The ongoing conflict in Sudan, now entering its fourth year, has created a catastrophic health crisis, dismantling the nation’s once-fragile healthcare system and leaving millions vulnerable to easily preventable diseases. As the fighting continues to rage, the foundational elements of public health – from routine vaccination programs to disease surveillance – have crumbled, paving the way for widespread outbreaks that claim countless lives. International medical organizations like Médecins Sans Frontières (MSF) are on the ground, witnessing firsthand the devastating consequences. They are issuing urgent pleas for global attention and action, emphasizing that without an immediate end to the barriers hindering humanitarian efforts, Sudan faces a relentless cycle of illness and death from diseases for which effective tools of prevention already exist. ## The Unfolding Catastrophe: A Nation Under Siege by Preventable Diseases The war's relentless toll has led to a dramatic collapse in immunization coverage across Sudan. Before the conflict, millions of children received vital vaccinations protecting them from diseases like measles, polio, and tetanus. Today, this protective shield has been severely weakened, leaving vast populations susceptible to outbreaks. This crisis is particularly acute for displaced communities, who often live in overcrowded conditions with limited access to clean water, sanitation, and medical care—perfect breeding grounds for infectious diseases. The consequences are stark. In the initial months of 2026 alone, MSF teams in Darfur have responded to six distinct measles outbreaks, treating over 13,000 cases. These outbreaks have swept through various locations, including Feina, Kas, Nyala, Tawila, and El Geneina, often striking areas where families have sought refuge after fleeing violence. The vast majority of those affected were either completely unvaccinated or had an unknown vaccination history, underscoring the severe gaps in routine immunization. ## Measles: A Highly Contagious Threat Measles is a highly contagious viral illness that can cause severe health complications, particularly in young children and those with compromised immune systems. Symptoms typically include a high fever, cough, runny nose, red eyes, and a characteristic rash. While often seen as a childhood illness, measles can lead to life-threatening conditions such as pneumonia, severe diarrhea, ear infections, and even brain inflammation (encephalitis), which can result in permanent disability or death. The vaccine against measles is highly effective, offering robust protection, yet its absence in Sudan is proving deadly. MSF’s emergency medical coordinator, Joseph Amadomon Sagara, highlighted how quickly measles can spread. In January 2026, Tawila saw 957 measles cases. Following a rapid, partner-led vaccination drive that reached over 130,000 people, cases plummeted to just 40 by late April. However, this success is often temporary. As people are forced to move due to ongoing conflict, new gaps in immunity emerge elsewhere, causing outbreaks to resurface repeatedly. This highlights the critical need for sustained, routine immunization rather than just reactive campaigns. ## Other Emerging Threats: Whooping Cough and Cholera Beyond measles, other vaccine-preventable diseases are also on the rise. In Rokero, a mountainous region in Central Darfur, a pertussis (whooping cough) outbreak affected over 1,000 people since mid-2025, only beginning to subside in March. Pertussis is a highly contagious respiratory infection characterized by severe coughing fits, often followed by a distinctive “whooping” sound as the person breathes in. It can be particularly dangerous for infants, leading to pneumonia, seizures, and even death. When MSF teams finally gained access to remote areas like Suni in South Darfur in mid-April, they discovered numerous cases of pertussis and measles, confirming the long periods communities had gone without basic health services. Adding to the crisis, Sudan is bracing for a potential surge in cholera, especially with the impending rainy season. Cholera is an acute diarrheal infection caused by consuming food or water contaminated with the bacterium Vibrio cholerae. It can lead to rapid dehydration and death if not promptly treated. Since 2024, cholera has claimed over 3,500 lives in Sudan, with MSF treating more than 42,000 cases in 2025 alone. Across nine of Sudan's 18 states, MSF surveillance teams are actively monitoring the situation and preparing for an escalation, highlighting the urgent need for improved water, sanitation, and hygiene (WASH) infrastructure alongside vaccination efforts. ## Critical Barriers to Life-Saving Immunization Despite the clear and urgent need, organizing vaccination campaigns in Sudan is fraught with immense challenges. Humanitarian organizations face a severe shortage of vaccine doses, crippled supply chains, and a dwindling number of trained vaccinators. Furthermore, the bureaucratic hurdles are staggering. Importing essential medical supplies requires multiple layers of approvals, and there are often long delays from the Ministry of Health to develop vaccination plans or officially confirm outbreaks. By the time authorization is finally granted, diseases have often spread widely, making containment far more difficult and costly. Miriam Alía, MSF's vaccination and outbreak advisor, pointed out that “drastic funding cuts and deliberate bureaucratic obstruction by the warring parties are blocking lifesaving vaccines and medicines from reaching people in need timely.” This obstruction includes denying safe passage for humanitarian supplies and personnel, creating a dangerous and inefficient environment for health workers trying to save lives. ## The Path Forward: Urgent Calls for Action Despite these formidable obstacles, vaccination drives have shown remarkable effectiveness. In El Geneina, West Darfur, measles cases dropped by 96% after 186,000 doses were administered. In Central Darfur, the Ministry of Health, with MSF support, conducted its first mass vaccination campaign since the war began, reaching 810,000 children. These successes demonstrate that even in the most challenging environments, with adequate resources and unimpeded access, lives can be saved. MSF is urging international donors to provide flexible funding, diplomatic actors to exert pressure on all warring parties to end administrative obstruction, unblock delivery routes, and guarantee safe passage for humanitarian aid. Mariam, a mother who brought her son for vaccination in Umalgora, West Darfur, powerfully articulated the community's need: “I’ve seen kids with measles… it’s painful; they have fever and rashes… In the community, we can’t control the disease on our own, we need vaccines.” The current focus on reactive outbreak response is simply not sustainable. While effective, these campaigns are temporary fixes. The ultimate goal must be to rebuild and sustain routine immunization programs that ensure every child, regardless of their location or the prevailing conflict, receives timely protection. Until these structural gaps are addressed – including the reconstruction of collapsed health systems, improved access to remote areas, and adequately resourced mobile health teams – Sudan will continue to face recurring outbreaks, tragically losing lives to diseases that the world has long known how to prevent. As World Immunization Week concludes, the message from Sudan is clear: vaccination saves lives, and every effort must be made to ensure these life-saving tools reach those in dire need. The international community, health authorities, and all parties to the conflict must prioritize human health and dignity above all else, paving the way for a healthier future for Sudan’s children.