Global progress in reducing preventable deaths among newborns, children and adolescents has slowed significantly since 2015, putting many countries at risk of failing to meet global child survival targets by 2030, a series of papers published by the US government has found. BMJ today.
Researchers estimate that up to 9.4 million people could die by 2030, including 2.5 million children under five, and are calling for renewed efforts and sustained investment to prevent the tragedy from spreading.
The results also showed that of the estimated 4.9 million deaths of children under five in 2024, preterm birth complications (860,000) and respiratory infections (660,000) were the main causes, while road injuries (113,138) and malaria (99,219) accounted for the majority of the 1.4 million deaths among children aged 5 to 19.
Although there has been an overall decline in child mortality, particularly under-five mortality, since the 1990s, progress remains uneven across regions, age groups, and gender.
To explore this further, researchers used data from 200 countries and territories (1990-2024) to estimate mortality rates and trends from birth to age 24, identifying where improvements are stalling and where investment is most important.
The findings show that although the number of deaths among children under five has fallen over the past two decades, 4.9 million children in this age group will die in 2024, with almost half of these deaths occurring in newborns.
Mortality rates for children under five fell by 3.9% between 2000 and 2015, but the decline was only 1.5% between 2015 and 2024.
Preterm birth complications and pneumonia are the leading causes of death in children under 5 years of age, and most of these deaths occur in sub-Saharan Africa and South Asia. If recent trends continue, 27.3 million children under the age of five will die by 2030, leaving 60 countries unable to meet their child survival targets.
By 2024, there will be an estimated 1.3 million deaths among people aged 5 to 19. Half of deaths among 5- to 14-year-olds are due to communicable (infectious) diseases, maternal, perinatal, and nutritional causes, and the rate of decline for these causes has slowed since 2016.
Childhood cancer, road traffic injuries and issues related to young motherhood are among the leading causes of death in this age group, but they do not always receive attention or priority action.
These are observations, and the researchers note limitations such as dependence on data of varying quality and availability, and uncertainties in model-based estimates and scenario-based predictions. But they say these findings provide the most comprehensive and up-to-date child survival statistics available.
They conclude that renewed efforts and continued investment are essential to ending preventable deaths and protecting every child’s right to life.
The slowing rate of decline in mortality over the past decade is a tragedy in progress, and rich countries need to invest more in official development assistance, experts say in a linked editorial. “We have a moral obligation to mobilize all efforts to accelerate the rate of decline in mortality.”
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Reference magazines:
Sharrow, D. Others. (2026). Global, regional and national levels and trends in under-five mortality, infant mortality and neonatal mortality from 1990 to 2024 and scenario-based projections to 2030: A modeling study. B.M.J. DOI: 10.1136/bmj-2025-088684. https://www.bmj.com/content/393/bmj-2025-088684
