South Sudan: Gaps in healthcare threaten lives as violence escalates
People in South Sudan are facing a deteriorating humanitarian situation, while international interest and support continue to decline, according to a new report by Doctors Without Borders/Médecins Sans Frontières (MSF).
The report, “Left behind in crisis: Escalating violence and healthcare collapse in South Sudan,” shares the human impact of the faltering health system and humanitarian response. It draws on routine medical data as well as testimonies from patients, caretakers, community members and healthcare staff living in areas where we work.
“I travelled from Keurdeng, it took one hour. There is a small health facility [in Keurdeng], but it does not have all the medication. Sometimes they finish supplies very fast. I took the child to the health centre, but there was no medication.”
A female caretaker in Toch
“South Sudan’s health system is stretched to breaking point,” says Sigrid Lamberg, MSF head of operations in South Sudan. “In every location where MSF works, our teams witness huge gaps in health services. Health facilities are either non-functional or severely under-resourced. Chronic shortages of medicine and staff mean people are dying from preventable and treatable diseases. Health facilities need support on the ground, not on paper.”
Escalating violence and direct attacks on health facilities
This year, violence between government and opposition forces, as well as non-state armed groups, steeply increased, marking the worst escalation since the signing of the 2018 peace agreement. Intensifying violence, attacks on health facilities and access constraints are further impeding the delivery of healthcare and assistance. According to the UN, new waves of violence have displaced over 320,000 people and 2,000 have been killed since January. In Malakal, between April and November 2025, MSF teams treated 141 trauma patients. This includes women and children, many of whom had gunshot wounds.
In flagrant violation of international humanitarian law, 2025 also saw a sharp increase in attacks on health facilities. MSF staff and facilities were no exception. We experienced eight targeted attacks in Central Equatoria, Jonglei and Upper Nile, forcing the closure of two hospitals in Ulang and Old Fangak. On Dec. 3, our facility was hit by an airstrike in Pieri town, Jonglei State. On the same day, MSF teams witnessed additional airstrikes in Lankien, where MSF also runs healthcare facilities.
Disease outbreaks, displacement and funding cuts overwhelm health services
Communities are facing multiple overlapping crises: conflict, large-scale displacement, flooding, malnutrition and disease outbreaks – including the largest cholera outbreak in the country’s history. International support, however, continued to decline in 2025, despite worsening living conditions and declining access to essential services.
The Health Sector Transformation Project, a multi-donor initiative launched in July 2024, remains South Sudan’s main vehicle for healthcare delivery. Led by the government, along with the World Health Organization, UNICEF and other partners, the project originally aimed to support 1,158 health facilities across 10 states and three administrative areas. However, due to funding constraints, only 816 facilities are currently supported under the program and even these still face persistent shortages of medicines and staff.
Left behind in crisis: Escalating violence and healthcare collapse in South Sudan
“I travelled from Keurdeng, it took one hour,” a female caretaker in Toch told MSF teams. “There is a small health facility [in Keurdeng], but it does not have all the medication. Sometimes they finish supplies very fast. I took the child to the health centre, but there was no medication.”
Malaria remains a major challenge and continues to be the leading cause of morbidity and mortality in South Sudan, particularly for women and children. Despite this, 2025 saw nationwide stockouts of malaria drugs during peak season for the second year in a row. Without timely treatment, malaria can quickly become deadly. Between January and September 2025, MSF teams treated 6,680 people with severe malaria who required hospitalization.
Rising needs require urgent action
For years, people in South Sudan have faced some of the world’s highest medical and humanitarian needs. In 2025, the situation in South Sudan has worsened significantly. Rising needs require urgent action: international donors must uphold their commitments to support health and humanitarian efforts and shortcomings in existing programs must be critically addressed.
At a minimum, the timely delivery of essential medicines, supplies and salaries for health workers need to be ensured. Amid escalating violence, humanitarian access, protection of civilians and respect for health facilities must be guaranteed. MSF also calls on South Sudan’s government to raise the national health budget in line with its Abuja Declaration commitment of allocating 15 per cent to health. Currently, only 1.3 per cent of the national budget is allocated to health.
“The situation in the country is catastrophic,” says Lamberg. “The urgent needs of people in South Sudan demand coordinated action, renewed commitment and genuine international solidarity. The world can’t look away, especially not now.”
