Global progress in reducing child deaths 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 report released by the United Nations and partner agencies.
The report, Levels & Trends in Child Mortality, shows that while under-five deaths worldwide have fallen by more than half since 2000, the pace of decline has slowed by over 60 per cent since 2015. Most of these deaths are considered preventable through low-cost interventions and improved access to quality health care.
Malnutrition identified as a direct cause of child deaths
For the first time, the report provides a comprehensive analysis of the causes of child mortality. It estimates that more than 100,000 children aged 1–59 months died directly from severe acute malnutrition in 2024, representing about five per cent of deaths in this age group. Experts warn the true burden is likely higher, as malnutrition often weakens immunity and increases the risk of death from common childhood diseases.
Countries with some of the highest numbers of direct deaths linked to severe acute malnutrition include Pakistan, Somalia and Sudan.
Newborn deaths remain a major concern
Newborn deaths account for nearly half of all under-five deaths globally, reflecting slower progress in improving survival around childbirth. Leading causes include complications from preterm birth (36 per cent) and complications during labour and delivery (21 per cent), as well as infections such as neonatal sepsis and congenital conditions.
After the first month of life, infectious diseases such as malaria, diarrhoea and pneumonia remain major causes of death. Malaria alone accounts for about 17 per cent of deaths in this age group, with the majority occurring in endemic areas of sub-Saharan Africa. Countries including Chad, Democratic Republic of the Congo, Niger and Nigeria carry a large share of this burden.
Regional disparities remain stark
The report highlights significant inequalities in child survival. In 2024, sub-Saharan Africa accounted for 58 per cent of all under-five deaths worldwide, while Southern Asia represented 25 per cent. In contrast, infectious diseases account for a much smaller proportion of child deaths in regions such as Europe, Northern America and Australia and New Zealand, reflecting better access to health services and preventive care.
Fragile and conflict-affected countries face particularly severe challenges, with children born in these settings nearly three times more likely to die before age five than those in more stable environments.
Deaths among older children and youth
The report also estimates that 2.1 million children, adolescents and young people aged 5–24 died in 2024. Infectious diseases and injuries remain leading causes among younger children, while risks shift during adolescence. Among girls aged 15–19, self-harm is the leading cause of death, while road traffic injuries are the leading cause among boys in the same age group.
Call for stronger investment in child survival
UN agencies warn that changes in global development financing are putting maternal, newborn and child health programmes under pressure. Sustained funding for health systems, surveys and data collection is essential to maintain and accelerate progress.
Experts emphasize that investing in child health remains one of the most cost-effective development strategies. Proven interventions such as vaccines, treatment for severe acute malnutrition and skilled care at birth can save lives while generating long-term social and economic benefits.
To accelerate progress, governments and partners are urged to prioritize child survival, focus on high-risk regions such as sub-Saharan Africa and Southern Asia, strengthen accountability through better data systems, and invest in primary health care services that can prevent and treat the leading causes of child deaths.
