The Cholera Epidemic Outbreak in Sudan and South Sudan has emerged as one of the most severe public health crises in the region in recent years. Driven by prolonged conflict, mass displacement, collapsed infrastructure, and environmental factors like flooding and poor sanitation, cholera—a highly contagious bacterial infection caused by Vibrio cholerae—has spread rapidly across both countries since mid-2024. This outbreak highlights how war and humanitarian emergencies can transform a preventable, treatable disease into a deadly epidemic.
Cholera spreads primarily through contaminated water and food, thriving in areas with inadequate clean water access, poor hygiene, and overcrowding. Symptoms include severe diarrhea, vomiting, and dehydration, which can lead to death within hours if untreated. However, with prompt rehydration (oral or intravenous fluids) and antibiotics in severe cases, the case fatality rate (CFR) can drop below 1%. In conflict zones, these basic interventions become challenging, pushing CFR higher.
In Sudan, the current wave began in late July 2024, amid the ongoing civil war between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) that erupted in April 2023. The conflict has devastated infrastructure, including water supply systems, power grids, and health facilities. Drone attacks and bombardments have targeted essential services, leading to surges in cases—such as in March and May 2025—when water access was severely compromised.
By mid-2025 (around July 11, 2025), Sudan reported over 87,219 cases and 2,260 deaths, with a CFR of 2.6%. The outbreak spread to nearly all 18 states, except Central Darfur initially, with particularly alarming transmission in Darfur and Kordofan regions due to limited humanitarian access. Earlier data shows peaks in 2024, with 50,832 cases and 1,380 deaths, followed by 23,488 cases and 517 deaths in the first half of 2025. Khartoum, White Nile, and North Kordofan showed increasing trends, while some eastern states saw declines after interventions. By later 2025 estimates, cumulative figures exceeded 83,000–120,000 cases and over 2,100–3,300 deaths nationwide since the start. Over 33.5 million people, including millions of children, remain at risk.
The war has displaced millions, creating overcrowded camps with no sanitation. Floods during rainy seasons contaminate water sources further, while destroyed sewage systems and waste accumulation breed the bacteria. Cross-border movements have also spread the disease to neighboring Chad and South Sudan.
In South Sudan, the outbreak was declared in late September/October 2024, starting in border areas like Renk County, often linked to refugees fleeing Sudan’s conflict. This has become the country’s worst cholera epidemic on record. By late 2025 (December), South Sudan recorded around 97,292 suspected cases and 1,600 deaths across 55 counties in 9 states and 3 administrative areas, with a CFR of 1.6%. Figures climbed to nearly 98,000 cases and over 1,600 deaths by early 2026.
States like Jonglei, Unity, Upper Nile, and Central Equatoria (including Juba) have been hardest hit. In Jonglei, recent violence and displacement—over 280,000 people displaced since late 2025—have overwhelmed cholera treatment centers. As of early February 2026, new cases continued, with 479 nationwide in January alone, many in Duk County among IDPs. The influx of displaced people into areas with minimal WASH (water, sanitation, and hygiene) services has fueled transmission, even in dry seasons.
Both countries face overlapping crises: Sudan’s war has caused famine in Darfur, while South Sudan’s violence disrupts aid. Malnutrition weakens immunity, making cholera deadlier—malnourished children are far more vulnerable. In South Sudan, over 450,000 children in Jonglei risk acute malnutrition amid halted services.
Humanitarian Response Efforts have been valiant but constrained. In Sudan, WHO, UNICEF, and partners have conducted large-scale oral cholera vaccination (OCV) campaigns—e.g., reaching over 2.24 million in Khartoum hotspots with 96% coverage, contributing to declines there. Multisectoral approaches include case management, surveillance, risk communication, and WASH improvements. However, funding gaps persist; Sudan’s response plan was only 16% funded by mid-2025, requiring $50 million urgently. Access challenges in Darfur and Kordofan necessitate cross-border operations via Chad or South Sudan.
In South Sudan, OCV campaigns reached 8.6 million people across 46 counties by late 2025, with 84.7% coverage. Organizations like MSF, UNICEF, and WHO have set up treatment centers, provided water purification, soap, and buckets, and delivered emergency kits. UNICEF has responded to Jonglei surges despite looted supplies and closed facilities. Global vaccine supply improvements by early 2026 allowed resumed preventive campaigns after years of shortages.
Challenges remain immense: insecurity blocks convoys (e.g., attacks suspending UN food aid in South Sudan), funding cuts (like USAID reductions in 2025), and destroyed infrastructure hinder sustained control. Climate factors, like rains, risk further spikes.
The outbreaks in Sudan and South Sudan serve as a stark reminder of how conflict exacerbates preventable diseases. Cholera thrives where basic services fail—clean water, sanitation, healthcare, and peace. As cases persist into 2026, with ongoing displacement and violence, the international community must prioritize funding, access, and diplomacy to curb transmission and prevent future waves. Without addressing root causes like war and poverty, these epidemics will recur, claiming thousands more lives in already vulnerable populations.
