NEW DELHI: An estimated 4.9 million children died before their fifth birthday in 2024 globally, including 2.3 million newborns, according to new estimates released by the UN on Wednesday.
Most of these deaths are preventable with proven, low-cost interventions and access to quality health care, said the report ‘Levels and Trends in Child Morality; by the United Nations Inter-agency Group for Child Mortality Estimation (UNIGME) Report 2025.
The report praises India’s progress in reducing child mortality. “India, with its wide demographic and sociocultural diversity, has shown an upward trajectory in its newborn and child health outcomes.”
The report highlights India’s sustained and large-scale efforts in improving child survival outcomes, particularly across neonatal and under-five mortality indicators.
Over the past two decades, India has played a pivotal role in reducing child mortality in the Southern Asia region, which has witnessed a 76% decline in under-five deaths since 1990 and 68% decline since 2000.
This sharp reduction is largely driven by countries like India through targeted public health interventions, improved institutional delivery systems, and expanded immunization coverage.
The region’s under-five mortality rate has fallen significantly - from 92 deaths per 1,000 live births in 2000 to nearly 32 in 2024, reflecting sustained progress in child health outcomes.
India’s Neonatal Mortality Rate records a decline of 70% from 1990. In 1990, India had a NMR of 57, which has now fallen to 17 in 2024. Under Five Mortality Rate witnesses a sharp fall of 79% from 1990's data. In 1990, the U5MR stood at 127 while in 2024 it declined to 27.
This was due to India’s focused interventions which contributed to reducing deaths caused by preventable conditions such as: pneumonia, diarrhoea, malaria and birth-related complications.
The report underscores that a majority of child deaths are preventable or treatable, and India’s scaling up of interventions such as: Universal Immunization Programme (UIP), Facility-based newborn care, Integrated Management of Neonatal and Childhood Illnesses (IMNCI) has significantly improved survival rates.
India’s improvements in neonatal care systems have been particularly impactful. Across Southern Asia: Neonatal deaths declined by nearly 60% since 2000 and Mortality in children aged 1–59 months declined by over 75%.
This reflects India’s emphasis on: Skilled birth attendance, Strengthening Special Newborn Care Units (SNCUs), and expanding antenatal and postnatal care.
While Southern Asia still accounts for nearly 25% of global under-five deaths, the region has made one of the fastest reductions globally, positioning India as a leader among high-burden countries.
Mortality in the region was driven largely by complications in the first month of life - including preterm delivery, birth asphyxia/ trauma, congenital anomalies, and neonatal infections, the report added.
These largely preventable conditions underscore the urgent need for investing in quality antenatal care, skilled health-care personnel at birth, care of small and sick newborns, and essential newborn services, the report added.
The report also highlights emerging priorities where India is actively focusing on, such as tackling neonatal mortality, which now constitutes a larger share of under-five deaths; and addressing prematurity and birth complications, which remain leading causes.
“India remains committed to achieving the Sustainable Development Goal (SDG) targets - Under-five mortality rate below 25 per 1,000 live births and neonatal mortality rate below 12 per 1,000 live births."
“With accelerated interventions, India is well-positioned to further reduce preventable deaths and contribute significantly to global child survival goals. India’s progress stands as a strong example of how policy prioritization, scale, and sustained public health efforts can drive transformative outcomes. As global progress slows, India’s momentum offers both hope and a replicable model for other nations.”
According to UNICEF Executive Director Catherine Russell, “No child should die from diseases that we know how to prevent. But we see worrying signs that progress in child survival is slowing – and at a time where we’re seeing further global budget cuts.”
“History has shown what is possible when the world commits to protecting its children. With sustained investment and political will, we can continue to build on those achievements for future generations.”
“The world has made remarkable progress in saving children’s lives, but many still die from preventable causes,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Children living amid conflict and crisis are nearly three times more likely to die before their fifth birthday. We must protect essential health and nutrition services and reach the most vulnerable families so every child has the chance not only to survive, but to thrive.”
"These findings are a collective call to speed up implementation of the proven, scalable solutions we know are within reach," said Monique Vledder, World Bank Group Director, Health. "The World Bank Group health target of reaching 1.5 billion people is our concrete commitment to accelerating access to quality primary health services for more children and families."
For the first time, the report estimates deaths directly caused by severe acute malnutrition (SAM), finding that more than 1,00,000 children aged 1-59 months – or 5 per cent – died from it in 2024.
The toll is far greater when indirect effects are considered, as malnutrition weakens children’s immunity and increases their risk of dying from common childhood diseases.
Newborn deaths account for nearly half of all under-five deaths, reflecting slower progress in preventing deaths around the time of birth. Leading causes among newborns were complications from preterm birth (36 per cent) and complications during labour and delivery (21 per cent). Infections, including neonatal sepsis and congenital anomalies, were also important causes.
Beyond the first month, infectious diseases such as malaria, diarrhoea, and pneumonia were major killers. Malaria remained the single largest killer in this age group (17 per cent) - with most deaths occurring in endemic areas of sub-Saharan Africa.
After steep declines between 2000 and 2015, progress towards reducing malaria mortality slowed in recent years. Deaths remain concentrated in a handful of endemic countries – such as Chad, Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitoes, drug resistance, and other biological threats continue to affect access to prevention and treatment.
The report also finds that an estimated 2.1 million children, adolescents and youth aged 5–24 died in 2024. Infectious diseases and injuries remain leading causes among younger children, while risks shift in adolescence: self-harm is the leading cause of death among girls aged 15–19, and road traffic injuries among boys.
Shifts in the global development financing landscape are placing critical maternal, newborn, and child health programmes under growing pressure. Surveys, health information systems, and the core functions that underpin effective care all need sustained funding not only to protect the progress made, but to accelerate it, the report added.
Evidence shows that investments in child health remain among the most cost-effective development measures. Proven, low-cost interventions – such as vaccines, treatment for severe acute malnutrition, and skilled care at birth – deliver some of the highest returns in global health, improving productivity, strengthening economies and reducing future public spending, it said.
"Every dollar invested in child survival can generate up to twenty dollars in social and economic benefits," it further said.