Sudan is in the grip of its deadliest cholera outbreak in years, an epidemic that international medical organizations warn is spiraling beyond the country’s borders and could set off a chain of public health emergencies across Africa. MSF said Thursday that the scale of the crisis—nearly 100,000 suspected cases and over 2,400 deaths—makes it the worst Sudan has seen in years.

Darfur at the Epicenter

The western town of Tawila, in North Darfur, has become a disease hotspot. Located 44 miles from El Fasher—the Sudanese Army’s last stronghold in the region—Tawila’s population has swelled with hundreds of thousands fleeing violence between the army and the Rapid Support Forces (RSF). These displaced families live in cramped, makeshift camps with virtually no clean water or sanitation.

MSF’s project coordinator in Tawila, Sylvain Penicaud, described the desperate conditions: “In displacement and refugee camps, families often have no choice but to drink from contaminated sources, and many contract cholera.” In one grim incident, a body was found in a camp well; it was removed, but within two days residents were forced to drink from the same source again.

Regional Spillover

The outbreak has crossed into South Sudan, where the UN says more than 80,000 cases and 1,400 deaths have been recorded since October 2024, marking its worst and longest cholera crisis on record. In Chad, cases have been reported in refugee settlements hosting Darfurians and others from countries battling their own epidemics. The Democratic Republic of Congo has confirmed nearly 30,000 suspected cases and 620 deaths since January, while Angola has endured its worst outbreak in almost two decades, with over 26,000 cases and nearly 750 deaths in five months.

Sheldon Yett, UNICEF’s representative in Sudan, warned that “as populations move, so does the disease. When we think we have it under control in one place, it pops up somewhere else.”

War and Aid Cuts Deepen the Crisis

The outbreak is unfolding against the backdrop of a civil war that erupted in April 2023 between Sudan’s military and the RSF, devastating infrastructure and disrupting humanitarian access. North Darfur’s conflict has left 640,000 children under five at risk of hunger, violence, and disease, UNICEF said.

Compounding the problem, foreign aid—critical for sustaining health services—has been slashed. In 2024, the United States provided $830 million in emergency aid to Sudan, more than any other donor. Cuts this year by the Trump administration have crippled programs that once funded food kitchens and medical facilities, leaving vulnerable populations without lifelines.

Rainy Season Threat

The World Health Organization warns that the rainy season, still underway, could dramatically worsen the epidemic by flooding and mixing sewage with drinking water supplies. “Already we’ve got a massive outbreak,” Yett said from Port Sudan, “and the rains are still in front of us.”

Without immediate large-scale intervention—improved water and sanitation systems, rapid treatment access, and renewed international aid—health experts fear Sudan’s cholera epidemic will intensify, spread further across Africa, and claim thousands more lives in the months ahead.