🟢 Strong Evidence
Despite halving child mortality from 10.1 million deaths in 2000 to 4.9 million in 2024, progress toward reducing newborn and child deaths has dramatically slowed since 2015. New estimates published in The BMJ reveal that 60 countries are unlikely to meet United Nations Sustainable Development Goal targets for child survival by 2030, threatening two decades of global health gains.
Key takeaways
- Child deaths under 5 dropped from 10.1 million (2000) to 4.9 million (2024) — a 51% global reduction
- 60 countries will miss UN SDG targets for newborn and child survival based on current trends
- Rwanda and Malawi achieved 80% and 71% mortality reductions respectively, outpacing global averages
- Progress has stagnated since 2015 with fewer than 5 years until the 2030 deadline
Study at a Glance
| Source | The BMJ |
| Study type | Global mortality estimates analysis |
| Time period | 2000-2024 with projections to 2030 |
| Population | Children under 5 years globally |
| Scope | Global analysis of UN member states |
Child Mortality Reduction Leaders Outpace Global Progress
Under-5 mortality reduction since 2000, selected countries vs global average
Source: The BMJ, 2026 | Georgian Medical Journal News
Remarkable Gains Now Under Threat
The global reduction in child mortality represents one of the most significant public health achievements of the 21st century. According to the World Health Organization, deaths among children under 5 fell by more than half between 2000 and 2024, from 10.1 million to 4.9 million annually.
However, this progress has decelerated markedly since 2015, coinciding with global economic challenges, conflict, and the COVID-19 pandemic. The analysis published in The BMJ suggests that without accelerated interventions, the momentum of two decades could stall entirely. Countries including Rwanda and Malawi demonstrate that rapid progress remains possible even with limited resources, having achieved mortality reductions of 80% and 71% respectively.
Geographic and Economic Disparities Persist
The 60 countries at risk of missing UN SDG targets are predominantly concentrated in sub-Saharan Africa and conflict-affected regions. According to UNICEF’s State of the World’s Children 2024, these nations face compound challenges including weak health systems, limited access to essential medicines, and ongoing humanitarian crises.
Resource-constrained countries that have succeeded, such as Nepal, Senegal, India, Ghana, and Burundi, provide evidence-based models for accelerated progress. These nations invested heavily in community health worker programs, immunization campaigns, and maternal health services, demonstrating that strategic interventions can overcome economic limitations.
Health System Strengthening Shows Promise
Countries achieving exceptional progress share common strategies: strengthening primary healthcare, improving nutritional interventions, and expanding access to life-saving treatments for pneumonia, diarrhea, and neonatal complications. The Lancet Commission on Newborn Health emphasizes that simple, cost-effective interventions could prevent up to 70% of newborn deaths.
Rwanda’s success story illustrates this approach. The country implemented comprehensive health system reforms including universal health insurance, community health cooperatives, and performance-based financing. These evidence-based interventions contributed to dramatic reductions in both maternal and child mortality rates.
Rwanda and Malawi have reduced under-5 mortality by 80% and 71% respectively since 2000, outpacing the global decline of 51%
— The BMJ mortality estimates series (The BMJ, 2026)
What this means
Frequently asked questions
Which interventions have proven most effective in reducing child mortality?
Evidence shows that scaling up immunization, improving nutrition, providing skilled birth attendance, and treating pneumonia and diarrhea with simple interventions like antibiotics and oral rehydration therapy can prevent the majority of child deaths.
How did countries like Rwanda achieve such dramatic reductions?
Rwanda implemented comprehensive health system reforms including universal health insurance, community health cooperatives, performance-based financing for health facilities, and massive investments in health worker training and infrastructure.
What would happen if the 2030 UN targets are missed?
Missing the SDG targets would mean millions of additional preventable child deaths, perpetuating cycles of poverty and inequality, and undermining global efforts to achieve universal health coverage and sustainable development.
The next five years represent a critical window for accelerating progress on child survival. Countries that have demonstrated success provide roadmaps for others, but political commitment, sustained financing, and coordinated international support will be essential to prevent backsliding on two decades of remarkable achievements in global child health.
Source: After remarkable progress, newborn, child, and adolescent survival is now at risk
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Medically reviewed by Prof. Giorgi Pkhakadze, MD, MPH, PhD. Spotted an error? Contact the editorial team.
