Since the outbreak of the conflict in Sudan on 15 April 2023, UNICEF, WHO and partners have been supporting the Federal Ministry of Health and state ministries of health in Sudan to maintain vital services across the country but are increasingly challenged by the limitations in safety and security, access and resourcing.

The agencies warn that further health system disruptions will result in unacceptably high numbers of preventable deaths among children and vulnerable populations. Urgent action is needed now to preserve Sudan’s health systems, especially at community and primary health care levels.

Six months into the conflict, health workers have gone without pay for months, and health facilities are occupied, looted or destroyed. About 70% of hospitals in conflict-affected states are not functional. WHO has verified 58 attacks on health care to date, with 31 deaths and 38 injuries of health workers and patients.

On top of the active fighting ongoing in Khartoum, Darfur and Kordofans, the rainy season is further limiting access to vulnerable communities, while creating conducive space for the spread of water- and vector-borne diseases.

Millions of families are caught in the middle of the fighting, and more than 5.8 million people, 2.5 million of them children, are newly displaced and on the move. With over 7.1 million people displaced internally – 4.5 million of them since the outbreak of conflict – Sudan now has the largest number of internally displaced people in the world. Lacking access to food, safe drinking water, a clean and healthy environment, health care and many basic services, the risk of death due to birth complications, reduced vaccination, disease outbreaks and malnutrition is rapidly rising.

While there are insufficient data for their verification, projections based on Johns Hopkins University’s Lives Saved Tool modelling indicate that at least 10 000 children under 5 years of age may die by the end of 2023 due to the increase in food insecurity, and disruptions to essential services since conflict broke out in Sudan – well over 20 times the official number of children of all ages killed by the fighting.

The number of hungry families has almost doubled, 700 000 children are suffering from severe acute malnutrition and 100 000 children require life-saving treatment for acute malnutrition with medical complications.