The vast majority of deaths among children under five are preventable with proven, low-cost interventions and access to quality healthcare, a new report emphasizes. For the first time, the analysis comprehensively integrates global estimates to detail not only how many children are dying and where, but also the specific causes of their deaths.
According to the “Levels and Trends in Child Mortality” report by the UN Inter-agency Group for Child Mortality Estimation, while deaths of children under five have more than halved since 2000, the rate of decline has slowed by over 60 percent since 2015.
Malnutrition and Key Threats Identified
A significant finding reveals that over 100,000 children between one month and five years old died directly from severe acute malnutrition. This marks the first global estimate for such deaths, with Pakistan, Somalia, and Sudan recording the highest numbers. Experts suggest the actual figure is likely higher due to malnutrition weakening immunity, increasing vulnerability to other diseases, and underreporting.
“No child should die from diseases we know how to prevent. Yet, we are seeing alarming signs that progress in child survival is stalling – and this is happening at a time of increasing global budget cuts,” said UNICEF Executive Director Catherine Russell.
Infectious diseases remain a major threat, with the nine most common infections accounting for 43 percent of under-five deaths globally. Beyond the first month of life, malaria, diarrhea, and pneumonia are leading causes of death, particularly in high-burden regions. Deaths are concentrated in a few endemic countries, including Chad, the Democratic Republic of Congo, Niger, and Nigeria, where conflict, climate shocks, invasive mosquitoes, drug resistance, and other biological threats continue to affect access to prevention and treatment. Neonatal deaths now account for nearly half of all under-five deaths, indicating slower progress in preventing deaths around the time of birth. Complications from preterm birth and those occurring during delivery are among the leading causes, alongside infections.
Children in Conflict Zones Face Higher Risks
Geographical disparities persist. Sub-Saharan Africa accounted for 58 percent of under-five deaths in 2024, while South Asia represented 25 percent. Children in fragile and conflict-affected regions are nearly three times more likely to die before their fifth birthday than those in other areas. The report also notes that 2.1 million children, adolescents, and young adults aged 5 to 24 died in 2024. While infectious diseases and injuries remain leading causes for young children, risks shift during adolescence; self-harm is the leading cause of death for girls aged 15-19, and road traffic injuries for boys. UN officials warned that declining development financing is placing increasing pressure on essential maternal, newborn, and child health programs.
Nations Lag Behind Child Health Goals
UN Under-Secretary-General for Economic and Social Affairs Li Junhua described the findings as a “stark reminder” that many countries are falling behind on their child health targets under the Sustainable Development Goals. “We know how to prevent these deaths. What is now needed is renewed political commitment, sustained investment in primary health care, and stronger data systems to ensure no child is left behind,” he stated. The report highlights that investments in child health, featuring proven interventions such as immunizations, nutrition programs, and skilled birth attendance, are among the most cost-effective development measures, capable of saving millions of lives.
