Health care gaps are threatening lives in South Sudan

People in South Sudan are facing a deteriorating humanitarian situation at a time of declining international interest and support, according to a new report released by Doctors Without Borders/Médecins Sans Frontières (MSF).

The report, “Left Behind in Crisis: Escalating Violence and Healthcare Collapse,” details the human impact of a faltering health system and humanitarian response, drawing on routine medical data as well as testimonies from patients, caretakers, community members, and health care staff living in areas where MSF works.

“South Sudan's health system is stretched to a breaking point,” said Dr. Sigrid Lamberg, head of field operations for MSF in South Sudan. “In every location where MSF works, our teams witness huge gaps in health services. Health facilities are either non-functional or severely under-resourced. Chronic shortages of medicine and staff mean that people are dying from preventable and treatable diseases. Health facilities need support on the ground—not on paper.”

The ICU at the Aweil State Hospital in South Sudan. — A crowded ICU ward at Aweil State Hospital. | South Sudan 2025 © Isaac Buay/MSF

The violence has displaced over 300,000 people

This year, violence between government and opposition forces and non-state armed groups steeply increased, marking the worst escalation since the signing of a 2018 peace agreement. Escalating violence, attacks on health facilities by all parties to the conflict, and access constraints are further impeding the delivery of health care and aid. According to the UN, since January, new waves of violence have displaced over 320,000 people and 2,000 have been killed. In Malakal, MSF teams treated 141 trauma patients between April and November 2025, including women and children, many with gunshot wounds.

We also saw a sharp increase in attacks on health facilities by all parties to the conflict, in flagrant violation of international humanitarian law. MSF alone experienced eight targeted attacks on its facilities and staff in Central Equatoria, Jonglei and Upper Nile states, forcing the closure of two hospitals in Ulang and Old Fangak. On December 3, our facility was hit by an airstrike in Pieri town, Jonglei. On the same day, our teams witnessed additional airstrikes in Lankien, where MSF also runs health care facilities.

The situation in the country is catastrophic. The urgent needs of people in South Sudan demand coordinated action, renewed commitment, and genuine international solidarity. The world can’t look away, especially not now.
Dr. Sigrid Lamberg, head of field operations for MSF in South Sudan

Communities are facing multiple overlapping crises: conflict, large-scale displacement, flooding, malnutrition, and disease outbreaks—including the largest cholera outbreak in South Sudan’s history. International support, however, continued to decline in 2025 despite people’s living situations and access to essential services getting worse.

The Health Sector Transformation Project, a multi-donor initiative launched in July 2024, remains South Sudan’s main vehicle for health care delivery. Led by the government with the World Health Organization, UNICEF, and other partners, the project originally aimed to support 1,158 health facilities across 10 states and three administrative areas. However, due to funding constraints, only 816 facilities are currently supported by the program, and even these still face persistent shortages of medicines and staff.

An MSF plane facilitates a medical evacuation in South Sudan. — MSF helped evacuate six people who were seriously injured in early December in Uror county after violent clashes. | South Sudan 2025 © MSF

Stocks of essential medications remain insufficient

Malaria remains a major challenge and continues to be the leading cause of morbidity and mortality in South Sudan, particularly for women and children. Despite this, for the second year in a row, 2025 saw nationwide stockouts of malaria drugs during peak season. Without timely treatment, malaria can quickly become deadly. Between January and September 2025, MSF teams treated 6,680 people with severe malaria who required hospitalization.

“I traveled from Keurdeng, it took one hour,” a female caretaker in Toch told MSF teams. “There is a small health facility [in Keurdeng], but it does not have all the medication—sometimes they finish supplies very fast. I took the child to the health center, but there was no medication.”

For years, people in South Sudan have faced some of the world’s highest medical and humanitarian needs. In 2025, the situation in South Sudan has worsened significantly. Rising needs require urgent action: International donors must uphold their commitments to support health and humanitarian efforts, and shortcomings in existing programs must be urgently addressed.

At a minimum, the timely delivery of essential medicines, supplies, and salaries for health workers must be ensured. Amid escalating violence, all actors must guarantee humanitarian access, the protection of civilians, and respect for health facilities. MSF also calls on South Sudan’s government to raise the national health budget in line with its Abuja Declaration commitment of allocating 15 percent to health. Currently, only 1.3 percent of the national budget is allocated to health.

“The situation in the country is catastrophic,” said Lamberg. “The urgent needs of people in South Sudan demand coordinated action, renewed commitment, and genuine international solidarity. The world can’t look away, especially not now.”