The number of children dying before their fifth birthday fell to an all-time low of 4.8 million in 2023, while stillbirths declined slightly to around 1.9 million, according to new reports released by the United Nations Inter-agency Group for Child Mortality Estimation (UN IGME).

These figures mark significant progress, with child deaths dropping by over half and stillbirths by more than a third since 2000, largely driven by global investments in maternal and child health. In 2022, the world reached a historic milestone when child deaths fell below 5 million for the first time. However, the reports warn that progress has slowed and may be at risk.

“Millions of children’s lives have been saved through proven interventions such as vaccination, nutrition, and access to safe water,” said UNICEF Executive Director Catherine Russell. “But these hard-earned gains are fragile. Without continued investment and sound policies, we risk reversing decades of progress.”

The reports raise alarm over recent and planned reductions in global funding for child survival programs. Aid cuts are already leading to health worker shortages, clinic closures, disrupted vaccination efforts, and shortages of life-saving supplies. These setbacks are hitting hardest in countries facing humanitarian crises, heavy debt, and high child mortality rates.

Progress on child survival had already slowed even before the funding crisis. Since 2015, the rate of decline in under-five deaths has dropped by 42%, and the rate of decline in stillbirths has slowed by 53% compared to the 2000–2015 period.

Newborns remain especially vulnerable. Nearly half of under-five deaths occur within the first month of life, primarily due to premature birth and birth complications. Beyond the newborn stage, preventable infectious diseases — including pneumonia, malaria, and diarrhoea — are leading causes of death. Likewise, nearly half of late stillbirths occur during labour, often due to maternal infections and lack of timely medical care.

The reports emphasize that better access to quality maternal, newborn, and child health care can save countless lives. This includes routine vaccinations, proper nutrition, treatment of common illnesses, and specialized care for small and sick newborns.

The data also highlight persistent inequalities. A child born in the highest-mortality country is 80 times more likely to die before age five than one born in the lowest-mortality country. Stillbirth risks are up to eight times higher in low-income countries.

UN IGME is calling on governments, donors, and partners to protect these life-saving gains and accelerate efforts to expand access to essential health, nutrition, and social protection services for children and mothers worldwide.

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