a map with dots in red showing where 5,000+ child deaths occure

Why Are 10 Million Children Dying?

By Karen Blum • Illustration by Paul Mirocha

More than 10 million children younger than age 5 die every year from diarrhea, pneumonia, measles, malaria, HIV and other causes. Half of the fatalities occur in India, Nigeria, China, Pakistan, the Congo and Ethiopia. 

Tragically, an estimated two-thirds of childhood deaths could be prevented by interventions as simple as breastfeeding or supplementing a child’s diet with vitamin A and zinc, says Robert Black, MD, MPH, chair of International Health and coauthor of a five-part series examining global childhood mortality published last year in The Lancet. 

Fifty-three percent of all child deaths can be attributed to undernutrition, according to Laura Caulfield, PhD, associate professor with the School’s Center for Human Nutrition. In a recent article, Caulfield and colleagues showed that even children who are small for their age but not malnourished are twice as likely to die as healthier children. The article is the first to demonstrate that undernutrition is responsible for 60 percent of diarrhea deaths, 52 percent of pneumonia deaths and 57 percent of malaria deaths. Caulfield also found that moderately malnourished children were four times as likely to die from malaria.

Often families have enough food to prevent undernutrition—just an extra 100 to 200 calories a day can make all the difference to a young child. However, some families don’t allocate food so that children get enough or children simply choose not to eat all that is offered. Public health programs teach adults strategies for improving children’s diets, avoiding micronutrient malnutrition and preventing illnesses through improved hygiene, says Caulfield.

The good news, according to Black, is that the Lancet series has reawakened interest in preventing child mortality. With support from the Bill & Melinda Gates Foundation, the Child Survival Partnership (a task force formed by UNICEF, WHO, USAID and others) is uniting existing resources in targeted countries to increase immunizations, vitamin A supplementation, and treatment of diarrhea, pneumonia and malaria.