Recent funding cuts have put decades of progress in child survival at risk, say global experts, calling for increased investments, service integration, and innovations to urgently scale up access to proven life-saving health, nutrition, and social protection services for children and pregnant mothers.
They say although the number of under-five deaths declined to 4.8m in 2023, stillbirths remained at around 1.9m.
Two recent reports – released by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME) – show that since 2000, child deaths have dropped by more than half and stillbirths by more than a third, fuelled by sustained investments in child survival worldwide.
In 2022, the world reached a historic milestone when child deaths dropped slightly below 5m for the first time.
But progress has slowed and too many children are still being lost to preventable causes.
The reports also show that where a child is born greatly influences their chances of survival, revealing that the risk of death before age five is 80 times higher in the highest-mortality country than the lowest-mortality country. For example, a child born in sub-Saharan Africa, is on average, 18 times more likely to die before turning five than one born in Australia and New Zealand.
Stillbirth disparities are just as severe, with nearly 80% occurring in sub-Saharan Africa and Southern Asia, where women are six to eight times more likely to experience a stillbirth than women in Europe or North America.
Meanwhile, women in low-income countries are eight times more likely to experience a stillbirth than those in high-income countries.
Global commitment
Millions of children are alive today because of the global commitment to proven interventions, like vaccines, nutrition, and access to safe water and basic sanitation,” said Unicef executive director Catherine Russell.
“Bringing preventable child deaths to a record low is a remarkable achievement. But without the right policy choices and adequate investment, we risk reversing these hard-earned gains, with millions more children dying from preventable causes. We cannot allow that to happen.”
The recent funding cuts from major donors are threatening life-saving child survival programmes, healthcare worker shortages, clinic closures, vaccination programme disruptions, and a lack of essential supplies, like malaria treatments.
They could also undermine monitoring and tracking efforts, making it harder to reach the most vulnerable children, the Inter-agency Group warned.
Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said there was a need – more than ever – to step up collaboration to protect and improve children’s health.
Even before the current funding crisis, the pace of progress on child survival had already slowed. Since 2015, the annual rate of reduction of under-five mortality has slowed by 42%, and stillbirth reduction has slowed by 53%, compared with 2000–2015.
Almost half of under-five deaths happen within the first month of life, mostly due to premature birth and complications during labour. Beyond the newborn period, infectious diseases, including acute respiratory infections like pneumonia, malaria, and diarrhoea, are the leading causes of preventable child death.
Meanwhile, 45% of late stillbirths occur during labour, often due to maternal infections, prolonged or obstructed labour, and lack of timely medical intervention.
Better access to quality maternal, newborn, and child health care at all levels of the health system will save many more lives, said the reports.
“Most preventable child deaths occur in low-income countries, where essential services, vaccines, and treatments are often inaccessible”, said Juan Pablo Uribe, World Bank Global Director for Health and Director of the Global Financing Facility.
The reports also show that where a child is born greatly influences their chances of survival
UN IGME members call on governments, donors, and partners across the private and public sectors to protect the hard-won gains in saving children’s lives and accelerate efforts.
The two reports – Levels & Trends in Child Mortality and Counting Every Stillbirth – are the first of a series of important global data sets released in 2025. UN maternal mortality figures will be published in the coming weeks.
UNIGME-2024-Child-Mortality-Report_28-March
See more from MedicalBrief archives:
Global child mortality drops, but preventable deaths still high
UNICEF mortality estimates: Millions of children dying of preventable causes
Most child deaths in poor countries preventable, study finds