Child Mortality Progress Stalls: 4.9 Million Children Die Before Age Five in 2024 | WHO Report

Why Has Progress in Reducing Child Deaths Slowed Down?

According to new estimates released by the World Health Organization and partner agencies in early 2026, an estimated 4.9 million children died before reaching their fifth birthday in 2024, including approximately 2.3 million newborns who died within their first 28 days of life. While global under-five mortality has declined substantially since 2000 — when the annual toll exceeded 10 million — the pace of progress has slowed in recent years, raising alarm among global health experts.

Several converging factors explain the deceleration. Armed conflict and displacement have disrupted health systems in sub-Saharan Africa and parts of South Asia, where the burden of child mortality is concentrated. Climate-related events including flooding, drought, and extreme heat have strained fragile health infrastructure. The COVID-19 pandemic also caused significant setbacks in routine immunization coverage and access to maternal and child health services, the effects of which continue to ripple through health systems. WHO has emphasized that the vast majority of these deaths are preventable with proven interventions such as skilled birth attendance, breastfeeding support, oral rehydration therapy, antibiotics for pneumonia, and routine vaccination.

Which Regions Are Most Affected by Child Mortality?

The geographic concentration of child mortality remains stark. Sub-Saharan Africa continues to bear the heaviest burden, with children in the region facing the highest risk of dying before age five compared to any other part of the world. South Asia is the second most affected region. Together, these two regions account for the overwhelming majority of preventable child deaths, driven by a combination of poverty, inadequate health infrastructure, food insecurity, and limited access to clean water and sanitation.

Within these regions, disparities are further amplified by rural versus urban divides, maternal education levels, and household wealth. Children born in the poorest households are significantly more likely to die before age five than those in wealthier families, even within the same country. WHO and UNICEF have repeatedly called for targeted investments in primary health care, community health workers, and nutrition programs in the most underserved areas to close these gaps.

What Interventions Can Prevent Child Deaths Most Effectively?

The leading causes of death among children under five are well established: neonatal complications (including preterm birth and birth asphyxia), pneumonia, diarrhea, and malaria. Malnutrition is an underlying contributing factor in roughly half of all under-five deaths, according to WHO estimates. Crucially, effective and affordable interventions exist for each of these conditions. Oral rehydration salts and zinc can treat childhood diarrhea. Antibiotics can cure bacterial pneumonia. Insecticide-treated bed nets and antimalarial medications address malaria. Skilled birth attendance and kangaroo mother care reduce neonatal mortality.

The challenge is not a lack of knowledge but a failure of implementation and equity. Global health organizations including WHO, UNICEF, and Gavi have called for renewed political commitment and increased financing to ensure that every child, regardless of where they are born, has access to basic health services. The 2026 WHO report serves as a sobering reminder that while the tools to save children's lives are available, reaching the most vulnerable populations requires sustained investment and systemic change in how primary health care is delivered in low-resource settings.