Nearly five million children died before their fifth birthday in 2024, the majority from preventable or treatable causes, as a landmark United Nations report warns that decades of progress in child survival are dangerously slowing.
An estimated 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns, according to new estimates released by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). While under-five deaths globally have fallen by more than half since 2000, the pace of reduction has slowed by more than 60 per cent since 2015.
The 2025 Levels and Trends in Child Mortality report — produced jointly by UNICEF, the World Health Organization (WHO), the World Bank Group and the UN Department of Economic and Social Affairs — carries an especially sobering finding for newborn survival. Newborn deaths account for nearly half of all under-five deaths, with leading causes among newborns being complications from preterm birth at 36 per cent and complications during labour and delivery at 21 per cent.
For the first time, the report directly estimates deaths caused by severe acute malnutrition (SAM). More than 100,000 children aged one to 59 months died directly from severe acute malnutrition in 2024, representing five per cent of deaths in that age group. The actual toll is considered substantially higher, as malnutrition weakens immunity and increases the risk of dying from common diseases, yet mortality data frequently fail to record it as an underlying cause of death.
Beyond the first month of life, infectious diseases remained dominant killers, with malaria accounting for 17 per cent of deaths in children aged one to 59 months, most occurring in endemic areas of sub-Saharan Africa. The nine leading infectious diseases were responsible for 54 per cent of all under-five deaths in the region.
Children in fragile and conflict-affected countries remain at extreme risk. Children born in fragile and conflict-affected settings are nearly three times more likely to die before their fifth birthday compared to those elsewhere.
An additional 2.1 million children, adolescents and youth aged five to 24 died in 2024. Among adolescents, self-harm was the leading cause of death for girls aged 15 to 19, and road traffic injuries the leading cause for boys in the same age group.
UNICEF Executive Director Catherine Russell said the findings demanded urgent attention at a time of global budget cuts to child health financing. WHO Director-General Dr Tedros Adhanom Ghebreyesus echoed that call, warning that essential health services must be protected for the most vulnerable families.
