Shrinking humanitarian support has had a devastating effect on both Sudanese refugees and host communities in Chad, particularly for malnourished children and pregnant or breastfeeding women.
Doctors Without Borders/Médecins Sans Frontières (MSF) found more than 1 in 5 pregnant or breastfeeding women screened during the first six months of 2026 were moderately or severely malnourished. At the same time, child malnutrition admissions at the MSF-supported health center in Adré have increased.
Three-quarters of those with malnutrition belonged to host communities excluded from local food distributions due to rigid aid rules which restrict access strictly to registered refugees amid critical funding shortfalls.
MSF calls on international donors to fund Chad's 2026 response plans and explicitly include host communities in food and nutrition assistance.
Relocation of refugees does not resolve the crisis
Since the war in Sudan began, more than 930,000 Sudanese refugees have crossed into Chad, including over 700,000 who have crossed through the border town of Adré alone. More than 80 percent of them are women and children.
Since April 2023, the UN Refugee Agency and Chadian authorities have relocated 646,216 people from border transit sites to camps farther inside Chad, including Metché and Arkoum. This figure also includes 45,321 who have been relocated since January 2026.
“Having survived months of relentless violence, refugees arrive in Adré physically shattered, malnourished, and deeply traumatized,” said Léa Ledru, MSF project coordinator in Adré. “They arrive only to be met with a brutal new reality, finding themselves in areas where host communities are already living in poverty and humanitarian actors remain scarce. Relocation does not resolve this: It simply moves the refugee population from one under-resourced host community's doorstep to another.”
Before proceeding with any further relocations to Metché and Arkoum, Chadian authorities and the UN Refugee Agency must guarantee that food, water, and health services meet emergency standards for both refugees and host communities amid the devastating funding cuts.
Malnutrition rises above emergency threshold
Of the 5,785 pregnant or breastfeeding women in Adré screened between January and June 2026, 1,225 (21.2 percent) were found to be moderately or severely malnourished. This includes 937 with moderate acute malnutrition and 288 with severe acute malnutrition. These figures are significantly higher than the emergency threshold of 15 percent, which defines critical humanitarian crises.
No organization is providing structured treatment for malnourished women, as humanitarian responses are limited to sporadic distributions of fortified flour blends whenever supplies are available. Severe acute malnutrition drastically raises the risk of miscarriage, obstetric hemorrhage, and premature birth.
Meanwhile, child malnutrition admissions at the MSF-supported Adré health center rose by 30 percent between January and April 2026, compared to the same period in 2025.
Stockouts and uncertain funding strain emergency response
In May and June, financial constraints resulted in stockouts of World Food Program (WFP) supplies of ready-to-use therapeutic food and corn-soy blend flour for treating moderate acute malnutrition, disrupting patients’ treatment. Supplies delivered at the end of June are expected to run out in September, with no clarity on further donations.
Supplies for the coming months are severely strained, with only two-thirds of annual therapeutic food needs covered. To stretch the limited supplies in stock, humanitarian organizations have been forced to ration treatment, cutting doses to 10 packets per child weekly instead of the full 14. If the full clinical doses are administered, stocks would be exhausted by November.
Meanwhile, host communities remain excluded from general food distributions in Adré, even as soaring prices in local markets push basic essentials out of reach. For example, the cost of a 20-liter (5.3 gallons) container of cooking oil has skyrocketed from 12,000 CFA francs ($21) to 20,000 CFA francs ($35).
Since January 2026, chronic underfunding has forced WFP to cut back bimonthly cash transfers for food assistance in Adré and Metché by half, now covering only 30 days instead of the full 60 between distributions. Even these reduced portions will run out this month, putting refugees at risk of losing their rations, too.
Overcrowding worsens water and sanitation conditions
More than 10,000 refugees from Adré are expected to arrive in Metché camp before the end of September, adding to the 43,300 refugees and host community members already living there. MSF and Action Contre la Faim remain the sole health care providers in the camp.
Shrinking humanitarian support has driven up pediatric admissions at the MSF-supported hospital by 75 percent, from 382 in the first half of 2025 to 670 in the same period of 2026. Only 8 liters (slightly more than 2 gallons) of water are available for per person daily — well below the 20-liter (5.3 gallons) emergency minimum. This has forced families to drink directly from unsafe water sources. Consequently, the number of patients with diarrhea has surged from 634 in the first half of 2025 to 1,044 in 2026.
In camps lacking safe water and latrines, waterborne diseases spread rapidly among refugees and host communities alike, which are both already weakened by hunger. With the rainy season underway, these gaps echo the conditions behind last year's cholera outbreak, which killed 167 of the 2,979 people who became ill with the disease between July and December 2025.
