Khartoum, Sudan · 3 July 2025 — A catastrophic cholera outbreak continued to sweep across Sudan in mid-2025, with over 87,000 suspected cases and 2,260 deaths reported by July, according to the World Health Organization (WHO) Eastern Mediterranean Regional Office. The outbreak had spread to all but one of Sudan's states, driven by the compounding effects of ongoing civil war, destroyed infrastructure, and seasonal flooding.
The epidemic, which began in late July 2024, escalated dramatically throughout 2025. By March 3, 2025, over 57,000 suspected cases and 1,534 deaths had been reported across 12 states. By October 2025, the Federal Ministry of Health would report 120,496 cases and 3,368 deaths nationwide — but by July, the trajectory was already alarming humanitarian agencies on the ground.
Civil War as a Disease Amplifier
The armed conflict that erupted in April 2023 between the Sudanese Armed Forces and the Rapid Support Forces created what humanitarian agencies describe as a perfect storm for waterborne disease. The International Committee of the Red Cross (ICRC) characterized the outbreak as Sudan's worst in years, with the civil war acting as the primary driver.
The conflict's impact on public health infrastructure has been devastating:
| Infrastructure Impact | Detail |
|---|---|
| Water facilities | Approximately 70% of water facilities damaged or non-functional due to lack of maintenance |
| Health facilities | An estimated 75–80% of health facilities in conflict-affected areas non-functional |
| Power infrastructure | Power plants and water systems destroyed in cities including Kosti and Rabak |
| Displacement | Millions forced into overcrowded, unsanitary displacement camps |
| Health workforce | Medical workers often unpaid or forced to flee; aid access frequently blocked by violence |
UNICEF reported that the destruction of power plants and water systems forced populations to rely on unsafe, contaminated water sources. Heavy seasonal rains caused flooding that further contaminated water supplies, accelerating transmission in displacement camps where overcrowding made rapid spread inevitable.
WHO and International Response
The World Health Organization, alongside partners including UNICEF and Gavi, led efforts to contain the outbreak despite severe security and funding constraints. The response strategy included:
- Vaccination campaigns: Millions of doses of oral cholera vaccine (OCV) were distributed to high-risk areas. However, effectiveness was limited by challenges in humanitarian access, particularly in areas controlled by warring factions.
- Case management: Rapid response teams were deployed, and cholera treatment centers were established in accessible areas.
- Disease surveillance: WHO supported improved disease surveillance and reporting systems, though data collection remained hampered by conflict.
- Risk communication: Community-level education campaigns promoted preventive knowledge, including water treatment and hygiene practices.
- Medical supplies: Essential medicines, rehydration solutions, and medical equipment were pre-positioned where access permitted.
The WHO utilized funding from the UN Central Emergency Response Fund (CERF), Gavi, and other international donors to support these activities. UNICEF's response focused on water, sanitation, and hygiene (WASH) interventions, including the distribution of water treatment supplies and the rehabilitation of water points where security allowed.
A Severely Underfunded Response
Despite the scale of the emergency, humanitarian agencies repeatedly emphasized that the response was severely underfunded. At one point in mid-2025, the cholera response plan was reportedly only 16% funded, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). This funding gap hindered the ability to scale up life-saving interventions, including the expansion of vaccination campaigns and the establishment of treatment centers in newly affected areas.
The Regional Context
Sudan's outbreak occurred within a broader resurgence of cholera across Africa and beyond. In 2025, WHO reported responding to more than 21 public health emergencies across the African region, with cholera active in multiple countries including Angola, the Democratic Republic of the Congo, and Malawi. The Global Task Force on Cholera Control has warned that climate change, conflict, and displacement are converging to create conditions favorable to cholera's spread in previously unaffected areas.
The oral cholera vaccine supply, managed through the global stockpile, faced significant pressure from multiple simultaneous outbreaks. While manufacturers have increased production capacity, demand consistently outstripped supply in 2025, forcing the International Coordinating Group to make difficult rationing decisions.
Looking Forward
By October 2025, the Federal Ministry of Health would report that the outbreak had reached 120,496 cases and 3,368 deaths nationwide. The continued escalation underscored the fundamental truth articulated by humanitarian agencies: without a cessation of hostilities and the restoration of basic infrastructure, cholera would continue to claim lives in Sudan.
The ICRC and other organizations emphasized that the response required not only medical interventions but also protection of health workers, guaranteed humanitarian access, and ultimately, a political solution to the conflict that has devastated one of Africa's largest countries.
Sources
- WHO EMRO, "Cholera spreads to all but one of Sudan's states," 2025 —
- UN OCHA, "Sudan: Cholera Operational Update No. 3, July 2025" —
- UNICEF, "The fight against cholera in Sudan," 2025 —
- ICRC, "Sudan faces worst cholera outbreak in years as war devastates infrastructure," 2025 —
- ReliefWeb, "Cholera outbreak worsens amid conflict in Sudan," 2025 —
- WHO, "Cholera Health Emergency Appeal 2025" —
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Institutional Research Desk · Foresight Institute of Research and Translation
The collective editorial and research translation board of FIRAT, synthesising peer-reviewed evidence, policy briefs, and division milestones across our seven foundational research pillars.
