Sudan: Sharp vaccination decline allowing preventable disease spread

Darfur is facing a growing health crisis that is allowing diseases which can be prevented by vaccines to spread unchecked. The Médecins Sans Frontières / Doctors Without Borders (MSF) report “Vaccine-preventable disease outbreaks in Darfur” urges Sudanese authorities to allow vaccines to enter the region and for funding to be increased.

Since the outbreak of the war in Sudan in 2023, routine immunisation coverage has plummeted, reversing years of progress in protecting children against preventable diseases.

The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) estimate that the coverage for the first dose of the measles and diphtheria, pertussis, and tetanus (DPT) vaccines has dropped by nearly half in the last four years. Now, only around 47 percent of people are protected from either disease.

This low coverage has worsened outbreaks in Darfur. Because infections are not fully contained, MSF teams are increasingly treating patients for vaccine-preventable diseases such as measles. In Darfur, we treated over 30,000 people in a two-year period, most of whom were children.  

Furthermore, several areas have experienced recurring transmissions every year and despite emergency vaccination campaigns, immunity gaps remain.

The most vulnerable are bearing the brunt

Our teams in Darfur found that three quarters of people treated for measles had never received a vaccine. Nearly 70 percent were children under five, highlighting how the youngest are bearing the brunt of this preventable health crisis.

Measles is spreading at an alarming rate. By April 2026, there had already been a fourfold increase in cases (over 10,000) recorded in South Darfur compared to the entire previous year. 

This growing immunity gap is more severe for children, pregnant women, displaced people and communities living far from urban centres.

Vaccine-preventable diseases are especially dangerous when patients contract other conditions such as malaria and malnutrition, which are rampant across Darfur.  

“Our teams are constantly treating children for diseases that could have been prevented with a vaccine", says Sebastián Traficante, MSF emergency coordinator in Darfur. "Many children reach our facilities in a critical condition, and they simply don't make it out of the hospital." 

The cause of the crisis

Sudan is facing one of the world's largest humanitarian crises. Since the conflict started in April 2023, ongoing violence and mass displacement have resulted in disruption to infrastructure, essential services and humanitarian access.

Behind the sharp decline in immunisation is the collapse of Darfur's health system, leaving the population without access to lifesaving vaccines.

Collapse of the health system

WHO has stated that 37 percent of health facilities across Sudan are non-functional. Those still open in Darfur have severe shortages of staff, medicines, vaccines, equipment and supplies. This has also had an impact on cold chains, meaning that vaccines are unable to safely stored and delivered.

Delays in vaccination approvals

Administrative obstruction and approval delays have prevented vaccinations being ready in time to respond to outbreaks. Campaigns often take place after diseases have already spread and high-risk localities are sometimes left unprotected.

Funding cuts  

At a time when Darfur is already facing recurring outbreaks of measles, cholera and other preventable diseases, cuts to funding and reduced resources are affecting vaccine campaigns, cold chain maintenance and outbreak responses.

Further cuts risk accelerating the collapse of essential health services and leaving even more communities without lifesaving care.  

The methods used to deliver vaccines, such as mobile, outreach and catch-up approaches are limited due to inflexible funding mechanisms. 

Routine vaccination is essential

Outbreak responses such as targeted emergency vaccination campaigns can be effective. A severe measles outbreak in Tawila, North Darfur this year saw more than 1,900 cases treated within four months. An emergency mass vaccination campaign reached 130,000 children and cases dropped by 95 percent.

However, despite these campaigns often achieving a high coverage, they often aren't sustainable when tackling such an alarming rise in preventable diseases. Outbreaks often go undetected until the disease has spread widely, and emergency vaccination campaigns begin too late.

It is essential to have sustained investment in routine vaccination, cold-chain infrastructure, vaccination staff and disease surveillance to stop the reoccurrence of outbreaks of measles, pertussis and other preventable diseases.

Routine vaccination means an already vulnerable population can be protected not just now, but over the long term.