Global Child Deaths Fall—but Progress Stalls as 4.9M Under-Fives Die in 2024

Despite decades of progress in saving young lives, an estimated 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns, according to a major new global report. Health experts warn that while child mortality has more than halved since 2000, progress has sharply slowed—raising concerns that the world is falling off track to meet global development targets.

Progress Slowing After Years of Gains

The report, Levels & Trends in Child Mortality, reveals that although global under-five deaths have dropped significantly over the past two decades, the pace of decline has slowed by more than 60% since 2015.

This slowdown comes at a critical moment, as:

• Millions of deaths remain preventable with low-cost interventions

• Global health systems face funding pressures and rising inequalities

• Fragile and conflict-affected regions continue to lag behind

"No child should die from diseases we know how to prevent," said UNICEF Executive Director Catherine Russell, warning that declining global funding could reverse hard-won gains.

Newborns Account for Nearly Half of Deaths

A striking finding is that newborn deaths now make up nearly 50% of all under-five mortality, reflecting slower progress in improving care around birth.

Leading causes include:

• Preterm birth complications (36%)

• Complications during labour and delivery (21%)

• Infections such as neonatal sepsis

• Congenital anomalies

Experts say these deaths are largely preventable with quality antenatal care, skilled birth attendance, and improved neonatal services.

Malnutrition: A Hidden but Deadly Driver

For the first time, the report quantifies deaths directly caused by severe acute malnutrition (SAM), estimating:

• Over 100,000 child deaths (ages 1–59 months) in 2024

• Around 5% of deaths in this age group

However, the real toll is far higher. Malnutrition weakens immunity, making children more vulnerable to diseases like pneumonia and diarrhoea. Many deaths linked to malnutrition go unrecorded, meaning the burden is likely significantly underestimated.

Countries with the highest direct deaths include Pakistan, Somalia, and Sudan.

Infectious Diseases Still Major Killers

Beyond the neonatal period, preventable infectious diseases remain leading causes of death:

• Malaria (17%) – the single largest killer in this age group

• Pneumonia

• Diarrhoeal diseases

Progress against these diseases has stalled in recent years, particularly in high-burden countries such as Chad, the Democratic Republic of Congo, Niger, and Nigeria, where conflict, climate shocks, and weak health systems limit access to care.

Deep Global Inequalities in Child Survival

Child deaths remain heavily concentrated in specific regions:

• Sub-Saharan Africa accounts for 58% of all under-five deaths

• Southern Asia accounts for 25%

In sub-Saharan Africa, infectious diseases cause over half of child deaths, compared to just:

• 9% in Europe and Northern America

• 6% in Australia and New Zealand

Children in fragile and conflict-affected settings are nearly three times more likely to die before age five than those in stable regions.

Adolescents Also at Risk: 2.1 Million Deaths

The report also highlights mortality among older children and youth:

• 2.1 million deaths among those aged 5–24 in 2024

Key risks shift with age:

• Self-harm is the leading cause of death among girls aged 15–19

• Road traffic injuries are the leading cause among boys

Funding Pressures Threaten Future Progress

Experts warn that declining global development financing is placing essential health systems under strain, including:

• Maternal and child health programmes

• Vaccination campaigns

• Data and health monitoring systems

Without sustained investment, progress could stall further—or reverse.

High Returns on Investment in Child Health

The report underscores that child health interventions remain among the most cost-effective global investments:

• Every $1 invested can generate up to $20 in economic and social returns

• Proven solutions include:

  • Vaccination programmes

  • Malnutrition treatment

  • Skilled care at birth

  • Primary healthcare access

Global Call to Action

International organisations are urging governments and partners to act urgently:

• Prioritise child survival in national budgets and policies

• Focus on high-risk regions and vulnerable populations

• Strengthen primary healthcare systems

• Improve data collection and accountability

WHO Director-General Dr Tedros Adhanom Ghebreyesus stressed the urgency:

"Children living amid conflict and crisis are nearly three times more likely to die. We must protect essential health services and reach the most vulnerable."

A Critical Moment for Global Health

While the world has made remarkable progress in reducing child mortality, the current slowdown highlights a turning point. With millions of lives still at stake—and solutions already known—the challenge now lies in political will, sustained funding, and equitable access to care.

As global leaders warn, the goal is no longer just survival—but ensuring every child has the chance to thrive.