Global Progress on Child Survival Slows as 4.9 Million Children Die Before Age Five

Progress in reducing child mortality worldwide is slowing, with an estimated 4.9 million children dying before their fifth birthday in 2024, including 2.3 million newborns, according to a new global report.

The report, Levels and Trends in Child Mortality, shows that under-five deaths have dropped by more than half since 2000. However, since 2015, the pace of reduction has declined by over 60 per cent, raising concern among global health experts.

Most of these deaths are preventable through low-cost interventions such as vaccines, improved nutrition, and access to quality health care.

For the first time, the report estimates deaths directly caused by severe acute malnutrition (SAM), revealing that more than 100,000 children aged 1–59 months died from the condition in 2024. The real burden is likely higher, as malnutrition weakens immunity and increases the risk of dying from common diseases.

Newborns accounted for nearly half of all under-five deaths, highlighting slow progress in addressing risks during pregnancy, childbirth, and the first weeks of life. Complications from preterm birth and difficulties during labour and delivery were the leading causes, alongside infections.

Beyond the neonatal period, infectious diseases remain the main killers. Malaria alone accounted for 17 per cent of deaths among children aged one month to five years, particularly in sub-Saharan Africa. Diarrhoea and pneumonia also continue to claim millions of lives.

The burden of child mortality remains highly unequal. Sub-Saharan Africa accounted for 58 per cent of all under-five deaths in 2024, while Southern Asia contributed 25 per cent. In contrast, significantly fewer deaths occur in Europe, Northern America, and Oceania due to better access to life-saving services.

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

The report also estimates that 2.1 million children, adolescents, and youth aged 5–24 died in 2024. Causes vary by age, with infectious diseases and injuries leading among younger children, while self-harm and road traffic injuries are major risks among adolescents.

Experts warn that shifting global funding priorities are placing critical maternal and child health programmes under pressure. Sustained investment is needed to maintain progress and expand access to essential services.

The report calls for renewed political commitment, increased funding, and stronger primary health care systems to ensure that every child has a chance to survive and thrive.