Sudan’s in progress epidemic is a devastating consequence of a deeper systemic crisis exacerbated by years of political instability and current war between the Sudanese Armed Forces and the rapid support forces (RSF), a paramilitary group. The conflict, which broke out in April 2023, precipitated one of the most serious humanitarian disasters in the world, resulting in 20,000 to 150,000 estimated deaths and move almost 13 million people. To add to the crisis, help organizations are no longer able to freely provide medical assistance due to insecurity and restrictions on the movement imposed by groups at war.
The scale of Destruction of sewer systems in urban areas and the decline of sanitation and hygiene services have increased the probability of other cholera epidemics. Sudan requires urgent health care reforms and longer -term solutions for conflict resolution to effectively approach cholera. This crisis is not only a health problem, but also reflects deeper socio -political fractures in the country.
Sudan cholera crisis
Federal Ministry of Sudan Health reported the first cases of cholera of his last epidemic at the end of July 2024. According to the World Health Organization (WHO) Situation reportsby April 2025Sudan had recorded around 59,000 cases and nearly 1,500 deaths. The bacteria of cholera, which propagate through contaminated foods or water, prosperous under unsanitary conditions. Although avowable and treatable, it is a serious threat to the millions of displaced Sudanese living in makeshift shelters in overcrowded refugee camps with insufficient hygiene.
With 17.3 million people Missing access to basic drinking water, it is functionally impossible to follow the hygiene practices necessary to slow down the propagation of the disease. In the state of Gezira, mass displacement Leave people without access to safe water, food and health care. Conflict zones have been particularly devastated.
Sudan needs urgent health care reforms and longer -term solutions for conflict resolution to effectively approach cholera
During the first two months of 2025, UNICEF reported that the white Nile region An increase in cholera casesinfective 2,700 and kill 65. Another 2,700 people Cholera under contract and 92 died in the two weeks that followed. Investigators traced the epidemic to a Projectile rocket launched By RSF who struck the installation of Rabak Power on February 16. This made the water pumps not functional, forcing residents to count on non -drinking water bought in donkey carts. Intense war, which killed hundreds of civilians During this period, left essential infrastructure in ruins and made existing public health gaps even wider.
A health system at the edge
The Sudan Ministry of Health acted quickly to contain the epidemic, but the answer was not adequate given the crushing number of cases. At the end of February, the Ministry of Health, which, and UNICEF, launched a vaccination campaign in the state of the white Nile which aimed to reach 1 million people. Doctors without borders create cholera treatment centers In El Gedaref– and established a new north further in AtbaraHowever, the demand for services has always exceeded the available resources. Patients and their families rushed into neighboring medical centers, especially Kosti University HospitalWhere medical staff had to treat certain patients on the ground given the lack of available beds. This level of tension is a heartbreaking but appropriate representation of the urgent need for international support and infrastructure development.
Even before the civil war, the Sudan health system was underfunded, fragmented and prey to critical shortages on health labor, including significant disparities in access, quality and affordability of care. Progress of the country to meet the Sustainable development objectives had advanced, But very slowly. The current conflict has erased the limited gains previously made in the public health system and inaugurated new challenges. WHO reports that the violent conflict forced 70% of public and private health care establishments In the affected states to close by the end of 2023. Data from the Federal Health Ministry of Sudan also indicate that more than 30% of public hospitals were no longer in service in the year following the start of the war. Conflicts and negligence have destroyed the infrastructure of Sudan health care, crushing remaining medical establishments.
A displaced Sudanese woman rests on a bed in the Abdallah Nagi shelter camp in Port Soudan, Sudan, April 15, 2025.
Reuters / Ibrahim Mohammed Ishak
The chaotic environment has exposed civilians to blind violence, generalized famine and systematic dismantling of the critical infrastructure of health care. Attacks against medical installations were deliberate. The reports indicate Targeted assault On health officers and the looting of hospitals, which seriously hinder the provision of essential services. Humanitarian agencies face important obstacles By providing aid due to bureaucratic obstacles such as visa delays and conflict -focused restrictions on movement and operations. Women and girls are particularly at risk of sexual violence, which has radically increased in this war. Reports documenting rape, sexual slavery and other forms of sexual violence emerged Throughout the conflict, constituting war crimes and serious violations of international humanitarian law.
Health workers in Sudan are facing working conditions below POP and often lacks essential medical treatments, including IV liquids, antibiotics and oral rehydration salts. Many doctors and nurses fled the country in response to violence and instability, aggravating the crisis. The remaining health workers are often not paid in time. Political insecurity is Disturbing supply chainsEntering the transport of important medical supplies and treatments.
The trip has also reached unprecedented levels. In Sudan, About 8.6 million people are moved internally –the greatest crisis of its kind in the world. About 3 million people fled to neighboring countries, including the Central African Republic, Chad, Egypt, Ethiopia and South Sudan. However, many asylum seekers face obstacles to entry, forcing them in the perilous conditions they have sought to escape. Overcrowded refugee camps In these neighboring countries, find it difficult to adapt to the influx of newcomers, and the scarcity of medical resources hinders efforts to contain epidemics of diseases, including cholera.
Sudan’s ability to follow and respond to disease epidemics is also becoming more limited. The current conflict has disrupted health surveillance systems, which makes it difficult to deploy appropriate interventions. Community surveillance systems reported 252 deaths in January 2025, highlighting the need for reinforced basic surveillance systems to help elucidate the impacts of disease epidemics.
The need for urgent action
The Sudan health system requires long -term investments to rebuild. Fundamental reforms could prevent the crisis from worsening and build a system that can resist future epidemics of disease. International collaboration and rapid action are necessary.
Since 2023, UNICEF has administered 13.7 million oral vaccines in choleraBut with national vaccination rates from 85% to 50% due to the conflict, the agency requested $ 750,000 in assistance to provide a complete response from the emergency cholera. Organizations such as borders without borders be called to War parties to grant without restrictions for the delivery of aid. Considering the failed negotiations For a ceasefire on April 15, international leaders must continue to put pressure for a resolution.
International organizations, including WHO and doctors without borders, have mobilized to provide emergency aid, but access remains an important challenge. In February, doctors without borders Suspended activities In the Zamzam camp in the north of Darfur, citing an “unacceptable level of risk” after two ambulances were shot. Doctors without borders and other aid organizations have requested International assistance scaling. This call is particularly relevant, given the loss of support of the American Agency for International Development (USAID).
USAID was the largest humanitarian donor in Sudan, providing Almost 44% of total humanitarian financingSencing $ 126.5 million received this calendar year on March 10. Due to stop working orders, 335 health establishments in Sudan were disrupted. Water, sanitation and hygiene programs, which are essential to combat the spread of cholera, have also been suddenly arrested. The lack of stability during the crisis highlights the need for a long -term strategy to rebuild Sudan’s health system and produce self -sufficient and conflict resistant public health infrastructure.
Sustainable and resilient health systems are not a luxury for periods of peace – they are a necessary basis for the survival and security of a country. To save lives, Sudan should act quickly and decisively to strengthen its health system for the current cholera epidemic and beyond.
The people displaced following rapid attacks on the support forces against the refuge of the Zamzam travel camp, in the city of Tawila, in northern Darfur, Sudan, April 15, 2025.
Reuters / Stringer