The United Nations has expressed deep concern over the slow progress in reducing child mortality, revealing that an estimated 4.9 million children still die annually before their fifth birthday, with newborns accounting for nearly half of these deaths .
UN agencies under the aegis of the UN Inter-agency Group for Child Mortality Estimation (UN IGME) stated this in a statement issued on Wednesday following the release of a new report titled “Level and Trends in Child Mortality” .
The report provides the most comprehensive assessment to date of the causes of under-five deaths, noting that most of these deaths are preventable with proven, low-cost interventions and access to quality healthcare .
While under-five deaths globally have fallen by more than half since 2000, the report reveals a troubling trend: since 2015, the pace of reduction in child mortality has slowed by more than 60 per cent .
This year’s report also integrates, for the first time, estimates on deaths directly caused by Severe Acute Malnutrition (SAM), finding that more than 100,000 children aged 1-59 months—or 5 per cent—died from it in 2024 .
“The toll is far greater when indirect effects are considered, as malnutrition weakens children’s immunity and increases their risk of dying from common childhood diseases,” the report states .
Child deaths remain heavily concentrated in a small number of regions. In 2024, sub-Saharan Africa accounted for 58 per cent of all under-five deaths, with leading infectious diseases responsible for 54 per cent of these deaths .
In stark contrast, in Europe and North America, this proportion drops to 9 per cent, and in Australia and New Zealand, it falls further to 6 per cent. The report notes that “these stark disparities reflect unequal access to proven, life-saving interventions” .
Malaria remains the single largest killer in the 1-59 month age group (17 per cent), with most deaths occurring in endemic areas of sub-Saharan Africa. Deaths remain concentrated in a handful of countries, including Chad, Democratic Republic of the Congo, Niger, and Nigeria, where conflict, climate shocks, and other biological threats continue to affect access to prevention and treatment .
Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth. Leading causes among newborns were complications from preterm birth (36 per cent) and complications during labour and delivery (21 per cent). Infections, including neonatal sepsis and congenital anomalies, were also important causes .
Beyond the first month, infectious diseases such as malaria, diarrhoea, and pneumonia are major killers. After steep declines between 2000 and 2015, progress towards reducing malaria mortality has slowed in recent years .
UNICEF Executive Director Catherine Russell emphasized the urgency of the situation.
“No child should die from diseases that we know how to prevent. However, we see worrying signs that progress in child survival is slowing—and at a time when we’re seeing further global budget cuts. History has shown what is possible when the world commits to protecting its children. With sustained investment and political will, we can continue to build on those achievements for future generations,” she said .
WHO Director-General Tedros Ghebreyesus highlighted the impact of conflict on child survival.
“The world has made remarkable progress in saving children’s lives, but many still die from preventable causes. Children living amid conflict and crisis are nearly three times more likely to die before their fifth birthday. We must protect essential health and nutrition services and reach the most vulnerable families so every child has the chance not only to survive, but to thrive,” he stated .
The report also finds that an estimated 2.1 million children, adolescents, and youth aged 5–24 died in 2024. Infectious diseases and injuries remain leading causes among younger children, while risks shift in adolescence, with self-harm being the leading cause of death among girls aged 15–19, and road traffic injuries among boys .
World Bank Group Director for Health, Monique Vledder, called for accelerated action.
“These findings are a collective call to speed up implementation of the proven, scalable solutions we know are within reach. The World Bank Group health target of reaching 1.5 billion people is our concrete commitment to accelerating access to quality primary health services for more children and families,” she said .
The report notes that fragile and conflict-affected countries continue to bear a disproportionate share of the burden, with children born in these settings nearly three times more likely to die before their fifth birthday than those elsewhere .
