The number of children who died before their fifth birthday has reached a historic low, dropping to 4.9 million in 2022, according to the latest estimates released by the United Nations Interagency Group for Child Mortality Estimation (UN IGME).
The report reveals that more children are surviving today than ever before, with the global under-5 mortality rate declining by 51 percent since 2000. Several low- and lower-middle-income countries have outpaced this decline, showing that progress is possible when resources are sufficiently allocated to primary healthcare, including child health and well-being. For example, the findings show that Cambodia, Malawi, Mongolia, and Rwanda have reduced under-5 mortality by over 75 percent since 2000.
But the findings also show that despite this progress, there is still a long road ahead to end all preventable child and youth deaths. In addition to the 4.9 million lives lost before the age of 5 – nearly half of which were newborns – the lives of another 2.1 million children and youth aged 5-24 were also cut short. Most of these deaths were concentrated in sub-Saharan Africa and Southern Asia.
This tragic loss of life is primarily due to preventable or treatable causes, such as preterm birth, complications around the time of birth, pneumonia, diarrhea, and malaria. Many lives could have been saved with better access to high-quality primary healthcare, including essential, low-cost interventions, such as vaccinations, availability of skilled health personnel at birth, support for early and continued breastfeeding, and diagnosis and treatment of childhood illnesses.
Improving access to quality health services and saving children’s lives from preventable deaths requires investment in education, jobs, and decent working conditions for health workers to deliver primary healthcare, including community health workers.
Studies show that child deaths in the highest-risk countries could drop substantially if community-based child survival interventions could reach those in need. This package of interventions alone would save millions of children and would deliver care closer to home. Integrated management of childhood illnesses – especially the leading causes of post-neonatal death, acute respiratory infections, diarrhea, and malaria – is needed to improve child health and survival.
While the global numbers show welcome signs of progress, there are also substantive threats and inequities that jeopardize child survival in many parts of the world. These threats include increasing inequity and economic instability, new and protracted conflicts, the intensifying impact of climate change, and the fallout of COVID-19, which could lead to stagnation or even reversal of gains and the continued needless loss of children’s lives. Children born into the poorest households are twice as likely to die before the age of 5 compared to the wealthiest households, while children living in fragile or conflict-affected settings are almost three times more likely to die before their fifth birthday than children elsewhere.
At current rates, 59 countries will miss the SDG under-5 mortality target, and 64 countries will fall short of the newborn mortality goal. That means an estimated 35 million children will die before reaching their fifth birthday by 2030—a death toll that will largely be borne by families in sub-Saharan Africa and Southern Asia or in low- and lower-middle-income countries.
The report also notes large gaps in data, particularly in sub-Saharan Africa and Southern Asia, where the mortality burden is high. Data and statistical systems must be improved to better track and monitor child survival and health, including indicators on mortality and health via household surveys, birth and death registration through Health Management Information Systems (HMIS), and Civil Registration and Vital Statistics (CRVS).
