Nearly five million children died before their fifth birthday in 2024, according to new estimates released today by leading international health organizations. The report, titled “Levels & Trends in Child Mortality,” indicates that 4.9 million children under the age of five perished last year, including 2.3 million newborns.
While the global under-five mortality rate has more than halved since 2000, the pace of progress has slowed significantly since 2015, decreasing by over 60 percent, the report states. This deceleration raises concerns about the ability to meet Sustainable Development Goal targets related to child survival.
For the first time, the report includes estimates of deaths directly caused by severe acute malnutrition (SAM), finding that over 100,000 children aged between one and 59 months died from the condition in 2024 – representing 5 percent of deaths in that age group. Experts caution that this figure is likely an underestimate, as malnutrition frequently weakens children’s immune systems, increasing their vulnerability to other life-threatening illnesses, and is often not recorded as a primary cause of death.
Pakistan, Somalia, and Sudan were identified as countries with some of the highest numbers of deaths directly attributable to severe acute malnutrition.
Newborn deaths continue to account for nearly half of all under-five deaths, highlighting the ongoing challenges in preventing deaths around the time of birth. Complications from preterm birth were responsible for 36 percent of newborn deaths, while complications during labor and delivery accounted for 21 percent. Infections, including neonatal sepsis and congenital anomalies, also contributed significantly.
Beyond the first month of life, infectious diseases remain major killers of young children. Malaria continues to be the single largest cause of death among children aged one to 59 months, accounting for 17 percent of deaths in this age group, with the majority of cases occurring in sub-Saharan Africa. Progress in reducing malaria mortality has slowed in recent years, hampered by factors such as conflict, climate change, drug resistance, and the spread of invasive mosquito species.
Geographic disparities in child survival rates remain stark. In 2024, sub-Saharan Africa accounted for 58 percent of all under-five deaths globally. In contrast, Europe and Northern America accounted for just 9 percent, and Australia and New Zealand, 6 percent. These differences reflect unequal access to essential healthcare interventions.
Southern Asia, accounting for 25 percent of all under-five deaths, faces a different set of challenges, with mortality largely driven by complications during the first month of life, including preterm delivery, birth asphyxia, congenital anomalies, and neonatal infections. The report emphasizes the urgent need for investment in quality antenatal care, skilled birth attendants, and essential newborn services in the region.
Children living in fragile and conflict-affected countries are nearly three times more likely to die before their fifth birthday compared to children in other settings.
The report also examined mortality rates among older children and adolescents, finding that an estimated 2.1 million individuals 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, with self-harm being the leading cause of death among girls aged 15-19 and road traffic injuries among boys.
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, “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 so every child has the chance not only to survive, but to thrive.”
The report calls for increased political and financial commitment to child survival, with a focus on reaching the most vulnerable populations and strengthening primary healthcare systems. It also emphasizes the need for improved data collection and accountability to track progress and ensure that no child is left behind.
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