Most of these deaths could be avoided with proven, inexpensive interventions and access to quality health care, the report highlights.
For the first time, the analysis provides a comprehensive picture of not only how many children are dying and where they are dying, but also why, by fully integrating global estimates of causes of death.
THE Levels and trends in infant mortality A report launched by the United Nations Inter-Agency Group on Child Mortality Estimation shows that, although under-five deaths have more than halved since 2000, the pace of reduction has slowed by more than 60 percent since 2015.
Malnutrition and other major threats
Among its key findings, more than 100,000 children aged one month to five years died directly from severe acute malnutrition – the first global estimate of such deaths – with some of the highest figures recorded in Pakistan, Somalia and Sudan.
Experts warn that 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 we know how to prevent. But we are seeing worrying signs that progress on child survival is slowing – and this at a time when we are seeing further global budget cuts,” said Catherine Russell, executive director of the United Nations Children’s Fund (UNICEF).
A mother holds her newborn baby in the special newborn care unit of a hospital in Uttar Pradesh, India.
Infectious diseases remain a major threat, with the top nine infections accounting for 43 percent of deaths among children under five worldwide.
Beyond the first month of life, diseases such as malaria, diarrhea and pneumonia remain the leading causes of death, particularly in high-burden settings.
Deaths remain concentrated in a handful of 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.
Newborn deaths now account for almost half of total under-five mortality, reflecting slower progress in preventing deaths at the time of birth. Complications related to premature birth and those occurring during labor and delivery are the main causes, alongside infections.
Children in conflict are more likely to die
Geographic disparities remain marked. Sub-Saharan Africa accounted for 58 percent of all deaths of children under five in 2024, while South Asia accounted for a further 25 percent.
Children living in fragile or conflict-affected areas are almost three times more likely to die before their fifth birthday than those living elsewhere.
The report also notes that 2.1 million children, adolescents and young people aged 5 to 24 died in 2024. Although infectious diseases and trauma remain the main causes among young children, risks shift during adolescence, with self-harm being the leading cause of death among girls aged 15 to 19, and road accidents among boys.
UN officials have warned that Declining development financing is putting increasing strain on essential maternal, newborn and child health programs..
Countries are not on track to meet their child survival goals
U.N. Economic and Social Affairs chief Li Junhua described the findings as “a stark reminder” that many countries are falling behind in meeting 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 health care and stronger data systems. to ensure that no child is left behind,” he said.
The report highlights that investments in child health remain among the most cost-effective development measures, with proven interventions such as vaccines, nutrition programs and skilled birth care capable of saving millions of lives.
