Measles cases are rising rapidly across Sudan’s Central, South, and West Darfur states, in the absence of an urgent and effective vaccination campaign.
More than 1,300 cases have been recorded in health facilities supported by Doctors Without Borders/Médecins Sans Frontières (MSF) since September—despite MSF repeatedly advocating for vaccination campaigns and the resumption of routine immunization programs.
MSF urges all authorities to immediately eliminate all bureaucratic and administrative barriers to transporting vaccines throughout Darfur. At the same time, there must be greater urgency from UNICEF to coordinate efforts to increase the transport and delivery of vaccines, syringes, and other necessary supplies. We also call on both the state and federal ministries of health to launch an urgent measles vaccination campaign and a routine immunization program.
Measles can—and should—be simple to prevent
“Measles is a preventable disease; it requires only routine immunization and timely reactive vaccination,” said Ahmed Fadel, MSF emergency coordinator in Darfur. “But due to conflict, administrative barriers, and delays by key agencies, both have been severely limited. These delays are leaving vulnerable children exposed to a disease that is also deadly.”
At El Geneina Teaching Hospital in West Darfur state, Ferdos Salih arrived with her 11-month-old baby, Banan, who has measles and severe acute malnutrition. "She was born prematurely because the war forced us to flee from Omdurman while I was pregnant," Ferdos explained. "She has suffered a lot with repeated hospitalization. Also because of the war, she couldn't get vaccinated."
Since being displaced, Ferdos and Banan live with two other families. Banan caught measles from her older brother because there was not enough space in the house to isolate him properly when he first got sick.
Sudan 2025 © Natalia Romero Peñuela/MSF
Conflict makes vaccine shipment almost impossible
Shipping vaccines for reactive campaigns and immunization programs is extremely challenging because of the operational environment in Sudan. Ongoing conflict has disrupted import routes and created significant administrative and bureaucratic hurdles for humanitarian actors involved in vaccination efforts, including delays linked to authorizations for cross-border shipments and procedures required by Sudanese authorities.
At the same time, the delivery of vaccines and other supplies necessary to carry out vaccinations are not coordinated sufficiently, arriving at different locations and times. This has created another hurdle before vaccinations can begin. “This is the main cause of delays in the field,” said Fadel. “The supply of vaccines and related supplies must be better coordinated so that both arrive where they are needed much more quickly.”
Malnutrition complicates measles treatment
Matara Abakar brought her 10-month-old son, Natrin, to Zalingei Hospital in Central Darfur after he had been sick for 17 days with a fever, diarrhea, cough, and a skin rash. He is also severely malnourished. "We are struggling to find jobs,” Matara said. "I’m a farmer, and it's hard to earn enough money to buy proper food. We depend only on asida [a Sudanese food made with sorghum or millet flour].” She has two more children who are not fully vaccinated either.
More than 34 percent of patients in Zalingei and Nyala are acutely malnourished, which increases the severity of the measles and rapidly leads to life-threatening complications, including pneumonia, encephalitis, and death. Delays in vaccine shipments and repeated postponements of a reactive vaccination campaign are leaving children unprotected while the outbreak continues to expand.
Sudan 2025 © Natalia Romero Peñuela/MSF
Responding to the measles outbreak despite difficulties
At Zalingei Hospital, MSF teams have treated 1,093 measles patients this year, with a sharp increase in recent months. At Nyala Teaching Hospital in South Darfur, teams treated 242 measles patients in 2025, 95 percent of them since September. Meanwhile, El Geneina Teaching Hospital in West Darfur received 429 measles cases in 2025, with 59 percent reported between September and November.
More than 29 percent of cases in Zalingei and 34 percent in Nyala were in children over 5 years old, highlighting the longstanding failure to ensure routine immunization in the region, even before the escalation of the current conflict. For this reason, the outbreak response should include children aged between 6 months and 15 years old.
MSF outbreak response in Sudan
Between November 2024 and May 2025, MSF teams carried out four vaccination campaigns in response to outbreaks:
- In November 2024, our teams vaccinated 9,600 children in North Jebel Marra.
- In February 2025, MSF conducted a measles intervention in South Darfur's Jebel Marra, treating 5,909 patients and vaccinating 36,209 children against measles.
- Between December 2024 and May 2025, our teams vaccinated more than 79,000 children in Rokero, North Jebel Marra. After the end of the campaign there was a reduction in number of measles cases by 96.5 percent.
- In April, MSF teams vaccinated more than 54,000 children in Foro Baranga, West Darfur.
Outbreak underscores essential need for vaccination
In June, large-scale vaccination campaigns were carried out in the Jebel Marra region of Central Darfur—however, the campaigns did not cover Zalingei, nor South or West Darfur. These are the places where MSF teams are now witnessing a sharp rise in cases.
At that time, MSF warned that the campaigns would have only a short-term impact. While some efforts have been made to bring in vaccines and dry supplies, there is still urgent need for a mass vaccination campaign as well as a scale-up of routine vaccinations to stop the spread.
Currently, MSF teams in Darfur are also treating patients with diphtheria, pertussis, and other vaccine-preventable diseases. “What is urgently needed now is for the Ministry of Health—with the support of health partners, including UNICEF—to resume routine immunization and ensure sufficient vaccine supplies,” said Ahmed Fadel, MSF emergency coordinator in Darfur. “Countless lives could be saved, yet after more than two and a half years of war, the world continues to fail the people of Sudan.”
This is happening amid a challenging global landscape. In 2024, 59 countries reported large, disruptive measles outbreaks—nearly triple the number reported in 2021, which is the highest number since the beginning of the pandemic. Meanwhile, deep funding cuts to the Global Measles and Rubella Laboratory Network and country immunization programs threaten to widen immunity gaps and drive further outbreaks.
