Sudan Humanitarian Crisis: Two Years of Conflict (April 2025)

April 2025 marked two years since a devastating civil war erupted in Sudan. The conflict, mainly between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has created an unparalleled humanitarian catastrophe. International bodies and UN agencies consistently point to Sudan as the location of the world's largest and most severe humanitarian crisis, particularly concerning displacement and hunger. Two years on, the humanitarian situation continues its alarming decline. Civilians bear the brunt of the violence, facing widespread suffering marked by famine-like conditions, rampant disease, the breakdown of essential services, and extreme brutality, including atrocities linked to both main warring factions and allied militias.

Key Humanitarian Figures

By April 2025, the scale of the crisis shows a nation overwhelmed. Out of Sudan's 47.5 million people, over 30 million—nearly two-thirds of the population—need urgent humanitarian help. This is a significant jump from 24.8 million people in 2024 and 15.8 million before the conflict started in 2023.

The displacement numbers are staggering:

• Internal Displacement: Sudan faces the world's largest internal displacement crisis, with nearly 9 million to over 11.5 million people forced from their homes within the country.

• Refugees & Returnees: Over 3 million, possibly up to 3.9 million, have fled across Sudan's borders.

• Total Displaced: The conflict has displaced more than 14 to 15 million people in total.

Food insecurity affects over half the population:

• Acute Food Insecurity (IPC Phase 3+): Between 24.6 million and nearly 26 million people face severe hunger.

• Catastrophic Hunger (IPC Phase 5/Famine): At least 638,000 people are experiencing catastrophic hunger, effectively famine, with millions more at risk of starvation.

• Acute Malnutrition: Nearly 5 million children under five and pregnant or breastfeeding women suffer from acute malnutrition. Among these, about 770,000 young children face Severe Acute Malnutrition (SAM).

The humanitarian response faces enormous challenges:

• Funding Needs (2025): US$4.2 billion is required for aid within Sudan, plus US$1.8 billion for the regional refugee response.

• Funding Received (Early 2025): Funding remains critically low. By early 2025, only a tiny fraction had been met, with some agencies reporting funding levels as low as 6-10%.

• Death Toll: Over 20,000 deaths have been recorded, though the actual number is likely far higher, potentially reaching 150,000. Recent attacks have killed hundreds of civilians, and at least nine aid workers have died delivering assistance.

• Total Population: ~47.5 Million

• People in Need (PIN): >30 Million

• Internally Displaced Persons (IDPs): ~9 Million to >11.5 Million 

• Refugees & Returnees (Fled Sudan): >3 Million to 3.9 Million 

• Total Displaced: >14 Million to ~15 Million 

• Acute Food Insecurity (IPC Phase 3+): >24.6 Million to ~26 Million (>50% population)

• Catastrophic Hunger (IPC Phase 5/Famine): >638,000 

• Acute Malnutrition (Children U5/PLW):  ~5 Million 

• Severe Acute Malnutrition (Children U5): ~770,000

• Funding Received (Early 2025): Critically Low (e.g., 6% - 10% reported by March/April)

• Reported Deaths (Minimum Recorded): >20,000 (Actual likely far higher, potentially up to 150,000)

Interconnected Crises and Global Inattention

Sudan's multiple crises—displacement, hunger, disease, violence—are interconnected and worsen each other. Displacement disrupts farming and market access, fueling hunger. Malnutrition weakens people, making them vulnerable to diseases. The collapsed health system cannot contain outbreaks. Persistent violence blocks aid delivery and prevents recovery. This creates a devastating cycle, making isolated solutions ineffective.

Despite numerous international bodies calling this the "world's worst" humanitarian crisis, there's concern it's becoming normalized globally. Needs have dramatically increased since the war began—aid recipients nearly doubled, famine is spreading—yet the global response hasn't kept pace. Humanitarian actors perceive a gap between the crisis's gravity and the sustained international political will and funding directed towards it.

The Scale of Displacement: A Global Epicenter

Internal Displacement (IDPs)

Sudan is undeniably home to the world's largest internal displacement crisis. Estimates range from nearly 9 million to over 11.5 million people forced from their homes within Sudan. The majority—over 8 million, perhaps exceeding 8.8 million—fled since the SAF-RSF conflict began in April 2023. This includes people previously displaced by conflicts like Darfur, now fleeing again.

Shifting frontlines mean many face displacement multiple times, deepening their vulnerability. Recent attacks on the large Zamzam displacement camp reportedly triggered further mass displacement, potentially involving up to 400,000 people.

Refugee Outflows and Regional Impact

The conflict has generated a massive refugee crisis, straining neighboring countries. Over 3 million, possibly up to 3.9 million, have fled Sudan since April 2023.

Host countries like Chad, South Sudan, Egypt, CAR, Ethiopia, Libya, and Uganda face immense pressure. Chad has shown great hospitality despite its scarcity; Egypt might host 1.5 million Sudanese refugees. The return of hundreds of thousands of South Sudanese to their fragile homeland is particularly complex, potentially deepening local tensions. Strain on resources like water and land fuels social tensions across the region. Some Sudanese refugees undertake dangerous journeys through countries like Libya trying to reach Europe.

Child Displacement Crisis

Sudan is also the epicenter of the world's largest child displacement crisis. Children make up over half the displaced population, both internally and externally. This means about 5 million children have been uprooted since the war started. Nearly a third of these displaced children are under five, highly vulnerable to malnutrition, disease, and trauma. An estimated 1 million Sudanese children are now refugees in neighboring countries.

Escalating Destitution and Exported Instability

Repeated displacement leads to escalating destitution. Each time people flee, they lose assets, deplete coping strategies, and lose social ties, becoming progressively more vulnerable and dependent on scarce aid. It's a downward spiral into deeper poverty and insecurity.

The massive refugee outflow threatens regional stability. The influx strains resources, potentially fueling conflict in host communities. The return of many to fragile South Sudan highlights this risk. The Sudanese conflict is exporting instability, potentially creating new crises or undermining peace in neighboring states.

Food Security Crisis and Famine Conditions: The World's Largest Hunger Crisis

Scale of Hunger

Sudan is enduring the world's largest hunger crisis. Over half the population—between 24.6 million and nearly 26 million people—face high levels of acute food insecurity (IPC Phase 3+). Within this group:

• 8.1 million face Emergency levels (IPC Phase 4).

• At least 638,000 face Catastrophe (IPC Phase 5), meaning famine conditions. Millions more are at imminent risk of starvation. Reports describe families eating leaves or grass, struggling for one meal a day.

Confirmed Famine and Projections

Famine (IPC Phase 5) is confirmed in parts of Sudan. The IPC Famine Review Committee verified famine conditions in at least five locations, including Zamzam, Abu Shouk, and Al Salam camps in North Darfur, and parts of the Western Nuba Mountains. Famine was first declared in Zamzam camp in August 2024.

The crisis is worsening. Famine is expected in five more areas in North Darfur between December 2024 and May 2025. Another 17 areas nationwide are at high risk of tipping into famine during the same period. This deterioration occurs during the post-harvest season, when food should be most available.

Drivers of Hunger

The SAF-RSF conflict is the root cause. It has led to:

• Near-total economic collapse, destroying livelihoods and buying power.

• Crippled agriculture: fields fallow, crops failing, farmland destroyed, equipment looted.

• Destroyed or disrupted markets and supply chains.

• Displacement of millions of farmers. As a result, staple food prices (sorghum, wheat flour) have soared, remaining over 100% higher than early 2024 levels, putting basic food out of reach. Climate shocks and severe restrictions on humanitarian aid access compound the problem.

Malnutrition Crisis

Sudan faces catastrophic levels of acute malnutrition, especially among children under five and pregnant/lactating women (PLW). Around 4.9 to 5 million in these groups suffer from acute malnutrition, a 22% increase from 2024.

• About 770,000 children under five suffer from Severe Acute Malnutrition (SAM), the deadliest form, needing urgent treatment to survive. Sudan now ranks among the top four countries globally for Global Acute Malnutrition (GAM) prevalence (13.6%). Malnutrition rates are rising sharply in areas like South Kordofan. While treatment centers exist (WHO-supported centers treated nearly 50,000 children with SAM; MSF runs feeding centers), demand far exceeds capacity, with centers reportedly always full. The upcoming rainy season is expected to worsen the malnutrition crisis, historically coinciding with peak SAM admissions.

Famine as Consequence and Long-Term Impact

The concentration of famine in active conflict zones like Darfur and Kordofan, coupled with systematic aid obstruction, attacks on markets, and destruction of agricultural capacity, raises serious concerns. The U.S. State Department determination that the RSF's prevention of aid access constitutes an element of genocide adds context. This suggests starvation might be partly a calculated outcome or tactic, especially in contested areas.

Beyond the immediate tragedy, the scale of child malnutrition signals a lasting catastrophe for Sudan's future. Severe malnutrition in early childhood causes irreversible physical and cognitive damage. Millions of affected children will likely suffer lifelong consequences, impacting health, education, and economic potential. This represents a devastating loss of human capital that will hinder Sudan's recovery for decades.

Health System Collapse and Disease Outbreaks

Decimated Health Infrastructure

Two years of conflict have brought Sudan's health system near total collapse. Over two-thirds of facilities nationally, and up to 80% in conflict zones, are non-operational or only partially functioning. Remaining facilities operate under extreme duress, risking closure due to shortages of staff (often unpaid or threatened), medicines, supplies, water, and power. Millions lack access to basic medical care.

Disease Outbreaks

The health system's collapse allows infectious diseases to spread rapidly. Factors include:

• Breakdown of disease surveillance.

• Disrupted vaccination campaigns (coverage much lower than pre-conflict).

• Collapse of clean water and sanitation.

• Inadequate vector control. As a result, over two-thirds of Sudan's states battle multiple outbreaks simultaneously. Cholera, measles, dengue fever, and malaria are rampant. In 2024 alone, 49,000 cholera cases and over 11,000 dengue cases were reported, hitting mothers and children hardest. A March 2025 cholera outbreak in White Nile reportedly killed ~100 and infected >2,700. Children are dying from vaccine-preventable diseases due to halted immunizations.

Attacks on Healthcare

Healthcare facilities, staff, and transport face repeated, deliberate attacks by conflict parties, violating international humanitarian law. WHO verified 156 such attacks between April 2023 and April 2025, killing 318 and injuring 273 patients and health workers. Attacks target hospitals, medical warehouses, ambulances, aid convoys, and health personnel. In El Fasher, MSF-supported facilities suffered 12 attacks, leaving only one public hospital partly capable of surgery by mid-2024. These attacks destroy infrastructure, kill staff, and instill fear, preventing care access.

Impending Rainy Season Threat

The approaching rainy season (May-October) poses a severe threat, expected to worsen the health crisis. Heavy rains and floods disrupt transport and access, especially on dirt roads. Flooding contaminates water, increasing risks of diseases like cholera. The season also sees surges in vector-borne diseases like malaria. Critically, this period aligns with the peak lean season and highest malnutrition rates. Several areas at high famine risk are also flood-prone, creating a potential convergence of catastrophes.

Health Vacuum and Rainy Season Multiplier

The health system's collapse and targeted attacks create a dangerous public health vacuum. This lack of basic services (surveillance, vaccination, water, sanitation, treatment), combined with widespread malnutrition, allows epidemics to spread uncontrollably. The system's failure actively enables disease outbreaks.

The predictable rainy season acts as a powerful annual multiplier of Sudan's crises. It simultaneously worsens health risks, deepens food insecurity by coinciding with peak malnutrition and cutting off access, and severely obstructs aid delivery due to impassable roads. Each year the conflict continues through the rainy season, the catastrophe worsens, making recovery harder and pushing people into deeper suffering.

Protection Crisis: Violence Against Civilians and Grave Violations

Widespread Atrocities and Impunity

The conflict features extreme violence against civilians. Both SAF and RSF, plus allied militias, are accused of widespread atrocities potentially amounting to war crimes, crimes against humanity, and genocide. In January 2025, the U.S. State Department determined the RSF and allies committed genocide in Darfur, citing ethnically targeted killings, systematic rape and sexual violence, and deliberate obstruction of aid. Tens of thousands have reportedly been arbitrarily detained in poor conditions with little family contact. Pervasive impunity seems to shield perpetrators.

Attacks on Civilians and Infrastructure

Civilians and essential infrastructure face frequent targeted and indiscriminate attacks. Methods include aerial bombing and heavy shelling in populated areas. Displacement camps (like Zamzam, Abushouk, Al-Salam) have been attacked. Villages have been assaulted, with reports of mass killings by RSF. Essential structures (markets, schools, hospitals) are damaged or destroyed. Specific incidents, especially in Darfur, killed hundreds of civilians quickly. In places like Al Fasher, clashes are almost daily. Homes and livelihoods are systematically destroyed.

Sexual and Gender-Based Violence (SGBV)

SGBV, mainly targeting women and girls, is pervasive and appears systematically used as a weapon of war. Forms include rape, gang rape, forced marriage, and abduction. The RSF is particularly notorious for mass rapes during attacks. SGBV is reportedly used to humiliate, dominate, terrorize, and force displacement. The number at risk of SGBV has tripled to 12.1 million. Survivors include children as young as one. Reported figures are likely a fraction of the actual prevalence due to fear, stigma, and lack of services preventing reporting. It's estimated up to 65% of women in Sudan may now face sexual violence.

Grave Violations Against Children

Children endure horrific suffering and rights violations. They are killed and maimed in crossfire. Verified violations include killing, maiming, abduction, recruitment into armed groups, and attacks on schools/hospitals. Darfur, Khartoum, Aljazeera, and South Kordofan report the highest numbers. Children suffer rape and sexual violence. The conflict inflicts deep psychological trauma, with millions potentially facing severe mental health issues. Children's futures are jeopardized by the education system's collapse; attacks on schools, their use as shelters, and displacement mean over 17 million children (around 90% of school-aged population) are out of school.

Dismantling Civilian Life and Cycles of Trauma

The pattern of violence suggests a strategy aimed at dismantling civilian life itself. Targeting civilians in homes, camps, markets, hospitals, schools, and attacking aid workers seems designed to break societal resilience, control populations through terror, and possibly achieve ethnic cleansing, as suggested by the Darfur genocide determination. Pervasive SGBV is a brutal tool in this strategy.

The cumulative exposure of millions, especially children, to extreme violence, displacement, starvation, sexual violence, and loss of normalcy inflicts profound psychological trauma. With limited mental health support available, there's a significant risk of creating an intergenerational cycle of trauma, hindering long-term recovery even after fighting stops.

Humanitarian Response: Efforts and Obstacles

Humanitarian Operations and Actors

Many humanitarian organizations operate in Sudan under extreme challenges. Key actors include UN agencies (OCHA, UNHCR, WFP, UNICEF, WHO, IOM, FAO) and numerous NGOs (IRC, MSF, Save the Children, World Vision, Relief International, Welthungerhilfe, USCRI, etc.).

They undertake vital activities:

• Distributing food aid and cash.

• Providing health services and supplies.

• Managing nutrition programs.

• Delivering water, sanitation, and hygiene (WASH) support.

• Providing emergency shelter.

• Implementing protection programs (child protection, SGBV response). Where security allows (like parts of Khartoum), organizations try to scale up. WFP managed temporary surges into hard-to-reach areas; WHO delivered significant medical supplies, including cross-border.

Critical Funding Shortfalls

The response is crippled by severe underfunding. The 2024 appeal was less than half funded by September. For 2025, US$4.2 billion is needed inside Sudan, plus US$1.8 billion regionally. Contributions lag dramatically. By March/April 2025:

• The Sudan plan was only 6% funded.

• IOM's plan was 10% funded.

• UNICEF received only US$12 million against its US$1 billion appeal.

• WHO's US$135 million plan was only 20% funded. Major donors, like the US, announced significant funding cuts, termed a "catastrophic blow" by officials. Consequences include threats to essential programs, reduced aid targets, cuts in food rations, and ultimately, loss of life.

Severe Access Constraints

Alongside funding issues, safely reaching people in need is a fundamental challenge. Access is hindered by:

• Insecurity: Ongoing fighting, shifting frontlines make movement dangerous.

• Bureaucratic Impediments: SAF and RSF authorities impose restrictions, arbitrary obstructions, and delays (over 60% of UNICEF deliveries faced delays in 2024).

• Denial of Access: Widespread reports of deliberate aid route blockages and denial of access for personnel (MSF blocked for months from reaching Khartoum hospitals).

• Attacks on Aid Workers: At least nine aid workers confirmed killed; deliberate targeting reported.

• Logistical Challenges: Difficult terrain, impending rains making roads impassable, border crossing disruptions (Adre, Tina), liquidity crisis impacting cash aid. Access is especially difficult in Darfur, Kordofan, Khartoum, and Al Jazirah states.

International Response and Diplomacy

High-level meetings (London April 2025, Brussels March 2025) aimed to mobilize attention, funding, unified positions, and access advocacy. UN officials, NGOs, and states persistently call for:

• Immediate cessation of hostilities.

• Adherence to international humanitarian law (protecting civilians).

• Guaranteed safe, unhindered humanitarian access.

• Increased, sustained funding.

• Concerted pressure on warring parties and sponsors to end fighting. Despite this, diplomatic efforts have failed to gain traction or are disjointed. A "lack of political will" among international actors is cited as a key obstacle. Peace remains elusive; the conflict and its consequences continue unabated.

The Aid Paradox and International Commitment

Sudan presents a paradox: many experienced aid groups are present, yet the catastrophe deepens. This stems from crippling underfunding and pervasive, often deliberate, denial of access. Aid workers are present but often unable to operate at scale or reach those most in need, especially in conflict zones or famine areas. The humanitarian system itself seems besieged, its capacity compromised. Presence doesn't equal impact when funding and safe access are lacking.

The massive funding shortfall for the "world's worst crisis" raises questions about international priorities. While donor fatigue and competition from other crises (Gaza, Ukraine) play roles, the scale of the gap suggests more. Explicit funding cuts by key donors and acknowledgments of a "lack of political will" hint the under-resourcing might stem from perceived lower strategic importance, a sense of intractability, or insufficient international leverage, resulting in passive neglect despite the suffering.

Summary of the Situation

Two years into the civil war, Sudan is undeniably facing the world's most severe and complex humanitarian catastrophe as of April 2025. The human cost is immense, marked by:

• The world's largest displacement crisis (nearly 15 million displaced).

• The world's largest hunger crisis (over half the population facing acute food insecurity, famine confirmed and spreading).

• A collapsed health system leading to rampant disease.

• A profound protection crisis with relentless violence against civilians, widespread atrocities including systematic SGBV, and grave violations against children, all with impunity.

Outlook and Response Gap

The outlook is exceptionally bleak, with needs expected to escalate further. The rainy season will likely worsen conditions and hinder aid. Despite efforts, the response fails to meet the overwhelming needs. This gap stems from chronic underfunding and pervasive access constraints, including deliberate obstruction. Without immediate, substantial, coordinated international action—securing funding, guaranteeing safe access, protecting civilians, and applying effective political pressure for a ceasefire—Sudan's catastrophe will deepen, condemning millions more to death and deprivation.

Erosion of Humanitarian Principles and International Response

Evidence indicates foundational principles of International Humanitarian Law (IHL) are systematically disregarded with near-total impunity in Sudan. Core tenets—protecting civilians, proportionality, allowing unimpeded aid—are routinely violated. This is seen in attacks on civilians and civilian infrastructure, pervasive SGBV, and obstruction/targeting of aid operations.