The World Health Organisation (WHO) has warned that progress in reducing child deaths is slowing, with 4.9 million children dying before age five in 2024.
The report given on Wednesday highlights preventable causes, rising adolescent risks and stark regional inequalities, urging increased investment in healthcare, nutrition and safety measures to protect vulnerable populations and sustain global gains in child survival.
In a new report released jointly with global partners, the World Health Organization said most of these deaths are preventable through “proven, low-cost interventions and access to quality health care.”
The findings show that while under-five deaths have fallen by more than half since 2000, progress has significantly slowed in recent years.
Since 2015, the pace of reduction in child mortality has declined by more than 60 percent, raising concerns about the ability of countries to meet global health targets.
The report provides a detailed assessment of where children are dying and the causes behind these deaths.
For the first time, it includes estimates of deaths directly caused by severe acute malnutrition, with more than 100,000 children aged between one and 59 months dying from the condition in 2024.
The report warns that the true burden is likely higher, as malnutrition weakens immunity and increases vulnerability to other diseases.
Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in addressing risks around childbirth.
The leading causes include complications from preterm birth, which account for 36 percent of deaths, and complications during labour and delivery at 21 percent. Infections such as neonatal sepsis and congenital anomalies also contribute significantly.
Beyond the neonatal period, infectious diseases remain a major threat. Malaria is identified as the single largest killer among children in this age group, responsible for 17 per cent of deaths, particularly in sub-Saharan Africa.
The report notes that progress in reducing malaria deaths has slowed after earlier gains between 2000 and 2015.
The burden of child mortality remains heavily concentrated in certain regions. Sub-Saharan Africa accounted for 58 percent of all under-five deaths in 2024, with infectious diseases responsible for more than half of these fatalities.
In contrast, the proportion of deaths linked to infectious diseases is significantly lower in regions such as Europe, Northern America, Australia and New Zealand.
Southern Asia accounted for 25 percent of global under-five deaths, with many fatalities linked to complications in the first month of life.
These include preterm delivery, birth asphyxia, congenital anomalies and neonatal infections, all of which the report says are largely preventable with improved healthcare access.
The report also highlights the disproportionate impact on fragile and conflict-affected countries, where children are nearly three times more likely to die before their fifth birthday compared to those in more stable settings.
Among older children, adolescents and youth, the report estimates that 2.1 million individuals aged between five and 24 died in 2024.
It notes a shift in risks during adolescence, stating that “self-harm is the leading cause of death among girls” aged 15 to 19, while “road traffic injuries” are the leading cause among boys in the same age group.
WHO and its partners have called for renewed political commitment and sustained investment in health systems to address the challenges.
The report emphasises the importance of prioritising child survival, particularly in high-burden regions, and improving access to affordable, quality healthcare services.
It also highlights the need to strengthen primary healthcare systems, enhance disease surveillance and invest in essential services such as immunisation, nutrition programmes and skilled care at birth.
Public health awareness and preventive measures are also seen as critical in reducing mortality rates.
The findings come amid concerns about funding pressures on global health programmes, with shifts in development financing threatening progress in maternal, newborn and child health initiatives.
WHO says evidence shows that investments in child health are among the most cost-effective development measures, with every dollar invested potentially generating up to twenty dollars in social and economic benefits.
The report concludes that while significant progress has been made over the past two decades, urgent action is needed to sustain gains and accelerate efforts to prevent avoidable deaths.
Without increased investment and coordinated action, millions of children will continue to die from causes that can be prevented.
