Efforts to meet Millennium Development Goal 4 (MDG 4)—a two-thirds reduction in child mortality by 2015—have led to a substantial decrease in deaths of children younger than 5 years. However, not all children have benefited equally from these gains. Furthermore, despite many country successes, the world as a whole remains off-track in meeting this goal. A growing consensus exists that fresh approaches will be needed in the years up to the MDG deadline and beyond to accelerate progress. A new report from Save the Children—Lives on the Line: An Agenda for Ending Preventable Deaths—highlights how countries need to shift their strategies based on the current child mortality landscape. It notes that newborn mortality rates are increasing, that child mortality is increasingly concentrated in particular regions and among the poorest and most disadvantaged groups, and that progress in reducing malnutrition remains stagnant and threatens to jeopardise overall progress.