Global Mortality: Leading Causes of Death, Child and Maternal Deaths

In 2021 there were 68 million deaths worldwide, and the top 10 causes accounted for 39 million of them, or 57% [1]. Seven of the top 10 causes were noncommunicable diseases, which together accounted for 38% of all deaths [1]. The leading causes fall into two groups: cardiovascular (ischaemic heart disease, stroke) and respiratory (COVID-19, chronic obstructive pulmonary disease, lower respiratory infections) [1].

• Ischaemic heart disease caused 13% of all deaths; its toll rose by 2.7 million since 2000 to 9.1 million in 2021 [1].
• COVID-19 caused 8.8 million deaths in 2021 and became the second leading cause [1].
• Stroke and chronic obstructive pulmonary disease ranked third and fourth, at about 10% and 5% of deaths [1].
• Lower respiratory infections killed 2.5 million people, 370,000 fewer than in 2000 [1].
• Trachea, bronchus and lung cancers rose from 1.2 million deaths in 2000 to 1.9 million in 2021 [1].
• Alzheimer's disease and other dementias killed 1.8 million people; 68% of these deaths were women [1].
• Diabetes deaths rose 95% since 2000, and kidney diseases moved from nineteenth to ninth, with deaths up 95% [1].

HIV and AIDS deaths fell 61% and dropped from seventh to twenty-first place between 2000 and 2021 [1]. Diarrhoeal disease deaths fell 45%, from sixth to thirteenth [1].

In low-income countries, 8 of the top 10 causes of death in 2021 were communicable diseases, and lower respiratory infections were the top killer [1]. COVID-19 ranked sixth there, killing 258,000 people [1]. In lower-middle-income countries COVID-19 topped the list with over 4 million deaths, and ischaemic heart disease deaths rose by more than 1.4 million since 2000 to 3.2 million [1]. In high-income countries COVID-19 killed 1.2 million people and ranked second, while deaths from Alzheimer's and other dementias rose nearly four-fold since 2000 [1].

UN IGME estimates that 4.9 million children died before their fifth birthday in 2024, including 2.3 million newborns [3]. A further 2.1 million children, adolescents and youth aged 5 to 24 died in 2024 [3][4]. The previous IGME round estimated 4.8 million under-five deaths in 2023 [5].

Sub-Saharan Africa accounted for 58% of under-five deaths in 2024 and Southern Asia for a further 25% [4]. Children in fragile and conflict-affected settings are nearly three times more likely to die before age five than those elsewhere [4]. The WHO African region had the highest neonatal mortality rate in 2024, at 26.3 deaths per 1,000 live births [3].

About 260,000 women died during and following pregnancy and childbirth in 2023, and about 92% of these deaths occurred in low- and lower-middle-income countries [2]. Sub-Saharan Africa accounted for around 70% (182,000) and southern Asia for around 17% (43,000) [2].

The maternal mortality ratio in 2023 was 346 per 100,000 live births in low-income countries versus 10 in high-income countries [2]. Maternal deaths rose from 282,000 in 2020 to 322,000 in 2021, a rise WHO says the COVID-19 pandemic may have contributed to [2]. The global ratio of 197 per 100,000 live births in 2023 is far from the SDG target of below 70 by 2030, which would need an annual reduction of almost 15% [2].

Cause-of-death figures come from the WHO fact sheet on the top 10 causes of death (7 August 2024), based on Global Health Estimates covering 2000-2021 [1]. Under-five and neonatal deaths come from UN IGME estimates published by WHO, UN DESA and UNICEF [3][4][5]. The 2023 value (4.8 million) and the 2024 value (4.9 million) come from different IGME rounds and should not be read as a year-on-year rise without checking revised series. Maternal mortality figures come from the WHO maternal mortality fact sheet [2]. All death counts are numbers of people; ratios are per 100,000 live births. No FREEE.REPORT calculations were used.