Significant progress was made in reducing under-five deaths over the past twenty years. This achievement is now under threat due to various challenges. The number of annual under-five deaths decreased substantially, from a high of 10.1 million to 4.9 million.

Factors such as aid cuts and rising debt burdens are contributing to the dismantling of systems that drove this progress. Further information is available on the economic, security, and moral benefits of protecting these gains, and the long-term returns of investing in child survival.