A new United Nations report has raised alarms over slowing global progress in reducing child mortality, revealing that an estimated 4.9 million children died before their fifth birthday in 2024, with the majority succumbing to preventable causes.
The report, “Levels & Trends in Child Mortality”, shows that while under-five deaths have dropped by more than half since 2000, the pace of decline has sharply slowed since 2015, raising concerns that global targets may be missed.
Of the total fatalities, 2.3 million occurred within the first month of life, highlighting persistent gaps in newborn care and maternal health services. Complications from preterm birth (36%), labour and delivery difficulties (21%), infections, and congenital conditions remain leading causes of newborn deaths.
UNICEF Executive Director Catherine Russell emphasized the urgency of sustained action: “No child should die from diseases that we know how to prevent. But we see worrying signs that progress in child survival is slowing, at a time when we’re seeing further global budget cuts. With sustained investment and political will, we can continue to build on those achievements for future generations.”
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For the first time, the report provides a detailed breakdown of child mortality causes, showing that severe acute malnutrition (SAM) directly claimed over 100,000 children aged 1 to 59 months in 2024. Health experts warn the real toll is higher, as malnutrition weakens immunity and increases vulnerability to deadly infections.
Beyond infancy, infectious diseases–including malaria, pneumonia, and diarrhoea–remain leading killers. Malaria alone accounted for 17% of deaths among older children, with sub-Saharan Africa bearing the heaviest burden.
The report also underscores stark regional inequalities: sub-Saharan Africa accounted for 58% of global under-five deaths, followed by Southern Asia at 25%. Children in fragile and conflict-affected areas are nearly three times more likely to die before age five than those in stable settings. In contrast, infectious diseases represent only 9% of child deaths in high-income regions like Europe and North America.
WHO Director-General Tedros Adhanom Ghebreyesus stressed the need to protect vulnerable children: “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.”
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The UN warned that shifting global financing priorities are straining maternal and child health programmes, threatening to reverse decades of progress. Despite evidence that interventions are highly cost-effective–yielding up to $20 in social and economic returns for every dollar invested–funding gaps persist.
Experts, including Monique Vledder and Li Junhua, called for renewed political commitment, increased domestic financing, and strengthened primary healthcare systems to accelerate progress. Key interventions highlighted include immunization, skilled care at birth, improved nutrition, and community-based health services.
Li Liu stressed: “These estimates demonstrate that many deaths among children under five are avoidable with proven, cost-effective interventions. The science is clear: strategic investments can save millions of lives.”
The report serves as a stark reminder that urgent action is needed to protect children and ensure that global development targets for child survival remain achievable.