In 2023, the number of children dying before their fifth birthday worldwide dropped to 4.8 million, while stillbirths saw a slight decrease but remained at about 1.9 million, according to two new reports released by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Despite these improvements, the reports warned that these gains are at risk due to substantial cuts in funding for child health programs.
The World Health Organization (WHO) highlighted that since 2000, child deaths have been reduced by more than 50%, and stillbirths have declined by over 30%, largely thanks to continued investments in child survival initiatives.
In 2022, global child mortality fell below five million for the first time. However, progress has slowed, and preventable deaths remain a significant concern.
UNICEF Executive Director, Catherine Russell, emphasized that millions of children are alive today because of global efforts involving vaccines, nutrition, and access to clean water and sanitation. However, she warned that without sustained investments and the right policies, these hard-won gains could be reversed.
The UN IGME reports point out that cuts in global funding for child survival programs have led to shortages of healthcare workers, clinic closures, interruptions in vaccination programs, and a lack of essential medical supplies such as malaria treatments. These reductions are most severe in regions already grappling with high child mortality rates, including areas facing humanitarian crises and economic instability.
WHO Director-General, Dr. Tedros Ghebreyesus, noted, “We have the tools to make a difference, but as funding declines, we must strengthen collaboration to protect children’s health.”
Even prior to these funding cuts, the reports show that progress in child survival has been slowing. Since 2015, the annual rate of reduction in under-five mortality has decreased by 42%, and the decline in stillbirths has slowed by 53% compared to the 2000-2015 period.
The reports also stress 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 like pneumonia, malaria, and diarrhea remain the leading causes of preventable deaths. Additionally, 45% of late stillbirths occur 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 states, highlighting the importance of early prenatal care, skilled birth attendance, routine vaccinations, nutrition programs, and effective treatments for childhood diseases.
The UN reports emphasize the disparities in child mortality between high- and low-income countries. A child born in sub-Saharan Africa is 18 times more likely to die before the age of five compared to a child born in Australia or New Zealand. Children from the poorest households, rural communities, and those with less-educated mothers are at the highest risk.
The disparity in stillbirth rates is similarly stark, with nearly 80% of stillbirths 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 stated, “Reducing these disparities is not just a moral imperative but a fundamental step toward sustainable development and global equity.” He added, “Every child deserves a fair chance at life, and it is our collective responsibility to ensure that no child is left behind.”
The UN IGME urges governments, donors, and the private sector to protect the progress made in reducing child mortality and to accelerate efforts to prevent more deaths. They stress 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.
