Children in urgent need of immunization as measles spreads in Darfur

MSF first observed a surge in measles cases in June 2024 in Rokero, Central Darfur, where MSF teams have been running the local Ministry of Health hospital without interruption since 2020. At the start of 2025, cases were also reported in East Jebel Marra in South Darfur, and in Forbrenga in West Darfur. More recently, new surges are occurring in Zalengei, Sortony, and in Tine, eastern Chad—all places where MSF operates.

From June 2024 until the end of May 2025, more than 9,950 patients were treated for measles in health facilities run or supported by MSF in the region. Around 2,700 were complicated cases requiring hospitalization, and 35 deaths were recorded. To manage the influx of patients, MSF had to expand pediatric bed capacity in three hospitals. 

Conflict and low immunization coverage compound threat

One of the root causes of this situation is the region’s already-low immunization coverage. “In Forbrenga, 30 percent of the measles patients we are receiving are above the age of 5 years and only 5 percent of them are vaccinated,” explains Sue Bucknell, MSF’s deputy head of mission in West Darfur. “This suggests that the lack of vaccination dates back further than the recent conflict.”

“The ongoing conflict is also contributing to this outbreak, constraining the capacities of medical actors to both prevent and respond to outbreaks of contagious diseases,” adds Dr. Cecilia Greco, MSF medical coordinator for Central Darfur. “Mass population displacement has made the illness spread even faster across the region, further complicating the situation.”

Since the war broke out in Sudan in April 2023, constant administrative impediments and regular blockades of key supply roads have caused vaccine shortages throughout Darfur. This led to the disruption of routine immunization programs in several locations, sometimes for months. In Sortony, for example, a camp for internally displaced people in North Darfur hosting more than 55,000 people, vaccination stopped completely from May 2024 to February 2025.

These constraints and shortages have also limited MSF’s ability to respond. Last year, MSF carried out several vaccination campaigns, including one in North Jebel Marra in November 2024 in which 9,600 children were vaccinated. However, due to limited vaccine supplies, MSF teams were forced to exclude children over 5 years old, despite clear needs. This inevitably reduced the long-term impact of these campaigns. While the vaccination campaign in North Jebel Marra initially slowed the outbreak, cases began to rise sharply again in February. 

Massive efforts are needed for prevention

Although mass vaccination campaigns are now underway in different parts of Darfur, they were delayed by lengthy negotiations. After MSF first raised the alarm about multiple surges in measles cases, it took months for the federal Ministry of Health in Port Sudan and UNICEF to release the needed vaccines from their stocks, finally enabling mass vaccination campaigns to be launched in different areas of Darfur. 

Last week, 55,800 children from nine months to 15 years old were vaccinated in Forbrenga as part of a campaign led by the Ministry of Health and supported by MSF. In a similar campaign, 93,000 more children are set to receive the vaccine in North Jebel Marra and Sortony by the end of this week.

“Even if they represent a certain achievement, these campaigns should have happened much sooner,” says Dr. Greco. “Many measles cases and their consequences could have been prevented. And as much as they are needed, such reactive campaigns are only a Band-Aid on an open wound unless massive efforts are put in place for immunization and prevention across Darfur, including its most remote areas.”

The threat of further outbreaks of disease will persist unless such efforts are initiated. “Measles is not the only contagious illness currently present in Darfur with the potential to turn into outbreaks,” says Bucknell. Over the last 10 days, about 200 people with suspected cases of cholera arrived in MSF-supported health facilities in two different Darfur states. This follows a significant cholera outbreak in Khartoum state and other parts of Sudan.

"It is essential that federal and local health authorities, UN agencies, and all medical actors on the ground collaborate not only to catch up on the vaccination of all the children left behind by immunization programs over the years, but also to enhance their ability to respond quickly and efficiently should any other outbreaks, like cholera, start spreading in Darfur,” adds Dr. Greco. “This includes the capacity to supply vaccines in and across Sudan, without facing the same impediments anymore.”