As many as 9.4 million people (including 2.5 million children under 5) could die by 2030, say experts
Renewed commitment and sustained investment critical to prevent unfolding tragedy
Global progress in reducing preventable deaths among newborn babies, children, and adolescents has slowed substantially since 2015, and many countries risk missing international child survival targets by 2030, find a series of papers published by The BMJ today.
Researchers estimate as many as 9.4 million people (including 2.5 million children under 5) could die by 2030, and call for renewed commitment and sustained investment to prevent an unfolding tragedy.
The results also show that of the estimated 4.9 million global deaths in children under 5 in 2024, preterm birth complications (860,000) and respiratory infections (660,000) were leading causes, while for the 1.4 million deaths among 5-19 year-olds, road traffic injuries (113,138) and malaria (99,219) predominated.
Despite overall declines in child mortality, particularly in under 5s, since the 1990s, progress remains uneven across regions, age groups, and sexes.
To explore this further, researchers drew on data from 200 countries and areas (1990-2024) to estimate mortality levels and trends from birth up to age 24 years, identifying where improvements have stalled and where investment is most critical.
The findings show that, although the number of deaths among children under 5 has decreased over the past two decades, 4.9 million children in this age group died in 2024, with almost half of the deaths occurring in newborn babies.
While the mortality rate among children under 5 declined by 3.9% in 2000-15, the rate of decline was only 1.5% in 2015-24.
Pre-term birth complications and pneumonia are the major causes of mortality among children under 5 and most of these deaths occur in sub-Saharan Africa and in South Asia. If recent trends continue, 27.3 million under-5 deaths are projected by 2030, with 60 countries missing child survival goals.
Among 5-19 year olds, an estimated 1.3 million deaths occurred in 2024. Half of deaths among 5-14 year olds were 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 relating to being a young mother are among the leading causes of mortality in this age category that have not always received attention or been prioritised for action.
These are observational findings and the researchers point to limitations, such as relying on data of varying quality and availability, and uncertainty in model based estimates and scenario based projections. However, they say these findings provide the most comprehensive, up-to-date child survival statistics available.
And they conclude that renewed commitment and sustained investment is essential to eliminate preventable deaths and uphold every child's right to survive.
The slowing rate of decline in mortality in the past decade is an unfolding tragedy, and wealthy nations must invest more in official development assistance, say experts in a linked editorial. "We must muster all efforts to accelerate the rate of decline in mortality, as a moral imperative."
