The State of Child Mortality: A Global Overview

While under-five mortality rates have more than halved since 2000 – a testament to decades of focused global health initiatives – the rate of improvement has dramatically slowed since 2015, decreasing by over 60 percent. This deceleration raises serious concerns about the future of child survival, especially as global funding for development programs faces increasing pressure.

This year’s comprehensive report, Levels & Trends in Child Mortality, offers the most detailed picture yet of child and adolescent mortality, pinpointing not only how many are dying, but where and, crucially, why. For the first time, the report fully integrates estimates of the specific causes of death, providing a clearer understanding of the challenges ahead.

The Hidden Burden of Malnutrition

Severe acute malnutrition (SAM) is now recognized as a direct cause of death for over 100,000 children aged one to 59 months in 2024 – representing 5 percent of all deaths in that age group. However, this figure likely underestimates the true impact of malnutrition, as it weakens children’s immune systems, making them far more susceptible to common, treatable diseases. Mortality data often fails to accurately reflect SAM as an underlying cause, obscuring the full extent of the problem. Pakistan, Somalia, and Sudan are among the countries with the highest numbers of direct deaths related to severe acute malnutrition.

Newborns Remain Most Vulnerable

Nearly half of all under-five deaths occur in the newborn period, highlighting the critical need for improved care around the time of birth. Complications from preterm birth account for 36 percent of newborn deaths, while complications during labor and delivery contribute to 21 percent. Infections, including neonatal sepsis and congenital anomalies, also pose significant threats.

Infectious Diseases Continue to Claim Lives

Beyond the first month, infectious diseases remain major killers of children. Malaria continues to be the single largest cause of death in this age group (17 percent), with the vast majority of cases occurring in sub-Saharan Africa. While progress in reducing malaria mortality was substantial between 2000 and 2015, it has slowed in recent years, particularly in countries like Chad, the Democratic Republic of the Congo, Niger, and Nigeria, where conflict, climate shocks, and drug resistance hinder prevention and treatment efforts.

Geographic Disparities: A Story of Inequality

Child deaths are heavily concentrated in specific regions. In 2024, sub-Saharan Africa accounted for 58 percent of all under-five deaths, with infectious diseases responsible for 54 percent of these fatalities. In stark contrast, Europe and Northern America account for only 9 percent, and Australia and New Zealand just 6 percent. These disparities underscore the profound inequalities in access to life-saving interventions.

Southern Asia accounts for 25 percent of all under-five deaths, with mortality largely driven by complications in the first month of life – including preterm delivery, birth asphyxia, congenital anomalies, and neonatal infections. Investing in quality antenatal care, skilled birth attendants, and essential newborn services is paramount in this region.

Children living in fragile and conflict-affected countries face an almost three-fold higher risk of dying before their fifth birthday compared to children elsewhere. The disruption of healthcare systems and increased vulnerability to disease in these settings contribute to this tragic reality.

Beyond Early Childhood: Adolescent Mortality

The report also highlights the challenges facing older children and adolescents. An estimated 2.1 million children and young people aged 5-24 died in 2024. While infectious diseases and injuries remain leading causes of death among younger children, 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.

Did You Know? Every dollar invested in child survival can generate up to twenty dollars in social and economic benefits, demonstrating the powerful return on investment in child health.

The Funding Crisis and the Path Forward

Shifts in global development financing are placing critical maternal, newborn, and child health programs under increasing strain. Sustained funding for surveys, health information systems, and core healthcare functions is essential not only to protect past gains but to accelerate progress. Proven, low-cost interventions – such as vaccines, treatment for severe acute malnutrition, and skilled care at birth – offer the highest returns in global health, improving productivity, strengthening economies, and reducing future public spending.

What role should governments play in prioritizing child health? And how can international collaboration be strengthened to address these global challenges?

Frequently Asked Questions About Child Mortality

• What is the current global child mortality rate?

  The current estimated child mortality rate is 4.9 million deaths before the age of five in 2024, a significant decrease from 2000 but a slowing rate of improvement.

• What are the leading causes of death for children under five?

  The leading causes include complications from preterm birth, complications during labor and delivery, infections (such as pneumonia, diarrhea, and malaria), and now, increasingly, severe acute malnutrition.

• Why is progress in reducing child mortality slowing down?

  Progress is slowing due to a combination of factors, including conflict, climate change, economic instability, and a decrease in global funding for development programs.

• What can be done to accelerate progress in reducing child mortality?

  Accelerating progress requires increased political commitment, sustained investment in primary healthcare systems, and a focus on reaching the most vulnerable populations.

• How does malnutrition contribute to child mortality?

  Severe acute malnutrition directly causes deaths and weakens children’s immune systems, making them more susceptible to common, treatable diseases, significantly increasing their risk of mortality.