Nearly 5 Million Children Died Before Age 5 in 2024: UNICEF Report

The global effort to reduce child mortality is facing headwinds, with new data revealing a slowdown in progress and an estimated 4.9 million children still dying before their fifth birthday in 2024. Although significant gains have been made since 2000 – a more than 50% reduction in under-five deaths globally – the rate of improvement has slowed by over 60% since 2015. These findings, released in the latest Levels & Trends in Child Mortality report, underscore the urgent demand for renewed commitment and investment in child health.

The Burden of Preventable Deaths

Despite the overall decline, 4.9 million deaths represent a staggering loss, particularly as the vast majority are preventable. The report highlights that 2.3 million of these deaths occurred in the newborn period, emphasizing the continued challenges in preventing deaths around the time of birth. Complications from preterm birth account for 36% of newborn deaths, while issues during labor and delivery contribute to 21%. Infections, including neonatal sepsis and congenital anomalies, also play a significant role.

Beyond the first month, infectious diseases remain major killers. Malaria continues to be the single largest cause of death in children over one month ancient, responsible for 17% of deaths in this age group, with the majority occurring in sub-Saharan Africa. However, progress against malaria has stalled in recent years, hampered by factors like conflict, climate change, and drug resistance. Diarrhoea and pneumonia also continue to claim young lives.

Malnutrition: A Hidden Crisis

For the first time, the report provides estimates on deaths directly caused by severe acute malnutrition (SAM), finding that over 100,000 children aged 1-59 months died from it in 2024 – representing 5% of all under-five deaths. This figure is likely an underestimate, as malnutrition often weakens a child’s immune system, increasing their vulnerability to other diseases, and SAM is frequently not recorded as the primary cause of death. Countries like Pakistan, Somalia, and Sudan are experiencing particularly high numbers of direct deaths from malnutrition.

Geographic Disparities and Vulnerable Populations

Child deaths are not evenly distributed across the globe. Sub-Saharan Africa bears the heaviest burden, accounting for 58% of all under-five deaths in 2024. Within the region, infectious diseases are responsible for 54% of these deaths. In contrast, Europe and Northern America account for only 9% of under-five deaths, and Australia and New Zealand, a mere 6%. These stark differences reflect unequal access to essential, life-saving interventions.

Southern Asia, accounting for 25% of all under-five deaths, faces a different set of challenges. Mortality in this region is largely driven by complications in the first month of life, including preterm delivery, birth asphyxia, congenital anomalies, and neonatal infections. This underscores the critical need for investment in quality antenatal care, skilled birth attendants, and essential newborn services. Children living in fragile and conflict-affected countries are nearly three times more likely to die before their fifth birthday than those in more stable settings.

Beyond Under-Five Mortality: Adolescent and Youth Deaths

The report also sheds light on mortality among older children and young people. An estimated 2.1 million adolescents and youth aged 5-24 died in 2024. While infectious diseases and injuries remain leading causes of death among younger children in this age group, the risks shift in adolescence. Self-harm is the leading cause of death among girls aged 15-19, while road traffic injuries are the primary cause for boys.

Financing and the Path Forward

The slowdown in progress coincides with shifts in the global development financing landscape, placing pressure on critical maternal, newborn, and child health programs. Sustained funding is needed not only to protect the gains made but also to accelerate progress. Evidence consistently demonstrates that investments in child health are among the most cost-effective development measures. For every dollar invested in child survival, up to twenty dollars can be generated in social and economic benefits, improving productivity, strengthening economies, and reducing future public spending.

To accelerate progress and save lives, the report calls for a concerted effort from governments, donors, and partners to:

• Prioritize child survival as a political and financial priority, with increased domestic resource mobilization and improved access to affordable, quality services.
• Focus on those at highest risk, particularly mothers and children in sub-Saharan Africa and Southern Asia, and in conflict and fragile settings.
• Strengthen accountability for existing commitments to reduce maternal, newborn, and child deaths through transparent data collection and reporting.
• Invest in primary health care systems to prevent, diagnose, and treat the leading causes of death in children, including through community health workers and skilled care at birth.

As UNICEF Executive Director Catherine Russell stated, “No child should die from diseases that we know how to prevent. But we see worrying signs that progress in child survival is slowing – and at a time where we’re seeing further global budget cuts.” The findings serve as a stark reminder that continued investment and political will are essential to building on past achievements and ensuring a healthier future for all children. The WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, echoed this sentiment, emphasizing that children living in conflict and crisis are disproportionately affected and require targeted protection and care. More information on the WHO’s response can be found on their website.

Looking Ahead: Strengthening Surveillance and Data Systems

The UN Inter-agency Group for Child Mortality Estimation (UN IGME) continues to refine its methods and integrate new data sources to provide the most accurate picture of child mortality trends. The recent report’s inclusion of estimates on deaths directly caused by severe acute malnutrition is a significant step forward, made possible by the integration of data from the Child and Adolescent Causes of Death Estimation (CA-CODE) group. Ongoing efforts to improve data collection, particularly in fragile and conflict-affected settings, are crucial for tracking progress and identifying areas where interventions are most needed. Regular reviews of these estimates, coupled with robust surveillance systems, will be essential for informing policy decisions and ensuring that resources are allocated effectively to save children’s lives. Further details on the UN IGME’s methodology and data sources are available on their website.