Progress in cutting child deaths has slowed sharply, with nearly 5 million children still dying before their fifth birthday each year, a new UN analysis has warned.
A worrying decline
The latest ‘Levels & Trends in Child Mortality’ report estimates 4.9 million under-fives died in 2024, including 2.3 million newborns, despite decades of progress and a range of proven, low cost interventions. Global under five deaths have more than halved since 2000, but the pace of decline has slowed markedly in recent years.
“The world has made remarkable progress in saving children’s lives, but many still die from preventable causes,” said Dr Tedros Adhanom Ghebreyesus, Director General, WHO.
Beyond the first month, infectious diseases such as malaria, diarrhoea and pneumonia remain the leading causes of death, with malaria responsible for 17% of deaths in children aged 1 to 59 months, largely in sub-Saharan Africa.
Researchers also, for the first time, estimate that more than 100,000 children aged 1 to 59 months died directly from severe acute malnutrition in 2024, with a much larger indirect burden as undernourished children are more vulnerable to infection. Alongside the 4.9 million under-fives, an additional 2.1 million people aged 5 to 24 died last year.
UN agencies say the science is well established, but progress is being held back by limited funding and political will. “No child should die from diseases that we know how to prevent,” said Catherine Russell, Executive Director, UNICEF.
What this means for pharma
For the pharmaceutical industry, the report underscores persistent gaps in access to essential medicines. Treatments for pneumonia, malaria and neonatal infections are widely available and relatively inexpensive, yet supply disruptions and limited local manufacturing capacity continue to restrict access in low- and middle-income countries, particularly in rural and conflict-affected settings.
Against this backdrop, multilateral purchasing and market‑shaping initiatives are becoming increasingly important. In November 2025, Gavi and UNICEF agreed an “equitable pricing” deal for the R21/Matrix‑M malaria vaccine that is expected to secure 30m additional doses to fully vaccinate almost 7 million more children, showing what is possible within aligned financing and procurement intiatives.
At the time, An Vermeersch, Chief Vaccine Programmes and Markets Officer, said the alliance was leveraging “innovative financing and partnerships to shape vaccine markets and secure access to affordable vaccines – saving lives and delivering economic benefits to countries in the process”.
