In Sudan, the deepening consequences of war have culminated in a malnutrition crisis of catastrophic proportions. After more than 500 days under siege, the city of El Fasher in North Darfur stands as a stark reminder of the toll of protracted conflict and humanitarian inaccessibility. Médecins Sans Frontières (MSF), providing care to those escaping El Fasher and reaching Tawila, has documented alarming levels of acute malnutrition—findings that corroborate the latest Integrated Food Security Phase Classification (IPC) assessments reporting famine in the region.
The collapse of food systems in El Fasher has rendered survival contingent on desperate measures. Basic staples became luxuries: in September 2025, seven kilograms of millet cost over SDG 500,000 (approximately USD 208), while a kilogram of sugar reached SDG 130,000 (USD 54). Residents turned to ambaz—traditionally animal feed—as a substitute for food. Initially distributed without cost, the price of ambaz rose steeply by June to SDG 50,000 for just 1.5 kilograms. Accounts from displaced persons describe brutal conditions, with community kitchens shuttered, markets shelled, and any efforts to bring in food violently intercepted by Rapid Support Forces (RSF).
Between late October and early November 2025, over 70% of children under five arriving in Tawila were acutely malnourished; 35% of those were severely so. Among screened adults, 60% were found acutely malnourished, and over a third of those exhibited severe acute malnutrition. Pregnant and lactating women, vital to future generational health, are facing even higher malnutrition rates, with grave implications for birth outcomes.
These statistics go beyond isolated incidents in Darfur. In Blue Nile and Khartoum states, MSF teams continue to treat growing numbers of malnourished individuals. The compounded effects of displacement, economic collapse, disease outbreaks, and limited humanitarian access have created a national emergency that demands sustained, coordinated international and African-led action.
In Blue Nile, the arrival of South Sudanese returnees has placed an untenable burden on already fragile services. Between July and September, 1,950 children were treated for severe acute malnutrition at Damazin Teaching Hospital, with 100 succumbing—many as a result of co-infections such as cholera, which has been exacerbated by poor sanitation and overcrowding.
In Khartoum, over 700,000 returnees have moved back into devastated neighbourhoods, where access to clean water and healthcare remains critically limited. Al-Buluk hospital in Omdurman admitted over 350 malnourished patients in September, while nearly half of children seen at Al-Banjadeed hospital in Khartoum city were diagnosed with malnutrition. The humanitarian footprint in Khartoum remains minimal, despite mounting needs and the shifting geography of the conflict.
Beyond numbers, the testimonies of survivors arriving in Tawila portray a context in which daily survival depends on avoiding militia-controlled routes, enduring hunger, and watching loved ones vanish—often with no news of their fate. This unfolding emergency, despite the clarity of evidence from IPC and MSF fieldwork, continues to be met with restricted humanitarian access.
What is unfolding in Sudan is not simply a story of food insecurity but one of systematic denial—where war, displacement, and governance failures intersect to deepen structural vulnerabilities. The RSF’s blockade tactics, including attacks on supply convoys and civilian escape routes, have violated principles of humanitarian protection. At the same time, international response has lagged, hampered by access constraints and an underfunded aid sector.
African-centred narratives demand that the crisis be viewed not as a passive outcome of war but as a consequence of deliberate policies and impunity. The people affected are not mere statistics—they are mothers forced to eat animal fodder, children dying of hunger-related disease, and entire communities forced into stateless displacement.
Humanitarian actors on the ground are urging immediate safe passage corridors, cessation of hostilities around civilian enclaves, and unfettered access for aid. MSF’s emergency coordinator, Myriam Laaroussi, has reiterated that while the crisis is national in scope, practical steps—such as access permission, funding mobilisation, and protection of civilians—could mitigate suffering significantly if taken now.
This crisis, like others across the continent, underscores the importance of African and regional leadership in articulating and driving solutions. It also calls for global solidarity that is responsive to African priorities—not from a lens of charity, but from an ethics of justice, accountability, and equity.
Without sustained intervention, the human cost in Sudan will escalate, and the legacy will be recorded not just in malnutrition figures but in preventable loss and systemic abandonment.
