Sudan civil war: Health system ‘on the verge of collapse’

This article is published in association with United Nations.

The war in Sudan has been tearing the country apart for almost 1,000 days, putting the country’s health system under intolerable pressure. The World Health Organization (WHO) is reporting widespread disease outbreaks, severe shortages, malnutrition and rising deaths.

The UN agency has revealed shocking figures related to attacks on healthcare facilities in Sudan, stressing that the country is recording the largest percentage of global deaths linked to the targeting of the health sector, in flagrant violation of international humanitarian law.

In a conversation with Abdelmonem Makki from UN News, Shible Sahbani, WHO Representative in Sudan, explains the severity of the situation, and how the organisation is supporting the health authorities and the country’s citizens.

Shible Sahbani: The war started in April 2023, which means that, in just a few days, it will have been going on for 1,000 days. In that time the country has been plunged into a rapidly deteriorating humanitarian situation, a security crisis, a displacement crisis, a famine-like crisis, but also a health crisis.

The weather and conditions in Sudan are conducive to the spread of malaria and dengue fever by mosquitoes. Outbreaks of vaccine-preventable diseases, such as measles and polio, are also being reported in many states right now.

Healthcare facilities are being attacked, there is a shortage of medicines and supplies, and a lack of financial and human resources to operate health services. This means that the system is on the verge of collapse.

Sudan was once considered to be the food basket of the entire region. Today, it is facing one of the most serious food crises in the world: more than 21 million people face high levels of acute malnutrition and food insecurity. Children under five years of age and pregnant or breastfeeding women are particularly at risk: we estimate that nearly 800,000 children under the age of five will have suffered severe acute malnutrition in 2025.

UN News: How is WHO supporting the Sudanese health authorities?

UN News

Shible Sahbani: The World Health Organization (WHO) is responsible for coordinating the health response, working with the Ministry of Health and other partners. We provide expertise and technical support, as well as capacity building to respond to disease outbreaks, malnutrition, non-communicable diseases, and mental health needs. Since the start of the war, WHO has provided about 3,000 metric tonnes of medical supplies worth about $33.3 million. We have also been providing cash support for healthcare employees who have not been receiving any salaries, and fuel to generate electricity at healthcare facilities.

UN News: According to UNICEF, vaccination rates in Sudan have fallen to their lowest level in 40 years, and thousands of children have missed out on vaccination doses. What dangers does this pose for the children of Sudan?

Shible Sahbani: This reduction in coverage is one of the main reasons that vaccine-preventable diseases such as measles, diphtheria and polio are spreading throughout the country. Malnutrition and other health conditions also make children less immune, putting their lives and futures at grave risk.

© UNFPA Sudan

A looted health care facility in Darfur (file, 2024)

UN News: Can a further deterioration of the health crisis be prevented?

Shible Sahbani: We have to think of Sudan as a country that needs to recover as quickly as possible. Sudan is a large country with a high population density, and they have immediate needs. But we also need to strengthen the health system. In this regard, we are working with the government to develop a new strategy for early recovery and development, and to strengthen resilience.

The eastern part of the country has remained stable and has not been directly affected by the war. But the massive influx of displaced people from other states has put a significant burden on health facilities.

The western part – especially Kordofan and Darfur – is where people are being bombed and facing serious security concerns and severe difficulty accessing health services. The central region, which includes Al-Jazira, Khartoum and Sennar, has been hit hard by the war, but is now accessible.