The global decline in child deaths has slowed by more than 60% since 2015, raising concern among health experts, even as an estimated 4.9 million children died before their fifth birthday in 2024, according to a new United Nations report.
The Levels & Trends in Child Mortality report says that although proven tools exist to save children’s lives, they are not being used equitably. Of the 4.9 million under-five deaths recorded, 2.3 million were newborns who died within their first 28 days.
While global under-five mortality has more than halved since 2000, the report highlights a worrying slowdown in progress. The World Health Organization says the pace of reduction has fallen sharply since 2015, warning that shifting funding priorities and weakening health systems risk reversing decades of gains.
Sub-Saharan Africa continues to bear the heaviest burden, accounting for 58% of all under-five deaths worldwide. Infectious diseases, including malaria, diarrhoea and pneumonia, are responsible for more than half of child deaths in the region.
Malaria remains the leading cause of death among children aged one to 59 months, with most fatalities concentrated in a small number of countries, including Democratic Republic of the Congo, Nigeria, Niger and Chad — all of which face conflict, climate shocks and fragile health systems.
For the first time, the report includes direct estimates of deaths caused by severe acute malnutrition, showing that more than 100,000 young children died from the condition in 2024. However, experts say the true number is likely higher, as malnutrition is often not recorded on death certificates despite increasing vulnerability to other diseases.
Children living in fragile and conflict-affected settings are nearly three times more likely to die before their fifth birthday than those in more stable environments, highlighting stark global inequalities in access to healthcare.
The report emphasises both the economic and moral urgency of investing in child survival, noting that every dollar spent can generate up to 20 dollars in social and economic returns.
It calls for renewed funding at a time when global development budgets are under pressure, urging governments and international partners to prioritise child health, strengthen primary healthcare systems, and invest in proven, low-cost interventions such as vaccines, malnutrition treatment and skilled care at birth, particularly in high-burden regions.
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