and 46.6 percent rural). There are no significant differences in the nutritional status of boys and girls. As many as 39.2 percent children of Punjab, 49.8 percent of Sindh, 47.8 percent in KP, 52.2 percent in Balochistan, 57.6 percent in FATA, 31.7 percent in Azad Jammu Kashmir and 50.6 percent in Gilgit are stunted. Accelerating progress in human development, including nutrition, remains the key challenge for sustained economic gains in Pakistan. Pakistan’s public spending on education and health is one of the lowest in South Asia (less than 3 percent of GDP combined), and allocation to nutrition are modest.