Between 2015 and 2021, the global under-5 mortality rate fell by 12% from 43 deaths per 1,000 live births in 2015 to 38 deaths and the global neonatal mortality rate fell from 20 to 18 deaths. In 2021, 5 million children died before reaching their fifth birthday—down from 6.1 million in 2015. Of 200 countries and areas analysed, only 54 countries are not on track to meet the target of lower than 25 deaths per 1,000 live births. Among these countries, 37 countries will need to more than double their current rate of progress or reverse a recent increasing trend to achieve the SDG target by 2030.