Global child mortality: it is hard to overestimate both the immensity of the tragedy, and the progress the world has made

Disastrous events with high death tolls always make the headlines, and rightfully so. Yet there are many daily, recurring tragedies in the world which create as much or more suffering and often go unnoticed.

The Institute for Health Metrics and Evaluation (IHME) estimates that in 1990 more than 12 million children died. Most of these deaths were preventable, and arose from illness and poverty.

Let’s put this in perspective. Aviation disasters are a form of tragedy that is both relatively uncommon and widely reported. A Boeing 747 can carry up to 620 people.1 The total number of child deaths in 1990 is equivalent to 53 massive aircraft disasters every day, involving primarily children, with no survivors.

While every plane crash makes the headlines and 53 of them in a single day would have media coverage everywhere, we see proportionally less reporting about the more prevalent causes of mortality. By considering how the unseen, daily cruelty of child death compares to discrete tragic events, we can find a sense of perspective about the scale involved.

Here at we present the empirical evidence of global development. To understand these issues and see the progress involved, we need to have a look at long-term changes over the course of history.

# A ten-fold decrease in child mortality

The below chart shows the share of children surviving the first five years of their lives. It goes back to the year 1800. Health conditions in the time of our ancestors were such that more than 4 out of 10 newborns died before their fifth birthday. The historical estimates further suggest that it was the entire world that lived in poor conditions: there was relatively little variation between world regions, and even in the best-off countries of 1800 every third child perished.

Children regularly dying was a reality for all families for a very long time. For millennia our ancestors lived in poor health and most had short lives.

The chart shows that this finally began to improve in the 20th century, as humanity achieved broad improvements in health and living conditions. In the first half of the 1900s, the global child mortality rate fell by more than half and yet was still high: every fifth child born in 1960 died before 1965. Fortunately, in recent decades – in our lifetimes – we have seen rapid progress. In 2015 global child mortality fell to 4.3% – 10-fold lower than two centuries ago.

One reason we do not see this progress is that we are unaware of how much worse the past was. A long-term perspective is crucial.

# Child mortality declined in all countries

The decline in global child mortality is not just due to improvements in a few well-off, developed regions. In fact, every single country achieved a reduction. This is what the chart below shows. Hover over the lines with your mouse to see the decline of child mortality in each country.

Yet, even after decades of unprecedented global progress there are still stark divides. The difference between the worst-off countries (e.g. Angola with a 16% child mortality) and the best-off countries (e.g. Luxembourg at 0.2%), shows what is possible and underscores that a lot of work remains to be done.

This work is already underway. The biggest recent improvements were achieved in the countries that were worst off in the 1950s. The least healthy countries have been catching up, and the inequality in health across the world today is substantially lower than a few decades ago.

With fewer children dying, we might initially expect populations to increase, leading to problems with living space and resource consumption. Thankfully, in the long term this does not appear to be the case: as countries develop and mortality falls, they also undergo a decrease in birth rates known as the demographic transition. This trend is expected to continue to apply to those developing countries which currently have both high mortality and high birth rates. We recently made a short video about this with our colleagues at Kurzgesagt.

# We are making progress against a broad range of causes of child death

What is killing our children? Here we compare the causes of child death in 1990 and in 2015. The data comes from the IHME’s Global Burden of Disease study.

This visualization shows the many causes of child deaths and the mortality rate that they are responsible for. Birth complications, pneumonia, diarrheal diseases, and malaria all still lead to the death of more than 400,000 children annually.

In many cases, the comparison with 1990 shows that we are on track to a rapid reduction. But the breakdown by cause also highlights that preventable diseases are still responsible for an unacceptably large share of child deaths and we have the duty and the possibility to reduce child mortality further.

# 27 major plane crashes averted every day

The achievement that this blog post highlights is that child mortality has decreased substantially. What does this mean in terms of the absolute number of child deaths that we discussed above?

The number of child deaths declined from over 12 million in 1990 to 5.8 million in 2015 (the year for which we have the latest data). Notably, this decline by 6.3 million child deaths happened despite the absolute number of births increasing slightly over the same period.

6.3 million fewer deaths means that compared with 1990, there are 17,258 fewer child deaths every single day.

We were also surprised to see the scale of the reduction of child mortality when broken down like this. Over a period of 25 years, in which the number of births had slightly increased, the world was able to reduce the number of child deaths every single day by more than 17,000. Compared with 1990, this is the equivalent of saving 27 planes from crashing on a daily basis. Were it to receive as much attention as aviation disasters do, we think this would be seen as an extremely big deal.

Every case of a family losing a child is a tragedy. And even after an impressive improvement in global health, the unseen daily cruelty of child death remains immense: close to 6 million children still die every year; 16,000 children every day.

The enormous global tragedy of preventable child death, and the progress against it, are best seen over time scales too long for a standard media cycle. We should still strive to be aware of both. The number of deaths remains very high, but the historical perspective gives us hope that a future where many more children are able to live full lives is possible.