Sub-Saharan countries began the health transition later than other countries. Most countries still have relatively low levels of life expectancy and high levels of infant and child mortality. To fairly judge the health transition in Africa and to identify gaps where further action is needed, it is appropriate to consider trends rather than simply current mortality indicators. This approach is particularly important for under-five mortality, the main target of public health policies and the most common indicator of levels of mortality. Under-five mortality is one of the eight Millennium Development Goals (Goal 4 and Target 4.A “Reduce by two thirds, between 1990 and 2015, the underfive mortality rate”). Progress in public health is monitored by three indicators, of which the under-five death rate.