Sudan’s Darfur region is grappling with a deadly cholera outbreak amid a complex humanitarian crisis marked by heavy rains, mass displacement, fragile water, sanitation and hygiene (WASH) infrastructure, along with limited access to healthcare.
New figures from the Africa Centres for Disease Control and Prevention (Africa CDC) show that all five Darfur states have reported high cases, with North Darfur accounting for 57% of all cases. Yet South Darfur bears the heaviest death burden – 66 out of 136 deaths recorded in the region so far in 2025.
In all, cholera has been reported across all 18 states in Sudan, with children over the age of 10 accounting for 15% of infections. Khartoum State alone has recorded 24,252 cases and 427 deaths in 2025.
Darfur is particularly vulnerable due to restricted access, ongoing conflict and the possibility of significant under-reporting. Displacement has increased the risk of cross-border transmission, with Chad already reporting cases in refugee settlements near the border with Sudan.
The crisis in Sudan is part of a broader regional emergency, with cholera surging across the continent and exposing deep weaknesses in public health systems. The country is one of 23 African nations currently facing cholera outbreaks, and among the worst affected alongside South Sudan, the Democratic Republic of Congo, and Angola.
In response, African leaders have launched the Continental Cholera Preparedness and Response Plan 1.0, spearheaded by Africa CDC and the World Health Organization (WHO), and championed by Zambian President H.E. Hakainde Hichilema. The six-month plan requires over $231 million in funding, with additional resources needed for long-term vaccine production and health system strengthening.
Yet the plan goes beyond coordination and resource mobilisation, showing how strong political leadership can bring multiple sectors together to address urgent public health challenges. It builds on the successful mpox response model, leveraging the Incident Management Support Team (IMST) to coordinate efforts across countries.
“The elimination of cholera is not only a health goal — it is a moral imperative, a catalyst for economic growth, and a decisive step toward achieving Agenda 2063: The Africa We Want,” said President Hichilema.
The IMST’s “4-One” principle — one team, one plan, one budget, one monitoring framework — ensures strategic coherence and operational efficiency. Cholera specialists will guide technical implementation, while a Continental Task Force will oversee progress toward the 2030 goal of eliminating cholera in over 20 countries, reducing deaths by 90%, and keeping fatality rates below 1%.
Without urgent action, Africa could see over 200,000 cholera cases and 6,000 deaths between September 2025 and February 2026. However, rapid interventions —including the deployment of 10 million vaccine doses, the establishment of treatment centres, and robust community engagement — could dramatically reduce the toll.
“Cholera is not just a health emergency — it is a reflection of deeper systemic inequalities,” said Africa CDC Director General Dr Jean Kaseya. “Our response must be swift, coordinated and rooted in solidarity. We cannot afford to let vulnerable communities bear the brunt of preventable disease.”
Back in Sudan, inadequate WASH infrastructure is a significant contributor to the outbreak. Ninety per cent of Khartoum’s water treatment plants are currently out of service. This has severely limited access to clean water and increased the risk of disease transmission. Compounding the situation, Sudan is also battling concurrent outbreaks of dengue fever, diphtheria, measles, and pertussis.
Flooding on 17 August displaced nearly 900 people in North Darfur, compounding the already dire conditions. Ongoing conflict has made parts of the region inaccessible, with shortages of medical supplies, clean water, and isolation centres complicating containment efforts.
Access to vaccines remains uneven across Sudan, with some regions facing severe challenges. In Darfur, oral cholera vaccine coverage is virtually non-existent, compared to a national average of just 5.4%. This gap is mainly due to ongoing civil conflict, which has made large parts of the region inaccessible to vaccination teams. As a result, displaced populations — many living in overcrowded camps — are especially vulnerable to cholera outbreaks.
Thus, the true extent of the outbreak may be obscured by the ongoing humanitarian crisis. Under-reporting, limited healthcare access, and delays in data collection continue to hinder a full understanding of the situation.
While the decline in new cases in the affected African countries offers a glimmer of hope, the overall situation underscores the extreme vulnerability of communities in conflict-affected regions like Darfur. The cholera outbreak is a stark reminder of the broader challenges African countries face in managing preventable diseases under strained conditions.
Health authorities stress the urgent need for increased support to improve water and sanitation facilities, expand access to treatment, and implement vaccination campaigns in affected areas.
The Continental Cholera Preparedness and Response Plan offers a practical and coordinated framework to support national efforts. But its success will depend on timely implementation, sustained funding and the ability to adapt to complex, on-the-ground realities.
Sudan’s ongoing crisis highlights the urgency of these efforts.
“This cholera crisis is not just a public health emergency but is also a powerful reminder and a call to our leaders that there is no health without peace,” said Dr Kaseya.
