Global Child Mortality 2024: 4.9 Million Under-Five Deaths as Progress Slows

Progress in reducing child deaths has slowed significantly, with an estimated 4.9 million children dying before their fifth birthday in 2024, including 2.3 million newborns, according to new United Nations estimates released on 18 March 2026. This figure represents a worrying stagnation in global efforts to improve child survival, despite earlier gains.

The data, published in the Levels and Trends in Child Mortality report by the UN Inter-agency Group for Child Mortality Estimation (UN IGME), shows that while under-five deaths have fallen by more than half since 2000, the pace of reduction has slowed by over 60 per cent since 2015. The report, launched on 18 March 2026, provides the first comprehensive integration of cause-of-death estimates, offering a clearer picture of where and why children are dying.

Severe acute malnutrition (SAM) was estimated as a direct cause of death for more than 100,000 children aged 1–59 months in 2024, accounting for 5 per cent of under-five deaths in that age group. The burden is likely higher, as malnutrition weakens immunity and increases vulnerability to diseases like pneumonia, diarrhoea, and malaria, yet is often not recorded as an underlying cause. Countries with the highest numbers of direct SAM-related deaths include Pakistan, Somalia, and Sudan.

Newborns continue to face the greatest risk, accounting for nearly half of all under-five deaths. Leading causes among newborns were complications from preterm birth (36 per cent) and complications during labour and delivery (21 per cent), with infections such as neonatal sepsis and congenital anomalies also contributing significantly.

Among children aged 1–59 months, infectious diseases remain major killers. Malaria was the single largest cause of death in this group, responsible for 17 per cent of fatalities, with most deaths occurring in sub-Saharan Africa. After steep declines between 2000 and 2015, progress in reducing malaria mortality has slowed in recent years, with deaths concentrated in countries such as Chad, the Democratic Republic of the Congo, Niger, and Nigeria, where conflict, climate shocks, invasive mosquito species, drug resistance, and limited healthcare access hinder prevention and treatment efforts.

Geographic disparities in child survival remain stark. In 2024, sub-Saharan Africa accounted for 58 per cent of all under-five deaths, with infectious diseases responsible for 54 per cent of deaths in the region. In contrast, Europe and Northern America accounted for just 9 per cent of such deaths, with infectious diseases contributing only 9 per cent of the total. Australia and New Zealand saw even lower shares, at 6 per cent, reflecting vastly unequal access to life-saving interventions.

Southern Asia accounted for 25 per cent of global under-five deaths in 2024, with mortality driven largely by preventable conditions in the first month of life, including preterm delivery, birth asphyxia or trauma, congenital anomalies, and neonatal infections. These findings underscore the urgent need for investment in quality antenatal care, skilled birth attendants, and essential newborn services.

Children born in fragile and conflict-affected settings face a disproportionate burden, being nearly three times more likely to die before their fifth birthday than those in more stable environments. The report also estimates that 2.1 million children, adolescents, and youth aged 5–24 died in 2024, with infectious diseases and injuries leading causes among younger children. Among adolescents, self-harm is the leading cause of death for girls aged 15–19, while road traffic injuries are the top cause for boys in the same age group.

The report warns that shifts in global development financing are placing maternal, newborn, and child health programmes under increasing pressure. Surveys, health information systems, and core healthcare functions require sustained funding not only to protect past progress but to accelerate it. Evidence shows that investments in child health are among the most cost-effective development measures, with proven interventions such as vaccines, treatment for severe acute malnutrition, and skilled care at birth delivering high returns. Every dollar invested in child survival can generate up to twenty dollars in social and economic benefits through improved productivity, stronger economies, and reduced future public spending.

To reverse the slowdown in progress, the report calls on governments, donors, and partners to: make child survival a political and financing priority, especially in high-burden countries. focus resources on those at highest risk, including mothers and children in sub-Saharan Africa, Southern Asia, and conflict-affected areas; strengthen accountability through transparent data collection and tracking; and invest in primary health care systems, including community health workers and skilled birth attendance, to prevent, diagnose, and treat the leading causes of child death.

The findings were echoed by global health leaders. 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.” WHO Director-General Dr Tedros Adhanom Ghebreyesus added: “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 so every child has the chance not only to survive, but to thrive.”

Monique Vledder, World Bank Group Director for Health, emphasized the scalability of solutions: “These findings are a collective call to speed up implementation of the proven, scalable solutions we know are within reach.” Under-Secretary-General for Economic and Social Affairs Li Junhua noted: “We know how to prevent these deaths. What is needed now is renewed political commitment, sustained investment in primary health care, and stronger data systems to ensure no child is left behind.”

Li Liu, PhD, associate professor at the Johns Hopkins Bloomberg School of Public Health and co-principal investigator of the Child and Adolescent Causes of Death Estimation (CA-CODE) group, highlighted the role of data and prevention: “The science is clear: targeted investments in primary health care, maternal and newborn health services, routine immunization, nutrition programmes, and quality and timely data systems can save millions of lives.”

The UN IGME, formed in 2004 and led by UNICEF with the WHO, World Bank Group, and the UN Department of Economic and Social Affairs’ Population Division, continues to improve methods for estimating child mortality and support countries in producing timely evaluations. The Johns Hopkins Bloomberg School of Public Health, founded in 1916, leads the CA-CODE research consortium that enabled the first full integration of cause-of-death data in this year’s report.

The next official update from the UN Inter-agency Group for Child Mortality Estimation is expected in 2027, when new survey, census, and civil registration data will be incorporated into the annual assessment of global child survival trends.

Readers are encouraged to share this article and join the conversation on how global health equity can be advanced through sustained investment and political will in child survival programmes.