{ "title": "MSF SOUTH SUDAN: Funding cuts: The Human Cost of Disinvestment ", "modified_at": "2026-11-03 15:58:39", "published_at": "2026-11-03 15:58:00", "url": "https://prezly.msf.org.uk/msf-south-sudan-funding-cuts-the-human-cost-of-disinvestment", "short_url": "http://prez.ly/SKoe", "culture": "en", "language": "EN", "subtitle": "3 November - Every day in M\u00e9decins Sans Fronti\u00e8res (MSF)-supported secondary hospitals across South Sudan, from Aweil, in a stable area under government control, to Akobo in Jonglei, an unstable conflict zone held by opposition groups, our teams receive women and children in increasingly severe condition, dying from diseases that could have been diagnosed and treated weeks earlier. Across the country, thousands of mothers and children find the doors of their primary healthcare clinics shuttered. They must travel long distances, at a cost they cannot afford, to reach a hospital only after preventable conditions have become critical. ", "slug": "msf-south-sudan-funding-cuts-the-human-cost-of-disinvestment", "body": "\n \n
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Aweil: a primary care network that closed without announcement

South Sudan’s public health system depends almost entirely on external financing. Since independence, it relied first on the Health Pooled Fund (HPF) and, from 2024, on the Health Sector Transformation Programme (HSTP), a multi-donor mechanism funded by the World Bank, Canada, the United Kingdom, Sweden and the European Union. The HSTP covers medicines, staff incentives and basic service provision across Primary Health Care Centres (PHCCs) and Primary Health Care Units (PHCUs) nationwide.

Aweil, the capital of Northern Bahr el Ghazal, is a government stronghold and one of the most stable areas in South Sudan, largely untouched by active conflict. It is the kind of place where, in principle, the HSTP should work. \u200b

The HSTP faced a funding shortfall even before its launch in 2024, when the US and Sweden, both previous donors to the Health Pooled Fund (HPF), did not commit funding to the new programme. As a result, the HSTP launched with plans to support only 816 health facilities across 10 states and two administrative areas, rather than the 1,158 originally envisaged. \u200b

The crisis reflects not only insufficient funding, but also a failure to translate available resources into functioning healthcare services. By January 2026, the number of functional PHCCs and PHCUs in Northern Bahr el Ghazal alone had fallen from 131 to 63. Staff incentive payments were reduced or stopped entirely. Facilities remained nominally listed as open while their doors were locked and their shelves empty. The health centre near Abuk’s village was one of 71 that closed, quietly, without announcement and without replacement.

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This animated map compares the availability of primary healthcare facilities in July 2024, when the Health Sector Transformation Project (HSTP) was launched, with October 2026, showing the tangible impact of funding cuts. © MSF

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Views of Lolku Primary Health Care Clinic (PHCC), which closed in May 2025, previously provided nutrition services for children under five with moderate acute malnutrition (MAM) and pregnant women, as well as medicines to treat malaria, diarrhoea and pneumonia. The facility was supported by Alight, an NGO funded by the US government, and closed following the US funding cuts announced in January 2025. © Aurélie Lécrivain/MSF
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Views of Lolku Primary Health Care Clinic (PHCC), which closed in May 2025, previously provided nutrition services for children under five with moderate acute malnutrition (MAM) and pregnant women, as well as medicines to treat malaria, diarrhoea and pneumonia. The facility was supported by Alight, an NGO funded by the US government, and closed following the US funding cuts announced in January 2025. © Aurélie Lécrivain/MSF
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Views of Lolku Primary Health Care Clinic (PHCC), which closed in May 2025, previously provided nutrition services for children under five with moderate acute malnutrition (MAM) and pregnant women, as well as medicines to treat malaria, diarrhoea and pneumonia. The facility was supported by Alight, an NGO funded by the US government, and closed following the US funding cuts announced in January 2025. © Aurélie Lécrivain/MSF
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Views of Lolku Primary Health Care Clinic (PHCC), which closed in May 2025, previously provided nutrition services for children under five with moderate acute malnutrition (MAM) and pregnant women, as well as medicines to treat malaria, diarrhoea and pneumonia. The facility was supported by Alight, an NGO funded by the US government, and closed following the US funding cuts announced in January 2025. © Aurélie Lécrivain/MSF
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A year and a half after giving birth at Aweil State Hospital, Abuk is back, carrying her 18-month-old son, Rau. MSF teams rushed the boy to the emergency ward. At eighteen months old, he weighs 6 kilograms. He is suffering from severe malaria and moderate acute malnutrition. \u200b

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MSF medical staff attempt to find a vein to take a blood sample from 18-month-old Rau in the emergency room at Aweil Hospital. Rau was brought to the hospital by his mother, Abuk Athak, after becoming severely ill with malaria. In the hospital Abuk found out that Rau was also moderately malnourished. © Aurélie Lécrivain/MSF
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“Before our healthcare centre closed, we could receive antenatal care, give birth, and get our children tested at the first sign of a fever,” explains Abuk. “One day, it simply closed. We were told there were no more funds. Now, I am forced to wait until the very last moment to bring my children to the hospital, simply because I cannot afford the travel costs.”

Aweil State Hospital: the last door open

Aweil State Hospital is the only secondary healthcare facility for an estimated 1.4 million people in Northern Bahr el Ghazal. It is now absorbing the caseload of a state whose primary care network has collapsed. \u200b

Between January and September 2026, total hospital admissions rose 44% - from 14,8170 to 21,352 - compared with the same period in 2025. Admissions of children under five with severe acute malnutrition rose 47% from 1,227 to 1,801, the highest malnutrition trend the hospital has recorded in five years. Vaginal deliveries with complications increased 35%. A fifth of all patients admitted are now classified as critical, a 20% increase from January to September 2025 (10,426 patients) to the same period in 2026 (12,549 patients).

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Inside the inpatient therapeutic feeding centre at MSF-supported Aweil State Hospital, which is operating at full capacity, providing care for children under five with severe acute malnutrition. Between January and October 2026, admissions rose by 47%, from 1,227 to 1,801, compared with the same period in 2025, marking the highest number recorded at the hospital in five years. © Aurélie Lécrivain/MSF
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In the inpatient therapeutic feeding centre, another mother, Nyanut Akot, sits beside her severely malnourished child. She used to receive ready to use therapeutic food (RUTF) for moderate malnutrition at her local clinic in Titchok, Aweil East. Since April, the facility has only partially functioned and supplies have dried up.

“I didn’t know my daughter had become severely malnourished until we reached the hospital,” she says. “She developed a fever and convulsions, and I knew I had to find a way here.” Reaching help meant a five-hour walk followed by a one-hour motorcycle ride costing 15,000 South Sudanese pounds, a heavy price that she had to borrow and does not know how to pay back.

“This year, drought and a lack of rainfall affected my crops. Then, floods destroyed what was left, leaving me with nothing to harvest.” Nyanut used to grow okra, pumpkin and tobacco. Like many South Sudanese, she now faces a food crisis that El Niño is set to worsen. 2026 is so far the driest year on record in the country, and El Niño’s disruption of rainfall could deepen the damage. Crop failure, poor harvests and malnutrition are the main concerns, with a real risk of IPC 5 (famine) conditions among some populations. “Without a harvest, I have no income.” she adds. \u200b

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Nyanut Akot sits beside her severely malnourished daughter at the inpatient therapeutic feeding centre. After her local clinic in Titchok, Aweil East, ran short of supplies, she walked for five hours and travelled another hour by motorcycle to reach the hospital, borrowing 15,000 South Sudanese pounds to pay for the journey, a debt she does not know how she will repay.
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“Every day I see mothers and their children lying on mats in the hospital compound for days after being discharged, unable to leave because they lack the money to return home,” says Dr Daniel Garang, MSF doctor in Aweil. “In my seven years working in Aweil for MSF, I have never witnessed a situation like this.”

A second blow: humanitarian funding falls

The HSTP’s failure to deliver from the outset was the first blow. The second followed quickly. In 2025, US funding for South Sudan’s Humanitarian Needs and Response Plan fell by 61% compared with 20241. The UK reduced its overall aid allocation to the country by 23% in 2025-26, with a further 39% decrease projected for 2026-272.

By October 2026, South Sudan’s Humanitarian Needs and Response Plan was only 36% funded3. Health allocations remain well below requirements. Declining bilateral donor funding to implementing partners, amid shifting donor priorities and reductions in development assistance, is further constraining the delivery of essential health services across South Sudan.

The effects are already visible around Aweil. In August, the World Food Programme (WFP) stopped food distributions in Wedweil refugee settlement, home to more than 35,000 Sudanese refugees, 45 km from Aweil State Hospital. The settlement’s only clinic, run by the International Rescue Committee (IRC), has also scaled back services following US funding cuts in 2025. Without further US funding, IRC was forced to close 21 healthcare facilities across South Sudan.

The most severe cases from Wedweil are referred by ambulance to Aweil State Hospital through IRC’s referral system. With food distributions having ended, healthcare services reduced, and UNICEF scaling back its activities, the MSF team expects more patients with severe health conditions to arrive at Aweil hospital.

Akobo: the same absence, compounded by conflict

Akobo lies one thousand kilometres to the east, in eastern Jonglei State, across a frontline and in a context already fractured by conflict. The town is under the control of opposition armed groups, and its health system relies heavily on humanitarian actors. The HSTP is meant to cover the whole country, but restrictions on access to opposition-controlled areas have significantly hindered its implementation there. \u200b

On 6 March 2026, South Sudanese government forces launched an offensive on Akobo, prompting the evacuation of the humanitarian community. Akobo Teaching Hospital, the only secondary health facility in the wider area, was subsequently looted amid the displacement and insecurity. Nearly the entire civilian population fled across the border to Ethiopia, where they received no humanitarian assistance. In mid-April, opposition armed groups retook the town. Around 100,000 people returned to find health facilities stripped of medicines, equipment and staff. \u200b

In July 2026, OCHA reported that government-imposed restrictions on the movement of cash, fuel and communications equipment into opposition-controlled territories were compounding the funding shortfall, affecting the delivery of essential assistance into Akobo and surrounding areas.

MSF resumed emergency activities on 11 May 2026 in a hospital stripped from electricity, fuel, and beds. \u200b

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Patients lie on the floor of the paediatric inpatient ward at Akobo Teaching Hospital, where MSF resumed emergency activities on 11 May 2026. The hospital had been looted and stripped of electricity, fuel and beds after South Sudanese government forces launched an offensive on Akobo on 6 March, prompting the evacuation of humanitarian workers. © Isaac Buay/MSF
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Views of Lolku Primary Health Care Clinic (PHCC), which closed in May 2025, previously provided nutrition services for children under five with moderate acute malnutrition (MAM) and pregnant women, as well as medicines to treat malaria, diarrhoea and pneumonia. The facility was supported by Alight, an NGO funded by the US government, and closed following the US funding cuts announced in January 2025. © Aurélie Lécrivain/MSF
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Short-term funding is expiring all at once

The emergency response that followed the return was real, but it was built entirely on short-term funding, and those timelines are now expiring progressively.

Save the Children, which ran 22 primary healthcare facilities in and around Akobo as part of the HSTP, has suspended its activities since late July. The organisation says the suspension will last until it completes an in-depth review of the security situation. Medair took over 12 malnutrition treatment sites, with international funding for these sites due to expire at the end of October. Finally, a new partner has been identified to take over all 12 sites and ensure their activities continue until December 2027.

Meanwhile, food assistance has ended: WFP distributions, which previously reached 80,000 people, stopped in July 2026 due to funding cuts. ALIMA has secured funding for its activities in Akobo only until December 2026, while CARE’s funding is secured until April 2027.

Emergency grants restore services for some months, then expire. The population that survived bombing, looting and displacement is likely to find itself, again, without healthcare, in a place where no structural system ever existed and where the international community is once again turning its attention elsewhere. Since the evacuation, the operating theatre at Akobo Hospital has remained closed, leaving Akobo County without access to surgical services.

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This timeline tracks the return and gradual withdrawal of humanitarian organisations following the March 2026 offensive in Akobo. The emergency response restored some services but relied on short-term funding that is now expiring. Save the Children suspended its activities in late July, WFP food assistance ended that month, and other organisations risk running out of funding by the end of the year. © MSF

The cost of a closed health unit

For 45-year-old Gatwech Biel Thiep, the sudden absence of medical care ended in a tragedy.

In late August, his 30-year-old wife, Nyamuoch Geng, was eight months pregnant when she developed severe abdominal pain. The Primary Health Care Unit, just a 10-minute walk from their home, had shut down permanently on 15 July after its supporting partner withdrew.

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View of Dilule Primary Health Care Unit (PHCU), found closed at 11 a.m. on a Friday, during its expected operating hours. Community members said the facility has been closed since July 2026 while it is still listed as functional. © Aurélie Lécrivain/MSF
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View of Dilule Primary Health Care Unit (PHCU), found closed at 11 a.m. on a Friday, during its expected operating hours. Community members said the facility has been closed since July 2026 while it is still listed as functional. © Aurélie Lécrivain/MSF
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“We kept her at home for three days while she suffered, because we knew the health unit was closed,” Thiep recalls. “A year ago, women went there for antenatal checkups and primary care. Today, there is nothing. Women just stay at home and deliver without any assistance.”

As her condition worsened, the family placed Nyamuoch on a fabric blanket and carried her by hand for two and a half hours through the muddy road to reach Akobo Hospital. She delivered a baby girl, Nyakhan, but then suffered severe postpartum haemorrhage.

With no operating theatre, no blood bank and no specialised surgical care, medical teams requested an emergency medical evacuation flight. The aircraft failed to arrive in time. On 29 August, Nyamuoch died.

Thiep carried his wife’s body back home on his shoulders and buried her in their family yard.

“The fact that our local clinic was closed, that there is no emergency surgery in Akobo, and that the plane did not come that day, it all played a part,” says Thiep. “Now I am left alone with four children, including a newborn.”

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Gatwech Biel Thiep, 45, stands in the courtyard of his home. Since his wife died following complications during childbirth at Akobo Hospital, he has been left to care for their four children, including their newborn daughter, alone. The family lives near Dilule Primary Health Care Unit, which closed on 15 July, leaving pregnant women without access to nearby antenatal care and maternity services. © Aurélie Lécrivain/MSF
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Two places, two causes, one outcome

Whether in government-controlled regions like Aweil, refugee settlements like Wad Weil, or opposition-controlled territories like Akobo, the withdrawal of international donor funding leaves treatable health conditions such as malnutrition, malaria and routine obstetric complications untreated until they become life-threatening.

In both Aweil and Akobo, MSF is the last organisation capable of providing secondary healthcare. In both, patients are arriving with conditions that should have been treated locally, weeks earlier. The difference is the cause: the withdrawal of donors from a national health programme in one, conflict layered on short-term humanitarian funding in the other. \u200b

 

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Patient Testimonies

Abuk Athak – Aweil West, ITFC Aweil Hospital

 

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MSF medical staff attempt to find a vein to take a blood sample from 18-month-old Rau in the emergency room at Aweil Hospital © Aurélie Lécrivain/MSF
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Abuk Athak holds her 18-month-old son, Rau, as MSF medical staff explain that he will be admitted to the malaria village at Aweil Hospital. This dedicated facility, opened and run by MSF during the rainy season, helps accommodate the surge in complicated malaria cases. © Aurélie Lécrivain/MSF
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“I never planned to walk for two hours while in active labour, but a year and a half ago, I had no choice.

When my labour started, I had to walk all the way from my village in Aweil West to Aweil State Hospital because the nearest health centre, in Rualngol, had been shut down in February 2025. There were no staff, no medicines, and no midwife, there was simply no one there. Before it shut its doors, the organization Concern Worldwide worked there, providing prenatal, maternity, and delivery care, as well as screening and treatment for malaria and malnutrition. But one day, it simply closed, and we were told there were no more funds. By the time I finally reached the hospital, I was exhausted and in agony. My baby boy, Rau, survived that day, but it was a journey no mother should ever have to make while giving birth.

Now, a year and a half later, on August 21, I had to rush back to the MSF-supported emergency paediatric ward at Aweil Hospital, carrying Rau in my arms once again.

At eighteen months old, my son weighs only 6 kilograms. He had a burning fever and his body was so swollen. I had already tried everything to get him treated closer to home, but the clinic in Rualngol couldn't provide care anymore. Towards the end of 2025, before closing completely, they were already constantly running out of basic medicines for malaria, pneumonia, and diarrhea, and supplies like Plumpy’Nut were rarely available. They couldn't diagnose him or treat him, so they just told me to go to the main hospital.

I had no choice. I put my sick baby on the back of a motorcycle and traveled for about an hour to reach Aweil. By the time we arrived, I was completely exhausted, and Rau was weak. I was carrying my child on the motorbike; he was very sick and very weak, and I was so afraid that he would die before we reached the hospital. I couldn't stop thinking about just getting him through the doors in time.

For us, that journey wasn't just a difficult trip, it was a race against time.”

As soon as Abuk and Rau arrived, the MSF medical team immediately rushed to assess him, taking his vital signs and trying to draw blood. But even placing an IV line and drawing blood was a struggle because Rau's body was so swollen. The nurses needed nearly ten attempts before they could finally access a vein and get the sample they needed. The results confirmed he was suffering from severe malaria alongside his malnutrition. That same evening, he was admitted to the MSF malaria treatment unit and enrolled in nutritional care.

“What breaks my heart isn't just that my son ended up in the hospital, it is how far I had to travel for care that used to be available right near my home. Before our healthcare centre closed, we could receive antenatal care, give birth safely, and get our children tested and treated at the very first sign of a fever, especially during the rainy season. Now, I am forced to wait until the very last moment to bring my children to the hospital, simply because I cannot afford the travel costs.

A clinic can still be listed as 'functional' on official papers, but for mothers on the ground, reality is completely different. To me, a real health centre isn't just a standing building with an occasional health worker or vaccine drive. It means having actual medicines, equipment, diagnostic tools, and treatments available when a child falls ill.

For my baby, that care wasn't there. I was one of the lucky ones, I managed to find a motorcycle, borrow the money for the ride, and reach Aweil Hospital in time to save my son. But so many families cannot do this. I don't want a health centre that exists only on paper. I just want the health centre near us to have the medicines, staff, and treatment my child needs, so that I do not have to wait until he is fighting for his life to take him all the way to the hospital.”

Nyanut Akot, Aweil East, Aweil ITFC

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Nyanut Akot sits beside her severely malnourished daughter at the inpatient therapeutic feeding centre. After her local clinic in Titchok, Aweil East, ran short of supplies, she walked for five hours and travelled another hour by motorcycle to reach the hospital, borrowing 15,000 South Sudanese pounds to pay for the journey, a debt she does not know how she will repay. © Aurélie Lécrivain/MSF
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My name is Nyanut Akot Ayok. I am about 34 years old, and I come from Titchok village in Aweil East. I have five children. I am here at Aweil Hospital with my two-and-a-half-year-old daughter, Awar Kuol Bol. My daughter had been receiving treatment for moderate acute malnutrition at the PHCU in Titchok. The health centre is only about 30 minutes’ walk from our home. She was receiving Plumpy’Nut there and was being followed for her malnutrition.

But since April, the PHCU has only been partially functioning. The nutritional supplies stopped, including the Plumpy’Nut my daughter had been receiving. The health centre is still there, but the nutrition services my daughter needed are no longer available.

I did not know that my daughter had become severely malnourished. I only found out when I brought her to the MSF-supported hospital in Aweil. She had developed a fever and convulsions, and I knew she was very sick, so I had to find a way to bring her to the hospital. It was the doctors here who told me that she was now severely malnourished. Getting to the hospital was very difficult.

From Titchok, I had to walk for about five hours with my sick child before reaching HalBul. My daughter was already unwell, and I was carrying her for much of the journey. I was tired, frightened and worried about what might happen to her on the way. After walking for five hours, I had to find a motorbike to take us the rest of the way. The motorbike journey took about one hour and cost 15,000 South Sudanese Pounds.

I struggled to find the money. I did not have 15,000 SSP. I had to borrow it from someone to bring my daughter to the hospital. I was worried about asking for the money, but I had no other choice. When your child is sick, you cannot stay at home because you do not have money. You have to find a way to get them to care no matter what. \u200b

During the journey, I was afraid. I did not know what was wrong with my daughter, and I did not know how serious her condition was. I was travelling for hours with a sick child, not knowing whether she would become worse before we reached the hospital. I was praying that we would arrive safely.

When we finally reached Aweil Hospital, the doctors examined her and told me that she was severely malnourished. This was the first time I knew that her condition had progressed from moderate to severe acute malnutrition.

I keep thinking about the health centre in Titchok. It is only 30 minutes from my home. Before, I could take my daughter there and she could receive Plumpy’Nut. If she needed follow-up, I could walk with her to the centre.

Now, although the PHCU is still partially functioning, the nutritional supplies are no longer available. For my daughter, that means the treatment she had been receiving stopped. When she became seriously ill, the only option was to travel all the way to Aweil Hospital.

The journey home will also be very difficult. I will have to walk for about eight hours with my child. I am already living in a very difficult situation. My husband died in January this year. He had oedema and anaemia, and when we brought him for treatment, it was too late. Since his death, I have been alone with my five children.

I am a farmer. I grow pumpkins, okra and tobacco. This year, drought and a lack of rainfall affected my crops. Then, floods destroyed what was left, leaving me with nothing to harvest. Without a harvest, I have very little food and no reliable income.

I collect what I can and do whatever is possible to feed my children. Now I have also had to borrow money just to bring my sick daughter to the hospital. I do not know how I will repay it.

What hurts me is that the PHCU is so close to my home. It is only 30 minutes away. But because the nutrition supplies are no longer available, I had to travel for five hours on foot, then pay for a motorbike, just to find out at the hospital how sick my daughter had become.

I did not know she was severely malnourished. I only knew that my child was sick.

If the nutritional service had continued at the PHCU, I could have continued bringing my daughter there for treatment and follow-up, close to home. Instead, her condition worsened, and I had to make a long and frightening journey to the hospital.

I am grateful that we reached the hospital and that my daughter is receiving care now. But I am afraid of what will happen when we have to return home, and I do not know when she will be discharged.

I only want my daughter to recover. I do not want another mother from my community to have to travel for hours with a sick child simply to access the treatment that used to be available 30 minutes from her home.

Gatwech Biel Thiep, Akobo, Jonglei State \u200b

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Gatwech Biel Thiep, 45, with his daughter © Aurélie Lécrivain/MSF
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Gatwech Biel Thiep, 45, with his daughter © Aurélie Lécrivain/MSF
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"My name is Gatwech Biel Thiep. I am 45 years old, and I live about a 10-minute walk from Dilule Primary Health Care Unit (PHCU). My wife, Nyamuoch Geng, was 30 years old and eight months pregnant with our fourth child, a baby girl we planned to name Nyakhan Gatwech. She died at Akobo Hospital on 29 August. Now I am left alone with our four children, including our newborn.

The primary healthcare facility near our home closed on 15 July. It used to provide antenatal care and maternity services, but women can no longer access these services there.

We kept her at home for three days while she suffered, because we knew the health unit was closed. A year ago, women went there for antenatal checkups and primary care. Today, there is nothing. Women just stay at home and deliver without any assistance.

When my wife began experiencing abdominal pain, we did not take her to the health unit because we knew it was no longer functioning. We hoped she would get better, but her condition worsened. We eventually had to carry her on a blanket for two and a half hours to reach Akobo Hospital. She was conscious throughout the journey, crying and screaming in pain.

At the hospital, she gave birth but then began bleeding heavily. The medical team planned an emergency referral, but the plane did not arrive. My wife died on 29 August.

The fact that our local clinic was closed, that there is no emergency surgery in Akobo, and that the plane did not come that day, it all played a part. Now I am left alone with four children, including a newborn.

When the conflict escalated in March, we fled to Yiryir, on the Ethiopian side of the border, about five hours’ walk from our home. We left in early March and returned on 19 April. We carried our children and left everything else behind. There were no humanitarian organisations helping us where we stayed. We slept under trees without plastic sheeting and survived on fish when we could find it. Sometimes we went two or three days without food. My pregnant wife and our children became weak and lost weight.

When we returned, we found our home looted. Even the doors had been taken. We still fear that the fighting could return.

My wife worked alongside me on our sorghum farm and helped care for our children. We usually ate twice a day, sometimes sorghum, milk, fish or meat. Now I must care for our children without her.

I am part of the local community leadership, and I am sharing our story because this must change. People need functioning health facilities close to home, and pregnant women must be able to receive care before their condition becomes an emergency. No family should have to carry a woman in labour for hours, only to lose her when the care she needs is out of reach."

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Nyachune Chuol Muon, 25, sits beside her five-year-old son, Marnath Tut Gatkuoth, at MSF-supported Akobo Teaching Hospital, where he is receiving treatment for tuberculosis. After repeated interruptions in his treatment due to shortages of TB medicines and the withdrawal of other healthcare providers, his condition deteriorated and he lost weight, he is now 9kg. Since April 2025, gaps in treatment have left his mother struggling to find care for him. MSF is now the only provider supplying TB medicines for two children at the hospital. © Aurélie Lécrivain/MSF
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Funding cuts leave 150,000 displaced people at risk of diseases in Bentiu and Malakal

JUBA, South Sudan, 3 November 2026 - Funding cuts and the withdrawal of aid organizations have left around 150,000 internally displaced people living in the Bentiu and Malakal camps in South Sudan without basic water, sanitation, and primary health services, increasingly exposing them to risk of cholera and other waterborne diseases, warns Doctors Without Borders/Médecins Sans Frontières (MSF).

Displaced communities in Upper Nile and Unity States depend heavily on external aid. As resources dwindle, the few organizations still operating there are further scaling back already limited services, putting water supply, waste collection, latrine maintenance, and primary healthcare at risk of total collapse in the coming months. MSF is calling on donors and humanitarian actors to act immediately to reverse funding shortfalls; maintain critical water, sanitation, hygiene, and health services; and prevent a renewed public health emergency. \u200b \u200b

“In Malakal, the clock is already running,” says Foued Gamoudi, MSF deputy head of operations in South Sudan. “The transfer of camps to government authorities does not remove the humanitarian needs of the people living there. As long as people remain in Bentiu and Malakal displacement sites, minimum WASH [water, sanitation, and hygiene], health, food, and nutrition services must be maintained.”

Bentiu and Malakal camps were established in 2013, when thousands of people fleeing violence sought protection at United Nations Peacekeeping bases. Formerly known as Protection of Civilians sites (PoC), Bentiu was redesignated as a conventional internal displacement camp in 2021 and placed under government authority, while Malakal was formally handed over in February 2026. \u200b \u200b

Despite these changes in status, both sites continue to host large populations living in protracted displacement. Many residents remain unwilling or unable to return safely. In a survey conducted in February 2026 by the International Organization for Migration (IOM), 55 per cent of households in Bentiu said that their intended destination was currently unsafe. Bentiu camp, home to about 111,000 people, is located in a flood-prone area, where an MSF assessment found that around 60 people share each functioning latrine, and only 109 handwashing stations serve the entire camp. Open defecation is also widespread across the camp.

Since 2024, South Sudan has recorded nearly 110,000 cholera cases and 1,970 deaths nationwide. During the peak of the outbreak in 2024–2025, Rubkona County in Unity State — where Bentiu is located — accounted for roughly a quarter of the cholera cases reported nationally during that period. \u200b

Although cholera cases in MSF-supported areas have remained low since mid-2025, the conditions that contributed to the outbreak persist. From January to September, more than 14,000 cholera cases were recorded across South Sudan, with Rubkona County alone accounting for nearly one-third of the total patients.

“We have already suffered from conflict, flooding, and cholera, and many of us still cannot return home,” says Nysunday Dobuol, a displaced woman living in Bentiu camp. “I decided to get vaccinated to protect myself and my family, and now I encourage others to do the same because we do not want to lose more lives to cholera.”

In Bentiu, IOM is the only organization currently providing water, sanitation and hygiene services (WASH) and primary healthcare in the camp, but it faces critical funding gaps following major cuts since 2024. Although its funding for WASH services has been extended by three months until March 2027, the continuation of these essential services beyond that date remains uncertain without additional support. Primary healthcare will remain a major gap from January 2027. \u200b

In Malakal, Upper Nile State, where IOM is also now the only water and sanitation provider, the organization has prioritized water supply and desludging over latrine construction and garbage collection, and without new funding, water supply to 40,000 people and desludging of around 900 latrines could stop.

Health services are also contracting in Malakal; International Medical Corps (IMC), which supported nearly 100 deliveries a month, ended its services including outpatient consultations, laboratory services, mental healthcare, and routine immunization. In theory, health services have been handed over to local health authorities, who are themselves short of supplies and staff, and have limited capacity to fill the gaps.

“Sometimes garbage remains uncollected for weeks, even months,” says Rebecca Abang, MSF counsellor. “Latrines are not always emptied, and waste flows into the drainage channels.” \u200b

Working with the Ministry of Health in Bentiu, MSF vaccinated 102,251 people during the second round of oral cholera vaccination in September 2026, reaching nearly 75 per cent of the target population.

“Vaccination is an important step, but it cannot work alone,” says Patrick Mayen Biel, MSF outreach manager in Bentiu. “Without sustained access to safe drinking water, functioning latrines, and adequate sanitation, people will remain at risk of future outbreaks.”

The service reductions in Malakal and Bentiu reflect a broader, worrying trend of reduced humanitarian aid in South Sudan over the years. Major donors — including the UK and other European countries, as well as the US — have scaled back support even as renewed violence since last year has driven needs up. In this context, the health risk in crowded displacement camps such as Malakal and Bentiu remains particularly high.

“This is an urgent call to donors to provide immediate funding to protect people’s dignity, avert a public health emergency, and prevent loss of life,” says Gamoudi. “Support must sustain safe water supplies, functioning latrines and desludging, adequate hand\u2011washing facilities, and primary healthcare.”

\n \n
\n Kate Lee\n \n \n
\n
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After her local clinic in Titchok, Aweil East, ran short of supplies, she walked for five hours and travelled another hour by motorcycle to reach the hospital, borrowing 15,000 South Sudanese pounds to pay for the journey, a debt she does not know how she will repay. \u00a9 Aur\u00e9lie L\u00e9crivain/MSF ", "original": "https://cdn.uc.assets.prezly.com/7ffd5193-260e-4970-9b95-049c4f16fb9e/", "medium": "https://cdn.uc.assets.prezly.com/7ffd5193-260e-4970-9b95-049c4f16fb9e/-/preview/500x500/-/format/auto/", "small": "https://cdn.uc.assets.prezly.com/7ffd5193-260e-4970-9b95-049c4f16fb9e/-/preview/200x200/-/format/auto/", "thumbnail": "https://cdn.uc.assets.prezly.com/7ffd5193-260e-4970-9b95-049c4f16fb9e/-/preview/100x100/-/format/auto/", "square": "https://cdn.uc.assets.prezly.com/7ffd5193-260e-4970-9b95-049c4f16fb9e/-/scale_crop/200x200/center/-/format/auto/", "squaresmall": "https://cdn.uc.assets.prezly.com/7ffd5193-260e-4970-9b95-049c4f16fb9e/-/scale_crop/58x58/center/-/format/auto/" }, { "caption": "Gatwech Biel Thiep, 45, with his daughter \u00a9 Aur\u00e9lie L\u00e9crivain/MSF ", "original": "https://cdn.uc.assets.prezly.com/3b7d4823-9740-4775-997e-66375d9f62e3/", "medium": "https://cdn.uc.assets.prezly.com/3b7d4823-9740-4775-997e-66375d9f62e3/-/format/auto/", "small": "https://cdn.uc.assets.prezly.com/3b7d4823-9740-4775-997e-66375d9f62e3/-/preview/200x200/-/format/auto/", "thumbnail": "https://cdn.uc.assets.prezly.com/3b7d4823-9740-4775-997e-66375d9f62e3/-/preview/100x100/-/format/auto/", "square": "https://cdn.uc.assets.prezly.com/3b7d4823-9740-4775-997e-66375d9f62e3/-/scale_crop/200x200/center/-/format/auto/", "squaresmall": "https://cdn.uc.assets.prezly.com/3b7d4823-9740-4775-997e-66375d9f62e3/-/scale_crop/58x58/center/-/format/auto/" }, { "caption": "Gatwech Biel Thiep, 45, with his daughter \u00a9 Aur\u00e9lie L\u00e9crivain/MSF ", "original": "https://cdn.uc.assets.prezly.com/dea38310-9a73-425a-8515-a17d352d5f30/", "medium": "https://cdn.uc.assets.prezly.com/dea38310-9a73-425a-8515-a17d352d5f30/-/format/auto/", "small": "https://cdn.uc.assets.prezly.com/dea38310-9a73-425a-8515-a17d352d5f30/-/preview/200x200/-/format/auto/", "thumbnail": "https://cdn.uc.assets.prezly.com/dea38310-9a73-425a-8515-a17d352d5f30/-/preview/100x100/-/format/auto/", "square": "https://cdn.uc.assets.prezly.com/dea38310-9a73-425a-8515-a17d352d5f30/-/scale_crop/200x200/center/-/format/auto/", "squaresmall": "https://cdn.uc.assets.prezly.com/dea38310-9a73-425a-8515-a17d352d5f30/-/scale_crop/58x58/center/-/format/auto/" }, { "caption": "Nyachune Chuol Muon, 25, sits beside her five-year-old son, Marnath Tut Gatkuoth, at MSF-supported Akobo Teaching Hospital, where he is receiving treatment for tuberculosis. After repeated interruptions in his treatment due to shortages of TB medicines and the withdrawal of other healthcare providers, his condition deteriorated and he lost weight, he is now 9kg. Since April 2025, gaps in treatment have left his mother struggling to find care for him. MSF is now the only provider supplying TB medicines for two children at the hospital. \u00a9 Aur\u00e9lie L\u00e9crivain/MSF ", "original": "https://cdn.uc.assets.prezly.com/6c2c78b1-6e2b-4966-8b0a-742920522df0/", "medium": "https://cdn.uc.assets.prezly.com/6c2c78b1-6e2b-4966-8b0a-742920522df0/-/preview/500x500/-/format/auto/", "small": "https://cdn.uc.assets.prezly.com/6c2c78b1-6e2b-4966-8b0a-742920522df0/-/preview/200x200/-/format/auto/", "thumbnail": "https://cdn.uc.assets.prezly.com/6c2c78b1-6e2b-4966-8b0a-742920522df0/-/preview/100x100/-/format/auto/", "square": "https://cdn.uc.assets.prezly.com/6c2c78b1-6e2b-4966-8b0a-742920522df0/-/scale_crop/200x200/center/-/format/auto/", "squaresmall": "https://cdn.uc.assets.prezly.com/6c2c78b1-6e2b-4966-8b0a-742920522df0/-/scale_crop/58x58/center/-/format/auto/" } ], "contacts": [ { "name": "Kate Lee", "company": null, "description": null, "email": "katriona.lee@london.msf.org", "website": null, "address": null, "telephone": null, "mobile": null, "twitter": null, "facebook": null, "linkedin": null, "instagram": null } ], "author": { "first_name": "Kate", "last_name": "Lee" }, "format_version": 6 }