Sudan's collapsing healthcare system a global emergency
Sudan is currently grappling with one of the worst humanitarian and public health crises in the world, as its healthcare system is collapsing under the weight of ongoing civil conflict.
The war, which erupted in April 2023 between the Sudanese Armed Forces and the paramilitary Rapid Support Forces, has inflicted immense damage on the country's medical infrastructure. Over the past two years, the violence has destroyed more than 250 hospitals and healthcare facilities, either through direct bombardment or looting. At least 60 percent of pharmacies and medical warehouses have been looted, burned or rendered inoperable.
Medical professionals have fled or been killed and those who remain are often targeted or are unable to safely reach their workplaces. Basic medical supplies, electricity, clean water and fuel are scarce or nonexistent in many parts of the country. The breakdown of health services has not only left millions without access to essential care but has also created ideal conditions for deadly disease outbreaks to spread unchecked.
Amid this destruction, the World Health Organization and the UN have raised alarms about the spiraling health emergency. Sudan now faces simultaneous outbreaks of cholera, malaria, measles and dengue, diseases that are being exacerbated by the collapse of sanitation systems, unsafe water sources and overcrowded refugee camps.
More than 20 million people — almost half the country's population — are in urgent need of medical care. Immunization campaigns have been halted and the absence of preventive medicine has led to the rapid reemergence of diseases once under control. The WHO has recorded at least 156 attacks on healthcare workers and facilities since the war began and these attacks continue to impede even the most basic humanitarian responses.
The UN has called Sudan one of the world's largest and most-neglected emergencies, noting that more than 12.4 million people have been displaced and famine is either present or imminent in several areas. Children are especially vulnerable: millions face severe malnutrition, lack access to medical care and are increasingly at risk of exploitation, trafficking and death.
If this crisis continues without immediate intervention, Sudan faces an impending humanitarian catastrophe that will have devastating consequences for its people for generations to come. The complete collapse of the healthcare system means that diseases will spread without resistance, maternal and infant mortality will surge and chronic illnesses will go untreated. With hospitals destroyed and doctors in hiding or exiled, even the simplest medical emergencies can become fatal.
With hospitals destroyed and doctors in hiding or exiled, even the simplest medical emergencies can become fatal
Dr. Majid Rafizadeh
The loss of educational and training institutions also means that rebuilding the health sector will take decades, even under optimal conditions. Famine, disease and the psychological trauma of war are already corroding the foundations of society, deepening poverty and dismantling any remaining trust in institutions. If the fighting persists, the country could be left with an entire generation deprived not only of healthcare, but of security, education and hope.
The consequences of the collapse of Sudan's healthcare system will not remain contained within its borders. The conflict has already displaced more than 3.3 million people into neighboring countries such as Chad, South Sudan, Egypt, Ethiopia and the Central African Republic. These nations, already burdened with fragile health systems and limited resources, are now under immense strain as they attempt to care for large numbers of malnourished and sick refugees.
Infectious diseases like cholera, which thrive in overcrowded and unsanitary conditions, pose a serious threat to regional public health. The breakdown in immunization coverage could result in the cross-border spread of measles and polio, undermining years of health progress in the region. Moreover, the protracted instability in Sudan risks destabilizing the entire Horn of Africa, a region already vulnerable to political fragmentation, insurgency and environmental stress.
The global implications of Sudan's health emergency are equally urgent. The ongoing collapse of Sudan's health system and the humanitarian vacuum it creates serve as a dire warning about the fragility of global health security. As we have seen with past pandemics and regional crises, diseases that emerge or expand in one part of the world can quickly spread beyond borders, especially when response efforts are delayed or under-resourced.
Moreover, the normalization of attacks on healthcare workers and facilities during armed conflict threatens the sanctity of international humanitarian law. If such violations continue with impunity in Sudan, they could set a precedent for future conflicts, eroding the principles that protect civilians and aid workers globally. The lack of a coordinated international response not only reflects a failure of political will, it also undermines collective commitments to global health and human rights.
What is urgently needed is a decisive, coordinated and sustained international response. The first and most pressing step is the implementation of an immediate ceasefire. This would allow for the safe establishment of humanitarian and health corridors — zones where aid organizations can deliver medical supplies, provide vaccinations and treat the wounded without threat of violence. These corridors are essential for saving lives in the short term, especially in regions that have been cut off from aid for months.
The UN, the WHO, Doctors Without Borders and other agencies require not only funding but also guaranteed security to operate effectively. Immediate airlifts of medicine, surgical equipment, vaccines and food must be prioritized. Equally important is the political pressure on both warring factions to cease attacks on healthcare infrastructure, in accordance with international humanitarian law.
Beyond these urgent interventions, the international community must work in collaboration with the African Union, the Intergovernmental Authority on Development and key regional actors to forge a pathway toward a permanent ceasefire and political resolution.
This includes building upon the Jeddah Declaration, which was signed in May 2023 under the auspices of the US and Saudi Arabia. The declaration outlined commitments by both warring parties to protect civilians, allow humanitarian access and refrain from targeting civilian infrastructure. Though the declaration has largely been violated, it remains one of the few frameworks for negotiation that has gained international recognition. Revitalizing the Jeddah process, expanding the number of mediating parties and ensuring local community representation are vital steps toward lasting peace. Without a stable political solution, humanitarian aid alone will never be sufficient.
In conclusion, Sudan's health crisis has reached a catastrophic stage and the situation demands the world's immediate and undivided attention. The country's healthcare system is not merely under stress — it is actively disintegrating. Millions are at risk of dying not only from bullets and bombs but from preventable diseases and starvation.
The consequences of inaction will reverberate far beyond Sudan's borders, threatening regional health, stability and security. The international community must act now — decisively and urgently — to implement a ceasefire, open health corridors and reengage in meaningful diplomacy. Failure to do so will not only doom millions in Sudan but will mark yet another tragic instance of global neglect in the face of a preventable disaster.
• Dr. Majid Rafizadeh is a Harvard-educated Iranian American political scientist. X: @Dr_Rafizadeh
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