An estimated 4.9 million children died before their fifth birthday in 2024 according to newly released global estimates. This staggering figure includes approximately 2.3 million newborns who lost their lives within their first month of existence. Most of these deaths remain entirely preventable with proven, low-cost interventions and access to quality health care, says a UN report. However, the global community faces a significant challenge as the pace of mortality reduction has slowed considerably.
According to the “Levels & Trends in Child Mortality” report, under-five deaths have fallen by half since 2000. Nevertheless, since 2015, the pace of reduction in child mortality has slowed by more than 60 per cent. This year’s report provides the clearest and most detailed picture yet of how many young people are dying. For the first time, it fully integrates estimates on specific causes of death to guide global health policy.
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The Silent Killer: Severe Acute Malnutrition (SAM)
For the first time, the report estimates deaths directly caused by severe acute malnutrition among children. Findings show that over 100,000 children aged 1 to 59 months died directly from SAM in 2024. This represents about 5 per cent of deaths in that specific age group during the current year. However, the actual toll is far greater when researchers consider the indirect effects of chronic hunger.
Malnutrition significantly weakens a child’s immunity and increases their risk of dying from common childhood diseases. Mortality data frequently fail to capture SAM as an underlying cause of death in many global regions. Furthermore, newborns under one month are not included in this figure, suggesting the burden is substantially underestimated. Countries with the highest numbers of direct deaths include Pakistan, Somalia, and the war-torn nation of Sudan.
The Critical First Month: Why Newborns Remain Vulnerable
Newborn deaths now account for nearly half of all under-five deaths recorded globally this year. This trend reflects slower progress in preventing deaths that occur specifically around the time of birth. Leading causes among newborns include complications from preterm birth, which accounts for 36 per cent of deaths. Additionally, complications during labour and delivery are responsible for 21 per cent of these early losses.
Infections, including neonatal sepsis and various congenital anomalies, remain important causes of death for newborns. Beyond the first month, infectious diseases such as malaria, diarrhoea, and pneumonia become the major killers. Malaria remained the single largest killer in this age group, accounting for 17 per cent of deaths. Most of these malaria deaths occur in endemic areas within the region of sub-Saharan Africa.
Geographic Disparities: A Divided World of Health Access
Child deaths remain highly concentrated geographically, revealing deep inequalities in global healthcare infrastructure and resource distribution. In 2024, sub-Saharan Africa accounted for a staggering 58 per cent of all global under-five deaths. In this region, nine leading infectious diseases were responsible for over half of all child deaths. In contrast, this proportion drops to just 6 per cent in Australia and New Zealand.
Southern Asia accounted for 25 per cent of all under-five deaths, driven largely by complications in early life. Mortality in this region stems from preterm delivery, birth asphyxia, trauma, and various neonatal infections. These largely preventable conditions underscore the urgent need for investing in quality antenatal care services. Skilled healthcare personnel at birth and essential newborn services are vital to improving these survival rates.
Conflict and Climate: The Burden of Fragile States
Fragile and conflict-affected countries continue to bear a disproportionate share of the global mortality burden. Children born in these settings are nearly three times more likely to die than those elsewhere. Conflict, climate shocks, and invasive mosquitos continue to affect access to prevention and treatment in these areas. Drug resistance and other biological threats also hinder progress in endemic countries like Chad and Nigeria.
Furthermore, the report found that an estimated 2.1 million children and youth aged 5-24 died in 2024. Infectious diseases and injuries remain leading causes among younger children within this specific age bracket. However, risks shift significantly as children enter adolescence, introducing new and tragic causes of death. Self-harm is the leading cause of death among girls aged 15-19 in many regions.
The Changing Landscape of Adolescent Risks
As children grow into their teenage years, the primary threats to their lives undergo a dramatic transformation. While younger children face biological threats, adolescents often succumb to societal and environmental factors. Road traffic injuries have emerged as the leading cause of death among boys in this age group. This highlights the need for better infrastructure and safety regulations to protect the global youth population.
The integration of cause-of-death data for older children provides a more comprehensive view of public health. It allows policymakers to address the specific needs of adolescents who are often overlooked in mortality reports. Consequently, health interventions must evolve to address mental health and physical safety alongside traditional disease prevention. Protecting the 5-24 age group requires a multifaceted approach involving education, transport, and healthcare.
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Why has Progress Stalled Since 2015?
The most alarming finding in the 2024 report is the 60 per cent slowdown in mortality reduction. This deceleration suggests that the “low-hanging fruit” of global health interventions has already been picked. While simple vaccinations and rehydration salts saved millions, the remaining deaths are tied to complex systemic issues. These issues include deeply entrenched poverty, political instability, and the worsening effects of the global climate crisis.
Furthermore, the concentration of deaths in sub-Saharan Africa and Southern Asia points to a failure of equity. We possess the medical knowledge to save these children, yet we fail to deliver the resources. The data on severe acute malnutrition shows that food insecurity is a direct medical threat to survival. If the world does not accelerate its efforts, millions more preventable deaths will occur by 2030.
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Q&A Section: Understanding the 2024 Mortality Data
Q: What is the primary reason the pace of child mortality reduction has slowed?
A: Since 2015, factors like conflict, climate shocks, and drug resistance have hindered access to life-saving treatments.
Q: How many children died before their fifth birthday in 2024?
A: An estimated 4.9 million children died before age five, including 2.3 million newborns in their first month.
Q: Which region has the highest concentration of child deaths?
A: Sub-Saharan Africa accounts for 58 per cent of all under-five deaths, followed by Southern Asia at 25 per cent.
Q: What are the leading causes of death for newborn babies?
A: The leading causes are preterm birth complications, labour complications, neonatal sepsis, and various congenital anomalies.
Frequently Asked Questions (FAQ)
Is severe acute malnutrition (SAM) a major cause of death?
Yes, SAM directly caused over 100,000 deaths in 2024, but its indirect impact through weakened immunity is much higher.
Which countries struggle most with direct deaths from malnutrition?
Pakistan, Somalia, and Sudan are identified as having some of the highest numbers of direct SAM deaths.
What is the leading killer of children after their first month of life?
Malaria is the largest single killer, responsible for 17 per cent of deaths in children aged 1-59 months.
How much more likely are children in conflict zones to die?
Children in fragile or conflict-affected settings are nearly three times more likely to die before age five.
What are the main causes of death for adolescents?
Self-harm is the leading cause for girls aged 15-19, while road traffic injuries lead for boys.
Has there been any long-term progress in child survival?
Yes, under-five deaths globally have fallen by more than half since the year 2000
