Health and humanitarian toll of Sudan's forgotten war

• Published in: The Lancet (British edition) Vol. 404; no. 10461; pp. 1383 - 1385
• Main Authors: Saleh, Ezzeldin, Dousa, Khalid M, Babiker, Ahmed, Rahma, Nour Elhouda At Alla, Hadi, Hamad Abdel, Elsayed, Mustafa, Elkhalifa, Suleima Ishag, Momin, Sami Mahmoud Abdelkhair, Abubaker, Ahmed, Nemery, Omer Mergani, Bashir, Luai Mohmmed, Bedri, Shahinaz, Fadul, Nada, Hamad, Yasir, Babiker, Zahir Osman Eltahir
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 12-10-2024; Elsevier Limited
• Subjects: Aggression; Agricultural production; Cholera; Coordination; Displaced persons; Epidemics; Famine; Food security; Funding; Health care; Health services; Humanitarian aid; Humanitarianism; Hygiene; Infectious diseases; International aid; Malaria; Malnutrition; Medical personnel; Medical supplies; Prostitution; Public awareness; Public health; Public participation; Sanitation; Sanitation facilities; Sex crimes; Sexual assault; Sexual behavior; Slavery; Social networks; Staff participation; Support services; Tropical diseases; Vaccination; Vector-borne diseases; Violence; War; Water conveyance; Water supply; Water supply systems; Waterborne diseases; United States > US; Sudan
• ISSN: 0140-6736; 1474-547X; 1474-547X
• DOI: 10.1016/S0140-6736(24)01939-1

A report by the UN Integrated Food Security Phase Classification Famine Review Committee published on Aug 1, 2024, showed famine conditions to be prevalent in North Darfur, including in camps for people who have been internally displaced.4 According to WHO, 25·6 million people—approximately 54% of Sudan's population—are currently experiencing high levels of acute food insecurity, with 14 areas almost experiencing famine.3 Furthermore, two-thirds of the 18 states in Sudan have been affected by three or more infectious-disease outbreaks, including cholera, dengue, malaria, and measles, as well as the re-emergence of poliovirus during the ongoing conflict.3 Substantial sexual exploitation, slavery, trafficking, rape, forced marriages, prostitution, and acts amounting to enforced disappearance have been reported since the start of the war.5 However, conflict-related sexual violence is under-reported due to social stigma and the absence of a legal framework for redress. Inadequate access, scarce medical supplies, staffing issues, and little coordination hampered the ability of local and international aid workers to provide care.3 Furthermore, UN agencies have reported deliberate access denials by warring parties.2 The trip to Sudan by the Director-General of WHO in September, 2024 emphasised the urgent need to promote peace and ensure unimpeded humanitarian access to all individuals in need.7 As WHO only secured 24% of the total funding it requested, addressing funding gaps for the Sudan health crisis is crucial to ensure that urgent life-saving assistance is provided. Objectives Monitoring indicators Inadequate engagement of international media Increase global awareness about the conflict in Sudan Media mentions, social media metrics, funding received, international news reports and articles, and public awareness surveys Internal and external displacement of people in Sudan Improve capacity to manage population displacement Safe corridors established, occupancy rates of temporary shelters, and legal and financial assistance provided Unsafe water supply and poor environmental sanitation Implement water, sanitation, and hygiene interventions Number of water-supply systems repaired, distribution numbers of hygiene kits, and number of sanitation facilities constructed and maintained Threat of famine Improve food security Quantity of food aid distributed, agricultural production, and malnutrition rates (especially among children) Collapse of health-care infrastructure Rebuild the health-care system Number of facilities restored and operational; use rates of services; number of health-care workers trained, deployed, and retained; quantity of medical supplies distributed; vaccination coverage; incidence rates of communicable diseases; access to mental health services; and participation in education programmes Increasing conflict-related sexual violence Enhance the safety and support of people who have experienced conflict-related sexual violence Safe spaces established, number of health-care workers and lawyers trained and deployed, and number of people who have experienced conflict-related sexual violence receiving support services Sparse international humanitarian aid Maximise the magnitude and impact of international humanitarian aid Funding for humanitarian aid, coordination meetings and joint initiatives, and logistics performance measures Table Objective-oriented framework to address complex public health challenges in Sudan