Child deaths remain concentrated in Sub-Saharan Africa, Southern Asia, UN says

An estimated 4.9 million children died before their fifth birthday last year, the UN Inter-agency Group for Child Mortality Estimation said in its latest Levels and Trends in Child Mortality report. Of those deaths, 58% were in sub-Saharan Africa and 25% in Southern Asia.

The report said progress in reducing child deaths has slowed sharply. Under-five deaths have fallen by more than half since 2000, but the pace of reduction has slowed by more than 60% since 2015.

“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,” UNICEF Executive Director Catherine Russell said.

Newborn deaths now account for nearly half of all under-five mortality worldwide. The report linked those deaths mainly to preterm birth complications, problems during labour and delivery, and infections.

Among children aged one to 59 months, infectious diseases remained a leading cause of death. The nine leading infections accounted for 43% of under-five deaths globally. Pneumonia, diarrhoea and malaria remained major killers, especially in high-burden settings.

For the first time, the report gave a global estimate of deaths directly caused by severe acute malnutrition. More than 100,000 children aged between one month and five died from it in 2024. Some of the highest numbers were recorded in Pakistan, Somalia and Sudan.

Deaths were heavily concentrated in a small group of countries. These included Chad, the Democratic Republic of the Congo, Niger and Nigeria. The report said conflict, climate shocks, invasive mosquitoes, drug resistance and weak access to prevention and treatment continued to drive mortality there.

Children in fragile and conflict-affected settings were nearly three times more likely to die before their fifth birthday than children elsewhere.

The UN also estimated that 2.1 million children, adolescents and young people aged five to 24 died in 2024. Li Junhua, the UN’s under-secretary-general for economic and social affairs, called the findings “a stark reminder” that many countries are off track to meet child survival targets under the Sustainable Development Goals.