Most of these deaths are preventable with evidence-based, low-cost interventions and access to high-quality health care, the report emphasizes.
For the first time, the analysis provides an overall picture of not only how many children die and where – but also why, by fully integrating global estimates of 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 more than halved since 2000, the rate of reduction has fallen by more than 60 percent 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 that the true toll is likely to be higher, as malnutrition weakens immunity and increases vulnerability to other diseases, while many cases go unreported.
“No child should die from diseases that we know how to prevent. But we are seeing worrying signs that progress on child survival is slowing – and 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 at the Special Newborn Care Unit at a hospital in Uttar Pradesh, India.
Infectious diseases remain a major threat, with the nine leading infections accounting for 43 percent of under-five deaths globally.
Beyond the first month of life, diseases such as malaria, diarrhea and pneumonia remain the most frequent causes of death, especially in high-stress environments.
Deaths are still concentrated in a handful of endemic countries – including Chad, the Democratic Republic of Congo, Niger and Nigeria – where conflicts, climate shock, invasive mosquitoes, 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 birth. Complications from premature birth and those that occur during labor and delivery are the leading causes, along with infections.
Children in conflict are more likely to die
Geographical differences are still significant. Sub-Saharan Africa accounted for 58 percent of all under-five deaths in 2024, while southern Asia represented another 25 percent.
Children in fragile and conflict-affected settings are almost three times more likely to die before their fifth birthday than elsewhere.
This is also noted in the report 2.1 million children, adolescents and young adults aged 5 to 24 died in 2024. While infectious diseases and injuries remain the leading causes among younger children, the risk shifts during adolescence, with self-harm being the leading cause of death among girls aged 15 to 19, and road traffic injuries among boys.
UN officials warned that Declining development funding is putting vital maternal, newborn and child health programs under increasing pressure.
Countries off track to achieve child survival goals
The UN’s head of economic and social affairs, Li Junhua, described the results as “a stark reminder” that many countries are on 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 health care and stronger data systems to ensure that no child is left behind,” he said.
The report emphasizes that investment in child health remains among the most cost-effective development efforts, with proven interventions such as vaccines, nutrition programs and skilled care at birth saving millions of lives.
