Each year more than 6.6 million people die before their fifth birthday. Nearly half of these children, says a new report from the World Health Organization, lived in just five countries: India, Nigeria, China, Pakistan and the Democratic Republic of the Congo. And, nearly half of these deaths were linked to malnutrition.

Even among these five countries, says a release from the WHO, India stands out. The infant mortality rate in India, according to the CIA, is 44.6 deaths per 1000 births. In the U.S. it’s 5.9 per 1000. The WHO says that 56 of every 1,000 Indian children will die before they turn five. This isn’t the highest rate—that unfortunate award goes to Angola, in southern African, where on average 164 of every 1,000 people die by age 5. Though, by sheer scale, more children are lost in India each year than any other country in the world—22 percent of deaths in children under five take place in India.

There’s some good news, though. The rate of child mortality is dropping fast. In 1990, says the WHO, 12 million children under age 5 died. In 2012, we lost 6.6 million. They say that more progress could easily come with increased access to basic health care, such as vaccines and antibiotics, and to increased access to nutritious food.

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