WHO calls Sudan war the world’s worst humanitarian crisis as health system collapses

The last patients to arrive at Al Saudi Hospital in El Fasher did not find beds.

They spilled into corridors and onto the dusty grounds outside, lying under trees and makeshift tarps as explosions echoed around North Darfur’s besieged capital. Inside, staff worked with dwindling supplies to treat shrapnel wounds, cholera and severe malnutrition in wards damaged by repeated attacks.

Thousands of kilometers away in Geneva, the scene was on the mind of the World Health Organization’s director-general as he opened his first media briefing of the year.

“Last Friday marked one-thousand days of Sudan’s civil war,” Dr. Tedros Adhanom Ghebreyesus said on Jan. 13. “Almost three years of continuous violence have turned Sudan into the worst humanitarian crisis globally.”

It was a stark escalation in language from the U.N. health agency, which is now publicly ranking Sudan’s war as the world’s most severe humanitarian and health emergency — ahead of longer-running crises in Syria and Yemen and newer conflicts in Ukraine and Gaza.

A crisis measured in millions

WHO estimates that 33.7 million people in Sudan — roughly two-thirds of the country’s population — will need humanitarian assistance this year. About 20 million of them require health assistance specifically.

Some 21 million are facing acute food insecurity, with famine already confirmed in parts of North Darfur and South Kordofan and at least 20 other areas at high risk, according to U.N. humanitarian assessments.

The war, which erupted in April 2023 between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has also created what U.N. agencies now call the world’s largest displacement crisis.

“Thirteen-point-six million people are displaced, making Sudan the largest displacement crisis in the world,” Tedros said. That figure includes about 9.3 million people uprooted inside Sudan and more than 4.3 million who have fled as refugees to Chad, South Sudan, Egypt, the Central African Republic, Ethiopia and other neighbors.

By mid-2025, U.N. refugee and migration agencies said Sudan had overtaken Syria as the largest displacement crisis ever recorded, with more than 11 million people internally displaced at that time.

For civilians, those milestones are measured not in statistics but in days of flight and deprivation.

“1,000 days of civilians paying the price”

U.N. officials marked the 1,000-day point with coordinated statements. At a separate briefing in Geneva on Jan. 9, Jens Laerke, spokesperson for the U.N. Office for the Coordination of Humanitarian Affairs, said “1,000 days since the start of the war in Sudan” meant “1,000 days of civilians paying the price for a war they did not choose.”

UNICEF said children in Sudan had endured “1,000 days of agony,” warning that more than 5 million had been displaced, many of them multiple times, and that a generation risked growing up stunted, unvaccinated and out of school.

Health care under attack

The health system, already fragile before the conflict amid years of economic crisis and underinvestment, has buckled under the strain.

WHO says more than one-third of health facilities nationwide are now non-functional. In a detailed update marking 1,000 days of war, the agency reported that 37% of facilities across Sudan are out of service entirely. In front-line areas, other U.N. officials and aid agencies estimate that 70% to 80% of clinics and hospitals have shut down due to damage, looting, insecurity or lack of staff and supplies.

“But just when the people of Sudan need it most, the health system has been severely damaged,” Tedros said. He pointed to “attacks on health care, lack of essential medical supplies, and shortages of health workers and funding.”

WHO’s surveillance system has verified 201 attacks on health care in Sudan since the conflict began, resulting in 1,858 deaths and 490 injuries. Regional WHO officials say those deaths account for more than 80% of all fatalities recorded in attacks on health care in complex emergencies worldwide in 2025.

Those incidents include strikes on hospitals in El Fasher and the town of Dilling in South Kordofan, where a drone attack on a military hospital killed and wounded dozens, and the shelling and storming of medical facilities in and around the capital, Khartoum.

The International Committee of the Red Cross has described patients at Al Saudi Hospital in El Fasher being treated outdoors under trees because the building is damaged and wards are overcrowded, and has repeatedly reminded the warring parties that attacks on hospitals and medical workers violate international humanitarian law.

Outbreaks spread as services break down

Beyond direct violence, a cascading breakdown in basic services is fueling overlapping disease outbreaks.

“Poor living conditions, overcrowding, lack of access to safe water, sanitation and hygiene, and a breakdown of routine immunization are fuelling disease outbreaks,” Tedros said.

Cholera has been reported in all 18 of Sudan’s states. Dengue fever has spread to 14 states, far beyond its traditional endemic zones, while malaria transmission is active in 16. Gaps in childhood vaccination — with measles and other immunization coverage falling sharply since 2023 — have led to flare-ups of measles and other preventable diseases, particularly in crowded displacement camps and remote communities cut off from services.

WHO says it has helped deliver more than 3,300 metric tons of medicines and medical supplies, valued at about $40 million, to dozens of health partners inside Sudan; supported cholera vaccination for roughly 24 million people; and assisted the treatment of more than 112,000 children suffering from severe acute malnutrition with medical complications.

The agency estimates that at least 3.3 million people have received care at WHO-supported hospitals, primary health centers and mobile clinics since the war began.

U.N. officials stress those efforts barely scratch the surface of need in a country of more than 45 million people where front lines are fluid, roads are unsafe and aid convoys are frequently blocked or looted.

Women and children bear the brunt

Women and girls are bearing a disproportionate share of the burden. U.N. gender and humanitarian agencies report that female-headed households are three times more likely than others to be food insecure, with about three-quarters reporting that they do not have enough to eat.

Human rights investigators and aid workers have documented widespread sexual violence, including rape and sexual slavery, particularly in areas held by the RSF and allied militias in Darfur.

Across Sudan and in refugee camps in neighboring countries, women and girls face heightened risk of assault when they leave shelters to collect firewood, fetch water or search for food. Many mothers skip meals so that their children can eat, aid groups say, and present late to clinics with advanced malnutrition.

The war’s impact on children is similarly stark. UNICEF warns that Sudan may be “the largest and most devastating humanitarian crisis in the world for children,” with millions at risk of malnutrition, disease, psychological trauma and permanent loss of education. Many displaced children have been out of school for months or years, and few have consistent access to vaccination, safe water or basic health care.

Funding shortfalls and a call for access

Despite these indicators, Sudan’s humanitarian response has been chronically underfunded. In recent years, U.N. humanitarian appeals for Sudan have received well below half of the money requested. Aid officials say competing crises — including the wars in Ukraine and Gaza — have diverted political attention and donor resources, forcing cutbacks in food distributions, health programs and protection services in Sudan and among refugees.

In his briefing, Tedros linked Sudan’s plight to a broader pattern of shrinking aid budgets and fragile health systems worldwide. He warned that “sudden and severe cuts to aid” over the past year had disrupted health services in many crisis-affected countries.

For Sudan, still engulfed in conflict, such long-term financing reforms are largely theoretical. Humanitarian agencies say their immediate priorities are basic: secure access to people in need, protection for civilians and aid workers, and the funds to maintain lifesaving operations.

“WHO calls for unrestricted and safe access to all areas of Sudan to restore access to health services,” Tedros said. “We call for the protection of civilians from attacks, including health and humanitarian workers and patients. And we call for an end to the conflict by all parties in Sudan. As always, the best medicine is peace.”

After 1,000 days of war, that prescription remains unfilled. As the fighting grinds on, the designation of Sudan as the world’s worst humanitarian crisis is not only a measure of its suffering but a test of whether the international response will match the scale of the emergency now unfolding.