Global Child and Adolescent Mortality Progress Slows Since 2015
Global progress in reducing child and adolescent mortality has significantly slowed since 2015, risking international child survival targets by 2030. Approximately 4.9 million children under five and 1.4 million aged 5-19 died in 2024, largely from preventable causes concentrated in Sub-Saharan Africa and South Asia.
Key Highlights
- Global child mortality reduction pace dropped over 60% since 2015.
- Nearly 5 million under-five children died in 2024, mostly from preventable causes.
- Sub-Saharan Africa and South Asia bear the heaviest burden of child deaths.
- Preterm birth and respiratory infections are leading causes for young children.
- Road injuries and malaria are major killers among adolescents aged 5-19.
- Many countries risk missing 2030 child survival goals if trends continue.
Global efforts to reduce child and adolescent mortality have experienced a substantial slowdown since 2015, jeopardizing the achievement of international child survival targets by 2030, according to comprehensive analyses by leading health organizations. A series of papers published by The BMJ and reports from the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME), UNICEF, and the World Health Organization (WHO) highlight this alarming trend.
Historically, significant strides were made in child survival. Between 2000 and 2015, the under-five mortality rate saw an annual decline of 3.9%. However, this pace dramatically decelerated to just 1.5% annually between 2015 and 2024, marking a slowdown of over 60%. This stalled progress means that millions of children continue to die from largely preventable causes.
In 2024 alone, an estimated 4.9 million children died before reaching their fifth birthday. Nearly half of these tragic deaths, approximately 2.3 million, occurred among newborns during their first month of life. Beyond early childhood, an additional 1.4 million children and adolescents aged 5 to 19 years also lost their lives in 2024. The cumulative impact is dire, with projections indicating that if current trends persist, 27.3 million under-five deaths could occur by 2030, and 60 countries may fail to meet their child survival goals. Some reports suggest that without urgent intervention, 35 million children will die before turning five by 2030.
The leading causes of death vary by age group but are overwhelmingly preventable. For children under five, complications from preterm birth were responsible for around 860,000 deaths, while respiratory infections accounted for approximately 660,000 deaths. Pneumonia and diarrhoea remain significant killers beyond the neonatal period. Alarmingly, severe acute malnutrition (SAM) directly caused over 100,000 deaths in children aged 1-59 months in 2024, though the true toll is likely underestimated due to indirect effects like weakened immunity. For the 5-19 age group, road traffic injuries were the leading cause of death, resulting in 113,138 fatalities, followed by malaria, which caused 99,219 deaths. Infectious diseases, maternal, perinatal, and nutritional causes contributed to half of the deaths among children aged 5-14.
The geographic distribution of these deaths is starkly uneven. The overwhelming burden is concentrated in Sub-Saharan Africa and South Asia. In 2024, Sub-Saharan Africa alone accounted for 58% of all under-five deaths, with infectious diseases being responsible for 54% of these fatalities in the region. South Asia also records a high percentage of child and youth mortality. This disparity underscores profound health inequities and unequal access to life-saving interventions. For an Indian audience, the inclusion of South Asia as a major affected region makes this news particularly relevant, highlighting the need for sustained and targeted public health interventions within the country.
Several factors contribute to this stalled progress. These include underinvestment in primary healthcare, persistent health inequities, gaps in vaccination coverage, and ongoing challenges such as conflict, climate shocks, and drug resistance, particularly impacting regions like Sub-Saharan Africa. The COVID-19 pandemic also played a role, though its direct impact on child mortality (under 14 years) was found to be negligible. However, COVID-19 did significantly affect mortality rates among older adolescents aged 15-24. Furthermore, there are concerns about the indirect effects of the pandemic, such as strained health systems, household income loss, and disruptions to essential healthcare services like vaccinations, which could contribute to increased mortality.
The scientific community and global health leaders are calling for renewed commitment and sustained investment to reverse these alarming trends. Targeted interventions in primary health care, maternal and newborn health services, routine immunization, nutrition programs, and robust data systems are crucial to saving millions of lives. As the world approaches the 2030 Sustainable Development Goals deadline, accelerating progress to end preventable child deaths must be a global priority to ensure every child has the opportunity to survive and thrive.
Frequently Asked Questions
What is the main finding regarding child and adolescent mortality trends?
The main finding is that global progress in reducing preventable deaths among newborn babies, children, and adolescents has slowed substantially since 2015, putting many countries at risk of missing international child survival targets by 2030.
How many children are currently dying annually and in which age groups?
An estimated 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns. Additionally, 1.4 million children and adolescents aged 5-19 years also died in 2024.
Which regions are most affected by the slowdown in mortality reduction?
The slowdown in mortality reduction disproportionately affects Sub-Saharan Africa and South Asia, with these regions accounting for the vast majority of child and adolescent deaths globally.
What are the primary causes of death for young children and adolescents?
For children under five, leading causes include complications from preterm birth and respiratory infections, along with pneumonia, diarrhoea, and severe acute malnutrition. For those aged 5-19, road traffic injuries and malaria are among the predominant causes.
What are the implications if current trends continue?
If current trends continue, an estimated 27.3 million under-five deaths are projected by 2030, and 60 countries risk missing their child survival goals, with some reports projecting 35 million children dying before age five by 2030.