A patient undergoes a medical consultation at an MSF mobile clinic in Gomgoi displacement camp. MSF is running mobile clinics in three displacement camps in Twic County, after people fled their homes in Agok when violence erupted. © Scott Hamilton/MSF

Severe health consequences expected for people of South Sudan as sudden funding cuts take effect

The British Government and other donors must urgently reinstate funding to South Sudan, after millions of dollars in support to the national healthcare system was recently withdrawn, said the medical humanitarian organisation Doctors Without Borders/Médecins Sans Frontières (MSF).  

The Health Pooled Fund (HPF) is the largest donor-financing mechanism for healthcare in South Sudan. The funding provides access to basic primary healthcare and some secondary healthcare, and includes payments for local healthcare workers, drugs and medical supplies, as well as technical assistance. 

As of 1 April 2022, the HPF had its budget slashed by a projected 24 per cent for this fiscal year due to the recent drastic cuts to the UK’s Official Development Assistance. This has resulted in the immediate suspension of funding to approximately 220 of the 797 public health facilities it was supporting in eight out of ten states in the country. Further cuts at the end of July will mean that nine state hospitals will also lose funding.

As the largest medical-humanitarian organisation working in South Sudan, MSF is alarmed by the scale and timing of these cuts to the national public healthcare system and warns against the foreseeable detrimental impact on people’s access to healthcare, especially for the most vulnerable.  

“After years of protracted conflict and recurrent humanitarian crises, South Sudan´s health system was already on life support, and these cuts will further cripple a chronically underfunded public health system struggling to meet the needs of the population,” says Federica Franco, MSF Country Director for South Sudan.

Approximately two-thirds of South Sudan’s 2,300 health facilities are already non-functional and less than half (44 per cent) of the total population live within five kilometres of a functional health facility. With floods, displacement, food insecurity and violence remaining significant issues in the country, these funding cuts come at the worst possible time.

“It is hard to overstate our profound concern for the continuity of health services and people’s ability to access them, which was already very constrained prior to these cuts taking effect,” said Franco. “These are not just abstract numbers – these cuts will have life or death implications for women, men and children in South Sudan.” 

South Sudan has some of the worst health indicators in the world and HPF fills a critical gap in healthcare financing in the country. As the cuts were made with no transition plan in place for the 220 healthcare facilities, and only four months for hospitals, mitigation and contingency plans have not been established. Therefore, the expected impact that these cuts will have on access to essential and life-saving medical care for the local population is alarming. 

In Bentiu, where more than 170,000 internally displaced people currently reside, disease outbreaks, malnutrition and other health issues are rife. Despite the vulnerability of the community, Bentiu State Hospital is one of the health facilities that HPF will suspend funding for in July. If no mitigation measures are identified, the MSF hospital will become the only fully functioning secondary healthcare facility in the entire state.

The Aweil State Hospital is yet another example of an essential health facility that will lose funding starting at the end of July. MSF has been running the hospital’s paediatric and maternity departments since 2008, with adult healthcare services being supported by the HPF. It is the only hospital for a population of more than 100,000 in Aweil town and over 1.2 million people in the whole state. 

“These cuts will mean fewer options for patients in a country with an already overstretched and under-resourced healthcare system,” says Franco. “We urge the UK Government and other HPF donors to reprioritise sustained assistance for South Sudan, and to urgently step in with sufficient additional funding to mitigate the gaps resulting from these latest cuts. We also call on the Government of South Sudan to ensure the provision of uninterrupted medical care.”

Due to being privately funded, MSF will continue to provide humanitarian and medical assistance through its programmes across South Sudan. MSF has already received requests for emergency assistance from several South Sudanese healthcare facilities and affected communities owing to the cuts. However, MSF is already over-stretched and struggling to meet the health needs of the population amidst concurrent emergencies, and has little capacity to scale up to meet the large gap left by the HPF funding cuts.