Shocking: Nearly 5 million children still die before age 5 every year — Here’s why

Most of these deaths are preventable with proven, low-cost interventions and access to quality health care, the report stresses.

For the first time, the analysis provides a comprehensive picture of not only how many children are dying and where – but also why, by fully integrating global estimates on causes of death.

The Levels and Trends in Child Mortality report launched by the UN Inter-agency Group for Child Mortality Estimation shows that, although under-five deaths have fallen by more than half since 2000, the pace of reduction has slowed by more than 60 per cent since 2015.

Malnutrition and other major threats

Among its key findings, more than 100,000 children aged between one month and five, died directly from severe acute malnutrition – the first global estimate of such deaths – with some of the highest numbers recorded in Pakistan, Somalia and Sudan.

Experts warn the true toll is likely higher, as malnutrition weakens immunity and increases vulnerability to other diseases, while many cases go unrecorded.

“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,” said Catherine Russell, Executive Director for the UN Children’s Fund (UNICEF).

Infectious diseases remain a major threat, with the nine leading infections accounting for 43 per cent of under-five deaths globally.

Beyond the first month of life, illnesses such as malaria, diarrhoea and pneumonia continue to be leading causes of death, particularly in high-burden settings.

Deaths remain concentrated in a handful of endemic countries – including Chad, Democratic Republic of Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment.

Newborn deaths now account for nearly half of all under-five mortality, reflecting slower progress in preventing deaths around the time of birth. Complications from preterm birth and those arising during labour and delivery are the leading causes, alongside infections.

Children in conflict more likely to die

Geographical disparities remain stark. Sub-Saharan Africa accounted for 58 per cent of all under-five deaths in 2024, while Southern Asia represented a further 25 per cent.

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

The report also notes that 2.1 million children, adolescents and young people aged 5 to 24, died in 2024. While infectious diseases and injuries remain leading causes among younger children, risks shift in adolescence, with self-harm the leading cause of death among girls aged 15 to 19, and road traffic injuries among boys.

UN officials warned that declining development financing is placing essential maternal, newborn and child health programmes under increasing strain.

Countries off track to meet child survival targets

The UN’s Economic and Social Affairs chief Li Junhua described the findings as “a stark reminder” that many countries are off track to meet child survival targets under the Sustainable Development Goals.

“We know how to prevent these deaths. What is needed now is renewed political commitment, sustained investment in primary healthcare, and stronger data systems to ensure no child is left behind,” he said.

The report underscores that investments in child health remain among the most cost-effective development measures, with proven interventions such as vaccines, nutrition programmes and skilled care at birth capable of saving millions of lives.