Government of Canada

Foreign Affairs, Trade and Development Canada

Reduce Child Mortality (MDG 4)


  • Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.


Substantial progress has been made to reduce child deaths over the years, but efforts still must be strengthened to meet the global target. Between 1990 and 2011 the mortality rate for children younger than five years of age in developing countries dropped by more than one third: 14,000 fewer children died each day. Some of the world's poorest countries, including Bangladesh, Ethiopia, Malawi, Niger, and Rwanda, have all reduced under-five mortality rates by more than half. Still, in sub-Saharan Africa, one in nine children dies before reaching the age of five.

Most child deaths are preventable. Five diseases—pneumonia, diarrhea, malaria, measles, and HIV/AIDS—account for about two thirds of all childhood deaths in developing countries. Most of these lives could have been saved through low-cost prevention and treatment measures such as vaccines, antibiotics, micronutrient supplements, insecticide-treated bed nets, and oral rehydration therapy. Discrimination against women and girls also exists within families, often resulting in boys being given preference for food and access to health care, while girls may be denied treatment and care.

Although some regions are on track to achieve Millennium Development Goal (MDG) 4 by 2015, unfortunately, many countries remain behind. Of 24 countries in total with under-five mortality rates exceeding 82 deaths per 1,000 live births in 2012, 23 are in sub-Saharan Africa, which accounted for half of the 6.6 million deaths in children younger than five years old worldwide that year. Evidence suggests that MDG 4 can still be achieved globally, but only if countries in sub-Saharan Africa and Southern Asia improve childhood disease management. Global efforts must focus on countries and regions in which child death rates are highest.

Canada's Contribution

Canada continues to play a leadership role in child health through Canada's Children and Youth Strategy for developing countries by improving access to maternal health care so that maternal and newborn deaths are reduced. Canada supports work in areas such as:

  • immunization;
  • micronutrient supplementation;
  • HIV/AIDS prevention and treatment; and
  • malaria control.

In 2010 malaria killed 655,000 people, of whom 90 percent lived in Africa and 86 percent were children younger than five years old. With support from Canada and other donors, the Global Fund to Fight AIDS, Tuberculosis and Malaria has financed the delivery of 260 million malaria drug treatments and the distribution of more than 310 million insecticide-treated nets to protect families from malaria.

At the 2010 G-8 meeting, hosted by Prime Minister Stephen Harper, leaders endorsed the Muskoka Initiative on Maternal, Newborn and Child Health—an initiative that garnered commitments of US$7.3 billion in new funding over five years, including $1.1 billion from Canada, to accelerate progress toward achieving MDGs 4 and 5.

Contributions from Canada and its partners

A little girl licking yogourt off a lid. © ACDI-CIDA/Greg Kinch

Increased immunization coverage: Canada has worked with GAVI (Global Alliance for Vaccines and Immunisation) since 2002 to increase access to immunization for people who live in developing countries. Through its support of GAVI's Advanced Market Commitment in 2007 for pneumococcal vaccine, Canada has helped GAVI and its partners launch pneumococcal vaccines in 26 countries, and provided vaccines to 10 million children in the process.

In April 2013, at the Global Vaccine Summit, Canada announced support for the Endgame Strategic Plan of the Global Initiative to Eradicate Polio (GPEI) designed to put an end to the disease worldwide by 2018. This new commitment will help the GPEI implement strategies and programs to eradicate polio and strengthen health systems, especially in the three countries where polio is a persistent problem: Afghanistan, Nigeria, and Pakistan.

Better nutrition: Since 1998, Canada’s support for the Micronutrient Initiative has helped provide vitamin A supplements to 200 million children each year. As the world’s leading supplier, Canada provides three quarters of the vitamin A supplements in the developing world. This support has significantly contributed to a global reduction in child deaths—with 14,000 fewer children dying each day.

Improved health systems: Through the Catalytic Initiative to Save a Million Lives, Canada supported country health systems by improving the availability and strengthening the capacity of front-line health workers. This support helps countries expand their abilities to save the lives of expectant mothers and children younger than five years old. Between 2007 and 2012, Canadian funding alone was estimated to have saved 200,000 lives. In addition, Canada's support helps prevent disabilities such as mental stunting and blindness caused by malnutrition and diseases such as malaria in many more children.