2024 IN REVIEW: Why Three Child Killer Diseases Rose Globally This Year

LONDON/GENEVA, (December 23, 2024) – Three child-killer diseases – dengue, cholera, and mpox - witnessed major resurgences in 2024, fuelled partly by climate crises and conflict, with these illnesses likely to cause significant strains on communities in 2025 without more focused global attention, said Save the Children.

More than 13,600 people, including children, are suspected or confirmed to have died from these three diseases this year, with cases of dengue and mpox reaching record highs. While there was a slight global decline in cases of cholera, the number of fatal cases of the virus jumped 126% from 2023. It was a horror year for dengue fever in 2024, with cases of the mosquito-borne virus reaching the highest number on record at 13.3 million – more than double the 6.5 million cases in 2023, which was itself a record high.[1] Increased urbanization and changes in climate and temperatures have fuelled the mosquitoes that spread the virus. The World Health Organization estimates that 4 billion people are currently at risk of dengue and related viruses, which will rise to 5 billion by 2050.

There were nearly half a million cases of cholera this year, with 3,432 deaths recorded by the end of September, when the most recent data was available.[2] While the number of cases in 2024 is 16% lower than last year, there has been a 126% spike in deaths, according to the WHO. The increase in mortality is likely due to the location of the outbreaks in conflict-affected areas where access to healthcare is severely compromised, and regions experiencing flooding that has damaged critical infrastructure.

This year saw a major increase in cases and fatalities from the mpox virus, which was declared a public health emergency of international concern in August 2024 by both the World Health Organization and the Africa Centre for Disease Control. This followed a surge of mpox infections in the Democratic Republic of Congo and surrounding countries in Africa, with a major portion of cases and deaths being children, and a new circulating variety (known as a 'clade') of mpox a particular concern to children.

Beauty, 17, lives with her sister and parents in an informal settlement in Lusaka, Zambia. Her community was hit by a major cholera outbreak earlier this year. Beauty said: "Cholera, this current outbreak, has really impacted me and my family because my father had to stop work because of the outbreak, and my mother – she's a teacher – she also had to stop work for the same issue. It was challenging for us in terms of finances and surviving, but, to God's grace, we're surviving. It's important to have access to clean water because most of the diseases that happen, they happen because people drink contaminated water. So, if you drink clean water…then you can prevent yourself from getting diseases like cholera."

Dr Revati Phalkey, Global Health and Nutrition Director, said: "Currently, about half of the world's population is not fully covered by essential, quality, affordable health services - denying them their right to health committed as part of universal health coverage ambitions. Health systems are under enormous pressure to deliver universal health coverage, with the majority of countries experiencing worsening or no significant change in service coverage since the launch of the sustainable development goals in 2015.

"We need greater global investments to build strong health systems that are able to deliver essential health services, especially vaccines and essential medicines, while responding to global health emergencies, including emerging issues like mpox.

"It is time for governments and the international community to step up and ensure all children are protected against disease and have access to adequate health services when they need them and where they need them. Every child has the right to survive and thrive, and it is our collective responsibility to deliver on this."

While these headline-grabbing illnesses saw rapid increases in cases or death rates in 2024, pneumonia remains the leading infectious cause of death among children under 5, killing about 500,000 children a year.

However, new estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) show that the number of children dying from pneumonia dropped sharply from 693,000 in 2019 to 502,000 in 2021, the lowest number ever recorded. This 28% reduction is being attributed to the impact of COVID-19 restrictions and underscores the power of preventing the spread of infection.

That said, the impact of the climate crisis is likely to increase respiratory diseases such as pneumonia once again, affecting children the most impacted by inequality and poverty.

Meanwhile, children are particularly vulnerable to dengue fever because their immune systems are weaker than adults, and they tend to play outside where there is less protection against mosquitos. Children under five are at particular risk of developing dehydration and shock from dengue if they contract the illness, and children are most impacted if the illness incapacitates or kills their parents and other caregivers.

Mpox causes fever, rash, and lesions all over the body, as well as severe headaches and fatigue. Some children develop respiratory problems and difficulty swallowing​. In severe cases, mpox can lead to sepsis, a life-threatening response to infection that requires immediate specialist medical attention.

Cholera takes a heavier toll on young children, especially those under the age of 5, who are at higher risk of severe dehydration and death during cholera outbreaks.

Around the world, Save the Children provides public healthcare for children and their families, including treatment for diseases like dengue, cholera and mpox, and works with schools and communities to improve awareness on how to prevent infection.

### NOTES: [1] Total number of dengue-related deaths globally in 2024 – 9600 see [2]; Total number of cholera and acute water diarrhea deaths in 2024 – 4018 see  [3]; Total number of Mpox deaths in 2024 – 57 see [4]; Total number of deaths of the three diseases in 2024 – 13,675. 
[2] According to the WHO Global Dengue Surveillance, since the beginning of 2024, over 13.3 million dengue cases and over 9600 dengue-related deaths have been reported globally. https://worldhealthorg.shinyapps.io/dengue_global/ 
[3] According to the WHO, from 1 January to 27 October 2024, a cumulative total of 486,760 cholera and acute watery diarrhoea cases and 4018 deaths were reported from 33 countries across five WHO regions. While the number of cases reported in October 2024 is 42% lower than the same period in 2023, the number of deaths has increased by 54% – reflecting severe response challenges in outbreak settings [ https://www.who.int/publications/m/item/multi-country-outbreak-of-cholera--external-situation-report--20---20-november-2024]
 [4] According to the WHO, as of 1 December 2024, in Africa, there were 13 171 confirmed cases of Mpox, including 57 deaths reported by 20 countries. https://worldhealthorg.shinyapps.io/mpx_global/