Sudan: Children in urgent need of immunization as a measles outbreak spreads in Darfur
Already-low immunization coverage and the ongoing conflict in Sudan are contributing to the spread of this potentially deadly disease.
Outbreaks of measles have spread widely across Sudan’s Darfur region over the past year, affecting people in many communities where Doctors Without Borders/Médecins Sans Frontières (MSF) teams are treating patients. While massive vaccination campaigns are finally ongoing in several locations across the region, efforts must be increased to catch up on the immunization of children who have never been vaccinated.
MSF first observed a surge of measles cases in June 2024 in Rokero, Central Darfur, where our teams have been running the local Ministry of Health hospital since 2020. At the start of this year, cases were also reported in East Jebel Marra in South Darfur, and in Forbrenga in West Darfur. More recently, new surges are also being observed in Zalengei, Sortony and in Tine, East Chad – all places where MSF operates.
“The ongoing conflict is also contributing to this outbreak, constraining the capacities of medical actors to both prevent and respond to outbreaks of contagious diseases.”
Cecilia Greco, physician and MSF medical coordinator for Central Darfur
From June 2024 until the end of May 2025, more than 9,950 patients were treated for measles in health facilities MSF runs or supports in the region. Around 2,700 were complicated cases requiring hospitalization, and 35 deaths were recorded. To manage the influx of patients, we had to expand our pediatric bed capacity in three hospitals.
One of the root causes of this situation is the region’s already-low immunization coverage.
“In Forbrenga, 30 per cent of the measles patients we are receiving are above the age of five years, and only five per cent of them are vaccinated,” says Sue Bucknell, MSF deputy country director in West Darfur. “This suggests that the lack of vaccination dates back further than the recent conflict.”
“The ongoing conflict is also contributing to this outbreak, constraining the capacities of medical staff to both prevent and respond to outbreaks of contagious diseases,” says Cecilia Greco, physician and MSF medical coordinator for Central Darfur. “Mass population displacement has made the illness spread even faster across the region, further complicating the situation.”
Since the war broke out in Sudan in April 2023, constant administrative impediments and regular blockades of key supply roads have caused vaccine shortages throughout Darfur. This has led to disruptions in routine immunization programs in several locations, sometimes for months. In Sortony, for example, a camp for internally displaced people in North Darfur that hosts more than 55,000 people, vaccination completely stopped from May 2024 to February 2025.
These constraints and shortages have also limited medical organizations, including MSF, to respond. Last year, MSF carried out several vaccination campaigns, such as in North Jebel Marra in November 2024 where 9,600 children were vaccinated. However, due to limited vaccine supplies, MSF teams were forced to reduce the target number and to exclude children over the age of five, despite clear needs. This inevitably reduced the long-term impact of these campaigns. In North Jebel Marra, while the vaccination campaign initially slowed the outbreak, cases began to rise sharply again in February.
“Even if they represent a certain achievement, these campaigns should have happened much sooner. Many measles cases and their consequences could have been prevented.”
Cecilia Greco, physician and MSF medical coordinator for Central Darfur
Although mass vaccination campaigns are now happening in different parts of Darfur, negotiations and procedures have been lengthy. After MSF first raised the alarm about multiple surges in measles cases, it took months for the federal Ministry of Health in Port Sudan and UNICEF to release the needed vaccines from their stocks, finally enabling mass vaccination campaigns to be launched in different areas of Darfur.
Two weeks ago, 55,800 children from nine months to 15 years old were vaccinated in Forbrenga as part of a campaign led by the Ministry of Health and supported by MSF. In a similar campaign, 93,000 more children were set to receive the vaccine in North Jebel Marra and Sortony, in a similar campaign the following week.
“Even if they represent a certain achievement, these campaigns should have happened much sooner. Many measles cases and their consequences could have been prevented,” says Greco. “And as much as they are needed, such reactive campaigns are only a Band-Aid to an open wound unless massive efforts are put in place on immunization and prevention across Darfur, including its most remote areas.”
There is the threat of further outbreaks of disease unless such efforts are initiated.
“Measles is not the only contagious illness currently present in Darfur with the potential to turn into outbreaks,” says Bucknell. “Over the last 10 days, about 200 suspected cholera cases were brought to MSF-supported health facilities in two different Darfur states. This follows a significant cholera outbreak in Khartoum state and other parts of Sudan.”
“It is essential that federal and local health authorities, UN agencies and all medical organizations collaborate,” says Greco. “This must be done not only to catch up on the vaccination of all the children left behind by immunization programs over the years, but also to enhance their ability to respond quickly and efficiently should any other outbreaks, like cholera, start spreading across Darfur. This includes the capacity to supply vaccines in and across Sudan, without facing the same impediments anymore.”
