Officials raise alarm over risk of ‘countless’ additional deaths, with health system in ‘freefall’ and cholera cases surging amid 18 month war.

United Nations agencies have warned that famine and disease threaten to cause “countless” deaths in war-torn Sudan unless emergency action is taken.

Malnourishment, crumbling healthcare facilities and a surge of cholera cases are blighting the population, officials from the World Health Organization (WHO) said on Tuesday as they underlined the “immense challenges” faced by aid workers after 18 months of war in the North African country.

“Malnourished children and mothers are dying due to lack of access to care, and cholera is spreading in many parts of the country,” said WHO’s regional director Hanan Balkhy at a media briefing in Cairo, the capital of neighbouring Egypt. “Without immediate intervention, famine and disease will claim countless more lives.”

Floundering

The ongoing war between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF) has raged since April 2023, killing 20,000 people and displacing more than 10 million – including 2.4 million who have fled to other countries – according to UN estimates.

The international community has been floundering in its efforts to bring an end to the devastating conflict, which has been overshadowed by the wars in Ukraine and Gaza.

The United States announced on Tuesday that it had added Algoney Hamdan Dagalo Musa, the younger brother of RSF commander Mohamed Hamdan Dagalo, widely known as Hemedti, to its sanctions list.

The US Department of Treasury accused Musa of leading RSF’s procurement of weapons and extending the country’s civil war.

However, Washington has so far rejected calls to sanction Hemedti directly over allegations that the RSF has committed human rights violations, including in the Darfur region.

The conflict has left more than 25 million people – over half the population of Sudan – in desperate need of food and healthcare.

Cholera appears to have surged over recent weeks, according to figures released by Sudan’s Ministry of Health on Monday. It reported 21,288 cases and 626 deaths since July, a significant uptick from the 15,577 cases and 506 deaths reported on September 26.

The ministry officially declared an outbreak of cholera in August, after a wave of cases was reported the previous month. The disease is spreading fast in areas devastated by heavy rainfall and floods, especially in the east of the country, where millions of displaced people are sheltering.

Most cases were reported in Kassala, where WHO, in collaboration with the Health Ministry and UNICEF, is carrying out a second round of an oral cholera vaccination campaign that kicked off last month.

Richard Brennan, WHO’s regional emergency director, said on Tuesday that the rise in cases was “concerning”, adding that it was “too early to determine the effectiveness of the vaccination campaign”.

Balkhy warned that Sudan’s health system is in “freefall”, with 75 percent of health facilities in the capital, Khartoum, now nonfunctional. She added that the situation in western Darfur states was worse.

The war between SAF and RSF began in mid-April 2023 after a growing rivalry burst into the open over internationally backed plans for transition towards civilian rule.