The number of children dying before their fifth birthday dropped to 4.8 million in 2023, while stillbirths declined slightly but remained at approximately 1.9 million, according to two reports released on Tuesday by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME).
Despite these achievements, decades of progress in child survival are now at risk, as major donors have announced or signaled significant cuts to funding for child health initiatives.
A statement from the World Health Organization (WHO) highlighted that since 2000, global child deaths have fallen by more than half, and stillbirths by over a third, largely due to sustained investments in child survival programs. In 2022, child mortality dropped below five million for the first time in recorded history. However, progress has slowed, and preventable deaths remain alarmingly high.
“Millions of children are alive today because of global commitments to proven interventions such as vaccines, nutrition, and access to clean water and sanitation,” said UNICEF Executive Director Catherine Russell. “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.”
Funding Cuts Jeopardize Progress
The UN IGME reports warn that reduced global funding for child survival programs is leading to shortages of healthcare workers, clinic closures, disruptions in vaccination programs, and shortages of essential medical supplies, including malaria treatments. These cuts disproportionately affect regions already struggling with high child mortality rates, particularly those facing humanitarian crises and economic instability.
“From tackling malaria to preventing stillbirths and ensuring life-saving care for newborns, we have the tools to make a difference,” said WHO Director-General Dr. Tedros Ghebreyesus. “But as funding declines, now more than ever, we must strengthen collaboration to protect children’s health.”
Even before the current funding crisis, progress in child survival had slowed. Since 2015, the annual rate of reduction in under-five mortality has declined by 42 percent, while the decline in stillbirths has slowed by 53 percent compared to the 2000–2015 period.
Preventable Causes and Persistent Disparities
The reports reveal that nearly half of all under-five deaths occur within the first month of life, mostly 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.
Similarly, 45 percent 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 save more lives,” the report stated. This includes early prenatal care, skilled birth attendance, routine vaccinations, nutrition programs, and effective treatment of childhood diseases.
The UN reports underscore stark disparities in child mortality rates between high- and low-income countries. 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.
Stillbirth disparities are equally severe. Nearly 80 percent of stillbirths occur 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.
A Call to Action
“Reducing these disparities is not just a moral imperative but a fundamental step toward sustainable development and global equity,” said UN DESA Under-Secretary-General Li Junhua. “Every child deserves a fair chance at life, and it is our collective responsibility to ensure that no child is left behind.”
UN IGME members are urging governments, donors, and private-sector partners to protect the progress made in reducing child mortality and accelerate efforts to prevent more deaths. They emphasize the need for increased investment, service integration, and innovation to expand access to life-saving healthcare, nutrition, and social protection services for children and pregnant mothers.
