New Delhi

A series of five research papers published in The British Medical Journal estimate that globally, 4.9 million children died before turning five in 2024, including 2.3 million neonatal deaths.

Mortality was found to be highest in sub-Saharan Africa and south Asia, even as researchers cited uncertainty in values due to data sparsity and quality.

Researchers, including those from the United Nations Children's Fund (UNICEF) Office of Strategy and Evidence-Innocenti, Italy, said that global progress in reducing preventable deaths among newborn babies, children, and adolescents has slowed substantially since 2015.

While the mortality rate among children under five declined by 3.9 per cent during 2000-15, the rate of decline was only 1.5 per cent in 2015-24, they said.

"An estimated 4.9 million children died before age five in 2024, including 2.3 million (2.1 to 2.5 million) neonatal deaths. Mortality was highest in sub-Saharan Africa and South Asia,where uncertainty intervals were widest due to data sparsity and quality," the authors wrote.

Pre-term birth complications and pneumonia were found to be the major causes of mortality among children under five.

The researchers added that an estimated 134 countries have achieved the sustainable development goal target for U5MR, which is to reduce the rate to 25 or fewer deaths per 1,000 live births by the year 2030.

Based on a projection of current trends, six more countries are expected to achieve the target by 2030, leaving 60 countries -- home to about 42 per cent (274.2 million) of the global under 5 population (645.8 million) in 2024 -- falling short of the target.

Among 5-19 year olds, 1.3 million deaths were estimated to have occurred in 2024.

Half of the deaths among 5-14 year olds were due to communicable diseases and maternal, perinatal, and nutritional causes, and the rate of decline for these causes has slowed since 2016, the researchers said.

Further, childhood cancer, road traffic injuries, and issues in adolescent mothers are among the leading causes of mortality in the age category that have not always received attention or been prioritised for action, the team added.

In a linked editorial, researchers, including those from icddr,b, an international health research institute in Bangladesh and Ghana's University of Health and Allied Sciences, said that an official development assistance to many low and middle income countries will be required to improve health and nutrition, and reduce morbidity and mortality.

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"Wealthy nations must invest more in official development assistance. Local philanthropy, especially now with the reduction in official development assistance, need to generously assist national governments and non-government organisations," they wrote.

"We must muster all efforts to accelerate the rate of decline in mortality, as a moral imperative," the editorial says.