For the second year in a row, Sudan is grappling with a severe cholera outbreak that has claimed at least 28 lives in the past month. The outbreak has emerged amidst heavy rains in regions crowded with people fleeing the country’s ongoing 16-month war, according to officials.
Since the current outbreak began on July 22, 658 cholera cases have been reported across five states, as confirmed by Shible Sahbani, the World Health Organization (WHO) country director, during an interview with Reuters in Port Sudan. With much of Sudan’s health infrastructure either collapsed or destroyed and medical staff displaced, the death rate has surged to 4.3%—a notably high figure compared to other cholera outbreaks. Sahbani warned that approximately 200,000 people are at high risk of contracting the disease.
The conflict between the Sudanese army and the paramilitary Rapid Support Forces (RSF) has resulted in one of the world’s most dire humanitarian crises, displacing over 10 million people both within Sudan and across its borders. The country is currently dealing with five simultaneous disease outbreaks, including dengue fever and measles.
As the RSF continues to advance across large parts of Sudan, many people have been cut off from critical aid. The army has restricted access, while RSF forces have looted supplies and hospitals. Efforts to deliver aid to the western region of Darfur have been further complicated by ongoing rains. International experts have identified famine conditions in Darfur’s Zamzam camp, an area severely affected by the rains and highly susceptible to cholera.
Between October 2023 and May 2024, the previous cholera wave in Sudan resulted in around 12,000 cases and over 350 deaths, according to Health Minister Haitham Mohamed Ibrahim. He noted that there had been no significant cholera outbreak in the nine years preceding the war. The current outbreak is concentrated in Kassala and Gedaref states, where 1.2 million displaced people are living.
In Gedaref, stagnant rainwater mixed with refuse has created breeding grounds for insects, further exacerbating the spread of disease. A local official reported that the majority of illnesses are due to poor water quality, insect infestations, and inadequate sewage management.
Many displaced individuals, fleeing RSF raids, are sheltering in overcrowded, makeshift camps where overflowing lavatories and unsanitary conditions provide an ideal environment for cholera to spread. The disease is typically transmitted through contaminated food and water.
Sahbani also mentioned that cholera cases have been reported in states like Khartoum and Gezira, which are largely controlled by the RSF, and warned that states in the Kordofan and Darfur regions might soon face outbreaks as well. He highlighted the challenges in delivering supplies to affected areas due to impassable roads during the rainy season, security concerns, and bureaucratic hurdles.
On Friday, Sahbani shared some “good news” amidst the crisis, announcing that the International Coordinated Group for vaccine allocation (ICG) had approved the delivery of 455,000 cholera vaccine doses to Sudan. Meanwhile, Minister Ibrahim stated that the army-aligned government has resorted to “unorthodox measures,” including airdrops, to deliver vaccines and supplies to RSF-controlled areas as well as isolated army-held territories.
Both officials underscored that the scale of need in Sudan far exceeds the current aid efforts, particularly as the United Nations’ humanitarian appeal for Sudan is only about one-third funded.
