Sudan has officially declared a cholera outbreak in Gedaref State, with 264 suspected cases, 4 confirmed cases, and 16 deaths reported by 25 September 2023. Investigations are underway to determine if cholera has spread to Khartoum and South Kordofan states due to increased cases of acute watery diarrhea.

Dr. Nima Abid, WHO Representative in Sudan, stressed the need for unhindered access to affected areas. He cited the devastating impact of cholera in a healthcare system already stretched thin by war, medical supply shortages, a lack of healthcare workers, malnutrition, and access difficulties.

Prior to the outbreak declaration, WHO had supplied antibiotics, oral rehydration solutions, and intravenous fluids to six states, including Gedaref, Khartoum, and South Kordofan. Rapid diagnostic test kits were distributed to all 18 Sudanese states. WHO is actively supporting three cholera isolation centers in Gedaref, with two equipped with medicines and health supplies, and full support provided to the third center with equipment and medical supplies.

In an effort to build capacity, over 2800 Sudanese health workers participated in an online program on acute watery diarrhea management earlier this year. Another online training course covering cholera, dengue, and malaria management protocols was recently conducted for over 8000 Sudanese health workers. Additionally, 185 health workers in Gedaref received on-the-job training in cholera and infectious disease surveillance and standard case management.

Presently, WHO is deploying rapid response teams to affected areas and assisting the Ministry of Health in transferring suspected cholera cases to the Public Health Laboratory in Port Sudan, equipped by WHO as a national reference facility. Surveillance continues in affected and high-risk regions to identify and address risk factors. Plans are in motion to request oral cholera vaccines from the International Coordinating Group on Oral Cholera Vaccine Provision for Cholera Control to protect the population and contain the outbreak.

With the support of WHO and health partners, the Ministry of Health is ramping up access to clean water and sanitation facilities. They are also ensuring that affected and at-risk communities are educated on transmission risks and proper hygiene practices to minimize contamination and prevent further spread of the outbreak.

Sudan faces a dire situation due to a war that erupted in April 2023, leading to mass displacement, disease outbreaks, and malnutrition. These challenges have been compounded by heavy rains and flooding. Attacks on health facilities, shortages of medical supplies and equipment, a lack of healthcare workers, and limited operational funds have overwhelmed the healthcare system. Approximately 70% of hospitals in conflict-affected states are non-functional, while healthcare facilities in non-conflict-affected areas are struggling to cope with an influx of internally displaced people.