Global progress in reducing child mortality has slowed, with 4.9 million children dying before the age of five in 2024, according to a UN report published today.
Of those 4.9 million deaths, 2.3 million were newborns, and the majority could have been prevented with low-cost preventive interventions and access to quality healthcare. The report “Levels and Trends in Child Mortality” notes that deaths worldwide of children under five have fallen by more than half since 2000, but since 2015 the rate of reduction has slowed by more than 60%.
The WHO estimates that in 2024, 100,000 children aged one to 59 months died from severe acute malnutrition — a figure likely much higher when indirect effects are considered, as malnutrition weakens immunity and increases vulnerability to common childhood diseases. Pakistan, Somalia and Sudan are among the countries with the most cases.
Newborn deaths account for nearly half of all deaths of children under five, “reflecting slower progress in preventing deaths in the perinatal period.” The leading causes of newborn death are complications from premature birth (36%) and complications during labour and delivery (21%), with infections including neonatal sepsis and congenital anomalies also significant.
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After the first month, infectious diseases such as malaria, diarrhoea and pneumonia are the leading causes of death, with malaria remaining the top killer in this age group (17%), mostly in endemic areas of sub-Saharan Africa.
Child deaths remain heavily concentrated in a small number of regions. In 2024, sub-Saharan Africa accounted for 58% of all deaths of children under five — half of them from infectious diseases — while South Asia accounted for 25%, driven primarily by complications in the first month of life. Children born in fragile and conflict-affected countries are almost three times more likely to die before age five than those born elsewhere.
The report also found that around 2.1 million children, adolescents and young people aged 5 to 24 died in 2024. Infectious diseases and injuries remain the leading causes of death among the youngest, while risks shift in adolescence: self-harm is the leading cause of death among girls aged 15 to 19, and road accidents among boys.
The WHO notes that changes in the global development financing landscape are placing essential maternal, neonatal and child health programmes under growing pressure. Every dollar invested in child survival can generate up to twenty dollars in social and economic benefits, the organisation stresses, urging governments, donors and partners to prioritise child survival, focus on those most at risk and invest in primary healthcare systems.
