UN Report: Nigeria, Africa Bear Brunt as 4.9m Children Die Before 5th Birthday

• Malaria, diarrhoea, pneumonia remain major killers

Emmanuel Addeh in Abuja

Nigeria and other Sub-Saharan African nations have accounted for the overwhelming majority of global child deaths, with as many as 4.9 million children dying before reaching their fifth birthday in 2024, a new report by the United Nations Inter-agency Group for Child Mortality Estimation has said.

The report said the region alone contributed 58 per cent of all the under-five deaths worldwide, reflecting deep structural challenges including weak health systems, limited access to essential care, persistent poverty, and the growing impact of conflict and climate-related shocks.

According to the report, infectious diseases remain the leading cause of death among children in sub-Saharan Africa, accounting for 54 per cent of fatalities in the age group.

It said malaria continues to be the single largest killer of children aged between one month and five years, responsible for 17 per cent of deaths, with the burden concentrated in a handful of countries, including Nigeria, Chad, Niger and Democratic Republic of the Congo.

The report attributed the persistence of these preventable deaths to gaps in access to proven interventions such as insecticide-treated nets, timely diagnosis, effective treatment, and broader primary healthcare services, particularly in rural and conflict-affected areas.

Beyond infectious diseases, the report said newborn deaths continue to account for nearly half of all under-five mortality globally, a trend that is also evident across many African countries.

It said complications from preterm birth contributed 36 per cent of neonatal deaths, while complications during labour and delivery accounted for 21 per cent, highlighting deficiencies in maternal healthcare services, including access to skilled birth attendants and emergency obstetric care.

The report further said that severe acute malnutrition remains a critical but often underreported contributor to child mortality. It estimated that more than 100,000 children aged one to 59 months died directly from the condition in 2024, while noting that the indirect impact is significantly higher, as malnutrition weakens immunity and increases vulnerability to common childhood illnesses such as pneumonia, diarrhoea, and malaria.

It added that many African countries are disproportionately affected by this dual burden of disease and malnutrition, driven by food insecurity, economic instability, and displacement caused by conflict and environmental stress.

“Beyond the first month, infectious diseases such as malaria, diarrhoea, and pneumonia were major killers. Malaria remained the single largest killer in this age group (17 per cent) – with most deaths occurring in endemic areas of sub-Saharan Africa. After steep declines between 2000 and 2015, progress towards reducing malaria mortality slowed in recent years.

“ Deaths remain concentrated in a handful of endemic countries – such as Chad, Democratic Republic of the Congo, Niger, and Nigeria – where conflict, climate shocks, invasive mosquitos, drug resistance, and other biological threats continue to affect access to prevention and treatment.

“Child deaths remain heavily concentrated in a small number of regions. In 2024, sub-Saharan Africa accounted for 58 per cent of all under-five deaths. In the region, the leading infectious diseases were responsible for 54 per cent of all under-five deaths,” it stated.

The report also said children living in fragile and conflict-affected settings, a category that includes several countries in sub-Saharan Africa , are nearly three times more likely to die before their fifth birthday than those in more stable environments, reflecting disruptions to healthcare delivery, immunisation programmes, and nutrition services.

While global under-five deaths have declined by more than half since 2000, the report said progress has slowed significantly since 2015, with the rate of reduction dropping by over 60 per cent. It warned that this slowdown is particularly concerning for high-burden regions such as Africa, where population growth continues to outpace improvements in child survival.

The report said shifting global development financing patterns are placing additional strain on maternal, newborn, and child health programmes, including vaccination, data systems, and frontline health services, raising concerns about the sustainability of past gains.

Commenting on the findings, UNICEF Executive Director, Catherine Russell said the world is witnessing worrying signs of stalled progress at a time of declining global health budgets, stressing that most of these deaths are preventable with known, cost-effective interventions.

“No child should die from diseases that we know how to prevent. But we see worrying signs that progress in child survival is slowing – and at a time where we’re seeing further global budget cuts,” said Russell.

“History has shown what is possible when the world commits to protecting its children. With sustained investment and political will, we can continue to build on those achievements for future generations,” Russell added.

Similarly, Director General of the World Health Organisation (WHO) Tedros Ghebreyesus, said children living in conflict and crisis settings face significantly higher risks, urging governments and partners to protect essential health and nutrition services, particularly in the most vulnerable regions.

“The world has made remarkable progress in saving children’s lives, but many still die from preventable causes,” said Ghebreyesus. “Children living amid conflict and crisis are nearly three times more likely to die before their fifth birthday. We must protect essential health and nutrition services and reach the most vulnerable families so every child has the chance not only to survive, but to thrive,” he stressed.

“These findings are a collective call to speed up implementation of the proven, scalable solutions we know are within reach,” said Monique Vledder, World Bank Group Director, Health.

“The World Bank Group health target of reaching 1.5 billion people is our concrete commitment to accelerating access to quality primary health services for more children and families,” Vledder said.

The report maintained that most child deaths are preventable through proven, low-cost interventions such as vaccination, skilled care at birth, and improved nutrition, noting that investments in child survival yield significant social and economic returns.

It stressed that reversing the trend in Africa will require sustained political will, strengthened primary healthcare systems, and targeted interventions focused on the most vulnerable populations.