According to a pair of newly released reports by the United Nations Inter-agency Group for Child Mortality Estimation (IGME), the world witnessed a decline in the number of children under the age of five dying globally, which fell to 4.8 million in 2023. Similarly, stillbirths dropped marginally, affecting approximately 1.9 million. Despite these strides, the preservation of decades-long advancements in child survival is fraught with challenges, as major sponsors have signaled or announced considerable reductions in funding for child health initiatives.
The World Health Organization (WHO) noted that the sustained investments in child survival programs have led to a significant reduction in child deaths since 2000, with a drop of more than half, and a decrease in stillbirths by over a third. Notably, in 2022, global child mortality dipped below the five million mark for the first time in recorded history. However, progress has slowed down, with preventable deaths remaining high.
UNICEF Executive Director, Catherine Russell, observed, “Millions of children are alive today due to the global commitments to proven interventions such as vaccines, nutrition, and access to clean water and sanitation.” She reiterated, “Achieving a record low in preventable child deaths is a remarkable milestone, but without the right policies and sustained investment, we risk reversing these hard-won gains.”
The UN IGME reports underscore the consequences of reduced global funding for child survival programs, resulting in shortages of healthcare workers, clinic closures, and disruptions in vaccination programs, as well as shortages of essential medical supplies, including malaria treatments. These cuts have disproportionately affected regions grappling with high child mortality rates, including areas facing humanitarian crises and economic instability.
WHO Director-General, Dr. Tedros Ghebreyesus, emphasized, “From tackling malaria to preventing stillbirths and ensuring life-saving care for newborns, we have the tools to make a difference. But as funding declines, now more than ever, we must strengthen collaboration to protect children’s health.”
Prior to the current funding crisis, progress in child survival had already decelerated. The reports highlight that the annual rate of reduction in under-five mortality has slowed by 42% since 2015, while the decline in stillbirths has slowed by 53% compared to the 2000–2015 period.
Data from the reports reveal that nearly half of all under-five deaths occur within the first month of life, primarily due to premature birth and complications during labor. Beyond the newborn stage, infectious diseases – including pneumonia, malaria, and diarrhea – remain the leading causes of preventable child deaths. Furthermore, 45% of late stillbirths happen during labor, often due to maternal infections, prolonged or obstructed labor, and lack of timely medical intervention.
Better access to quality maternal, newborn, and child healthcare at all levels will be crucial in saving more lives. This includes early prenatal care, skilled birth attendance, routine vaccinations, nutrition programs, and effective treatment of childhood diseases.
Stark disparities in child mortality rates exist between high- and low-income countries. The likelihood of a child dying before the age of five is 80 times higher in the highest-mortality country than in the lowest. A child born in sub-Saharan Africa is 18 times more likely to die before turning five than one born in Australia or New Zealand. Within countries, children from the poorest households, rural communities, and those with less-educated mothers face the highest risks.
Comparable disparities are evident in stillbirths, with nearly 80% occurring in sub-Saharan Africa and Southern Asia, where women are six to eight times more likely to experience a stillbirth than their counterparts in Europe or North America.
UN DESA Under-Secretary-General, Li Junhua, urged, “Reducing these disparities is not just a moral imperative but a fundamental step toward sustainable development and global equity. Every child deserves a fair chance at life, and it is our collective responsibility to ensure that no child is left behind.”
In light of these findings, the UN IGME is calling upon governments, donors, and private sector partners to safeguard the progress made in reducing child mortality and accelerate efforts to prevent more deaths. Emphasis is placed on increased investment, service integration, and innovation to expand access to life-saving healthcare, nutrition, and social protection services for children and pregnant mothers.
