On a blog post at PLOS, the tropical disease expert Peter Hotez and postdoctoral fellow Jennifer Herricks take a run through the data on the biggest killers of children around the world in 2013, part of a new dataset from Global Burden of Disease study published in the January Lancet. The main one is malaria, which killed more than half a million kids in 2013, dwarfing the other causes of death—pneumonia killed about half as many, and whooping cough a tenth.

Hotez and Herricks rightly point out that what’s interesting here is how many of these diseases are preventable with vaccinations. The fact that a technology exists, though, doesn’t always translate into it being deployed. They write:

Just having a vaccine developed and manufactured is not always the complete answer. Of the dozen or so killer diseases of children, five of them are infections for which vaccines are available – pneumococcal pneumonia, rotavirus enteritis, Haemophilus influenza type b pneumonia, measles, and whooping cough.

In other words, getting medicine and vaccine to remote areas is hard.

Here’s a chart of the numbers they post from the study, which looked at yearly deaths for kids under 59 months for almost 200 countries between 1990 and 2013.

You look at that and you think, “Mmm, not so great.”

But that’s not the only takeaway from the Lancet data. One of the figures in the Lancet study, a fascinating slopegraph, shows the change in position of several dozen causes of death over time. And it makes the news seem not so grim for kids. For example, preterm birth was the third most common cause of death in 1990, but it dropped to 7th most common cause of death in 2013. Yay? Kinda? We wanted to get a sense of how diseases that specifically affect children have changed over time, so we looked at the percent shift in the main mortality factors for the under-fives (and in a few cases the under-one-months) between 1990 and 2013.

Ah! Suddenly that’s not looking quite so depressing. Deaths from a host of diseases, from tetanus (preventable with a vaccine) to malnutrition (preventable with food) are down. Death from HIV/AIDS are up from 1990. Malaria is holding steady.

Well, actually, it’s kind of even better than that. AIDS, for example, says Hotez, who is the Dean of the National School of Tropical Medicine at Baylor College of Medicine, went up from 1990 until 2003, then started going down. He points to another Lancet study from last year.

Check out figure 7. AIDS deaths are higher in 2013 than they were in 1990, which is bad, but they’re heading in the right direction, which is downward. Same with malaria. It went up before it started going down, and this particular chart masks that hump shape. Hotez and I puzzled a bit over the drops in drowning (maybe a public education campaign?) and road deaths. Would those drops be due to better hospital care I wondered, for people who had been in accidents? Or said Hotez, maybe something simpler, even, than that: seatbelts.