The number of children expected to die before their 5th birthday is climbing for the first time in decades — and experts say the trend is both devastating and preventable.
According to new data published Thursday, Dec. 4, in the Gates Foundation’s 2025 Goalkeepers Report, child mortality worldwide is projected to reach an estimated 4.8 million deaths in 2025 — an increase of about 200,000 preventable deaths compared with last year.
“It is 100% avoidable. There is no reason why those children should be dying,” Mark Suzman, CEO of the Gates Foundation, told CNN.
He urged governments and private donors to double down on cost-effective, lifesaving interventions, including strengthening primary health care and expanding routine immunizations.
The report shows the surge is concentrated largely in several African countries — including places such as the Democratic Republic of Congo, Somalia, and Uganda — where conflict, displacement, climate-driven disease spread, and limited access to care have intensified existing vulnerabilities, the Wall Street Journal highlights. Until now, according to the World Health Organization, global child mortality rates have been falling dramatically since the 1990s. But decades of progress are being strained by shrinking global health budgets, rising national debts, and fragile health systems that are losing ground against preventable illnesses.
International aid cuts from major donor nations — including the United States — over the last year have also contributed to weakening vaccination programs and basic health infrastructure worldwide, amplifying the impact on countries already at risk.
And it may get worse. The report warns that if current funding cuts persist long-term, as many as 16 million additional children could die by 2045. The findings arrive at a moment when the Trump Administration is also weighing changes to domestic childhood immunization policy, raising concerns among public health experts about the potential resurgence of once-controlled diseases in the U.S.
The report, entitled “We Can’t Stop at Almost,” also outlines a roadmap to prevent this backslide, arguing that targeted investments in proven interventions — alongside next-generation innovations — could save millions of lives even in a constrained global budget environment.
“We could be the generation who had access to the most advanced science and innovation in human history—but couldn’t get the funding together to ensure it saved lives,” Bill Gates, chair of the Gates Foundation and the report’s author, wrote. “By making the right priorities and commitments, and investing in high-impact solutions, I’m confident we can stop a significant reversal in child deaths and help ensure millions more children are alive in 2045.”
