Child survival efforts are intensifying in sub-Saharan Africa and Southern Asia.

TARGET

Reduce by three quarters, between 1990 and 2015, the under-five mortality rate

Millennium Development Goal 4

Reduce child mortality

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Deaths in children under five have declined steadily worldwide. In 2007, the global under-five mortality rate was 67 deaths per 1,000 live births, down from 93 in 1990. That year, more than 12.6 million young children died from largely preventable or treatable causes; the figure has declined to around 9 million today, despite population growth.

For the developing regions as a whole, the under-five mortality rate dropped from 103 in 1990 to 74 in 2007. Still, many countries, particularly in sub-Saharan Africa and Southern Asia, have made little or no progress at all. The levels are highest in sub-Saharan Africa, where, in 2007, close to one in seven children died before his or her fifth birthday. Together with high levels of fertility, this has resulted in an increase in the absolute number of under-five deaths--from 4.2 million in 1990 to 4.6 million in 2007. Sub-Saharan Africa now accounts for half of all deaths among children under five.

Sub-Saharan Africa and Southern Asia remain overriding priorities, and intensified efforts hold promise. Across sub-Saharan Africa, recent survey data show remarkable improvements in several key child-survival interventions that are expected to yield further declines in under-five mortality over the next few years. These include vitamin A supplementation, the use of insecticide-treated bed nets (to prevent malaria), exclusive breastfeeding and immunization. In addition, there has been wider coverage of critical HIV interventions in most sub-Saharan countries where HIV prevalence is high. This includes antiretroviral treatment for pregnant mothers who are HIV-positive, to prevent transmission of the virus to their babies.