Sudan: Measles Cases Surge in Darfur Despite Months of Warnings and Calls for Vaccination

More than 1,300 cases have been recorded since September 2025 in health facilities supported by MSF despite MSF repeatedly advocating for vaccination campaigns and the resumption of routine immunisation programs.

MSF urge the authorities to immediately eliminate all bureaucratic and administrative barriers to transporting vaccines throughout Darfur. At the same time, there must be greater urgency from UNICEF to coordinate efforts to increase the transport and delivery of vaccines, syringes and the necessary supplies. We also call on both the State and Federal Ministries of Health to launch an urgent measles vaccination campaign and a routine immunisation program.

“Measles is a preventable disease; it requires only routine immunisation and timely reactive vaccination. But due to conflict, administrative barriers, and delays by key agencies, both have been severely limited,” says Ahmed Fadel, MSF Emergency Coordinator in Darfur. “These delays are leaving vulnerable children exposed to a disease that is also deadly.”

At El Geneina Teaching Hospital, Ferdos Salih brought Banan, her 11-month-old baby, who has measles and severe acute malnutrition. "She was born prematurely because the war forced us to flee from Omdurman while I was pregnant," Ferdos explained. "She has suffered a lot with repeated hospitalization. Also because of the war, she couldn't get vaccinated." Banan got the infection from her older brother because there was not enough space in the house to isolate him properly when he first got measles. Since the displacement, they live with two other families.

Shipping vaccines for reactive campaigns and immunization programs takes place in an extremely challenging operational environment in Sudan. Ongoing conflict has disrupted import routes and created significant administrative and bureaucratic hurdles for humanitarian actors involved in vaccination efforts, including delays linked to authorisations for cross-border shipments and procedures required by Sudanese authorities.

At the same time, the delivery of vaccines and the other supplies necessary to carry out vaccinations are not coordinated sufficiently, arriving at different locations and times creating another hurdle to be overcome before vaccinations can start. “This is the main cause of delays in the field. The supply of vaccines and related supplies must be better coordinated so that both arrive to where they are needed much more quickly",” says Fadel.

At Zalingei Hospital in Central Darfur, MSF teams have treated 1,093 measles patients so far in 2025, with a sharp increase in recent months: 78 percent of cases were recorded since September. In Nyala Teaching Hospital in South Darfur, teams treated 242 measles patients during the year, 95 percent of them since September. Meanwhile, El Geneina Teaching Hospital in West Darfur received 429 measles cases in 2025, with 59 percent reported between September and November.

Matara Abakar brought her ten-month-old son, Natrin, because he had been sick for 17 days with a fever, diarrhoea, a cough, and a skin rash. He is also severely malnourished. "We are

struggling to find jobs. I’m a farmer, and it's hard to earn enough money to buy proper food. We depend only on asida (Sudanese food made with sorghum or millet flours),” Matara says. She has two more children who are not fully vaccinated either.

More than 34 per cent of patients in Zalingei and Nyala are also acutely malnourished, which increases the severity of the disease and rapidly leads to life-threatening complications, including pneumonia, encephalitis and death. Delays in vaccine shipments and repeated postponements of a reactive vaccination campaign are leaving children unprotected while the outbreak continues to expand.

More than 29 per cent of cases in Zalingei and 34 per cent in Nyala were in children over five years old, highlighting the longstanding failure to ensure routine immunisation in the region, even before the escalation of the current conflict. Consequently, the response to these outbreaks should include children aged between six months and 15 years.

Insufficient vaccination campaigns

Six months ago, in June, large-scale vaccination campaigns were carried out in the Jabel Marra region of Central Darfur; however, they did not extend to Zalingei, nor to South or West Darfur, where MSF teams are now witnessing the sharp rise in cases. At that time, MSF warned that these campaigns would have only a short-term impact. While some efforts have been made to bring in vaccines and dry supplies, the need for mass vaccination campaign as well as scale up of the routine vaccinations are urgently needed to stop the spread.

Between November 2024 and May 2025, MSF teams carried out four vaccination campaigns in response to outbreaks:

· In November 2024, our teams vaccinated 9,600 children in North Jebel Marra.

· In February 2025, MSF conducted a measles intervention in South Darfur's Jebel Marra, treating 5,909 patients and vaccinating 36,209 children against measles.

· Between December 2024 and May 2025, our teams vaccinated more than 79,000 children in Rokero, North Jebel Marra. After the end of the campaign there was a reduction in number of measles cases by 96.5 percent.

· In April, MSF teams vaccinated more than 54,000 children in Foro Baranga, West Darfur.

MSF teams in Darfur are currently also treating patients with diphtheria, pertussis, and other vaccine-preventable diseases. “What is urgently needed now is for the Ministry of Health — with the support of health partners, including UNICEF — to resume routine immunisation and ensure sufficient vaccine supplies,” says Ahmed Fadel, MSF Emergency Coordinator in Darfur. “Countless lives could be saved, yet after more than two and a half years of war, the world continues to fail the people of Sudan”.

This is happening amid a challenging global landscape. In 2024, 59 countries reported large, disruptive measles outbreaks — nearly triple the number reported in 2021, which is the highest number since the beginning of the pandemic.

Meanwhile, deep funding cuts to the Global Measles and Rubella Laboratory Network (GMRLN) and country immunization programs are feared to widen immunity gaps and drive further outbreaks.