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Around 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns, according to a new global report, which stressed that most of these deaths could have been prevented through low-cost interventions and better access to quality health care.

The report, Levels & Trends in Child Mortality, shows that under-five deaths have dropped by more than half since 2000. However, progress has slowed sharply since 2015, with the rate of decline falling by over 60 percent.

For the first time, the report includes detailed estimates on causes of death, highlighting severe acute malnutrition (SAM) as a direct cause of more than 100,000 deaths among children aged 1–59 months in 2024. The actual toll is likely higher, as malnutrition weakens immunity and increases vulnerability to diseases, and is often underreported. Countries such as Pakistan, Somalia, and Sudan recorded some of the highest numbers.

Newborn deaths accounted for nearly half of all under-five fatalities, reflecting slower progress in care around childbirth. The leading causes were preterm birth complications (36 percent) and complications during labour and delivery (21 percent), along with infections and congenital conditions.

Among older children, infectious diseases remained the leading killers. Malaria accounted for 17 percent of deaths, particularly in sub-Saharan Africa, where progress has stalled due to conflict, climate shocks, drug resistance, and limited access to care. Deaths are concentrated in a few countries, including Chad, the Democratic Republic of the Congo, Niger, and Nigeria.

Geographic disparities remain stark. Sub-Saharan Africa accounted for 58 percent of under-five deaths in 2024, followed by Southern Asia at 25 percent. In contrast, infectious diseases caused just 9 percent of such deaths in Europe and Northern America, and 6 percent in Australia and New Zealand, reflecting unequal access to life-saving interventions.

In Southern Asia, most deaths were linked to preventable conditions in the first month of life, underscoring the need for better maternal and newborn care, including skilled birth attendance and essential newborn services.

Children in fragile and conflict-affected settings were nearly three times more likely to die before age five than those elsewhere.

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

The report warned that changing global financing trends are putting maternal and child health programmes at risk, emphasizing the need for sustained investment in health systems, data collection, and essential services.

It stressed that investing in child health remains highly cost-effective, noting that every dollar spent on child survival can generate up to $20 in social and economic benefits.

To accelerate progress, the report called on governments and partners to prioritize child survival, focus on high-risk populations, strengthen accountability, and invest in primary health care systems to prevent and treat the leading causes of child deaths.