The UN Children’s Fund (UNICEF) reports that 15 million boys and girls require support, up from 7.8 million at the start of 2023 – the year fighting erupted between the Sudanese Armed Forces (SAF) and former ally the Rapid Support Forces (RSF).

UNICEF said violence by warring parties against children, hunger and disease are surging, while displacement continues to disrupt lives. This is happening as both humanitarian access and funding are shrinking and as the rainy season approaches in May. 

Step up support

“With the rainy season around the corner, children who are already reeling from malnutrition and disease will be harder to reach,” said UNICEF Executive Director Catherine Russell. 

She urged the international community “to seize this pivotal window for action and step up for Sudan’s children.”

Sudan is currently the world’s largest humanitarian and child displacement crises. More than 30 million people overall need humanitarian assistance this year.

Young lives uprooted

The conflict has forced 12.4 million people to flee their homes and seek safety either elsewhere in Sudan or across the border.  More than half are children, with nearly a third under the age of five. UNICEF noted that in areas where people can return, unexploded ordnance and limited access to essential services put children’s lives at heightened risk. Meanwhile, famine is spreading, vaccination rates are dropping, and about 90 per cent of children are out of school.

The situation is being compounded by a deadly combination of interlinked factors, such as a ten-fold surge in the number of grave violations against children, namely killing and maiming; abduction; recruitment and use in hostilities; rape and other forms of sexual violence; attacks on schools and hospitals; and the denial of humanitarian access.

While grave violations were previously confined to regions such as Darfur, Blue Nile and South Kordofan, incidents have now been verified in more than half of Sudan’s 18 states.

The most recurrent verified grave violations include killing and maiming, abductions and attacks on schools and hospitals, with the highest numbers reported in the Darfurs, Khartoum, Aljazeera and South Kordofan.

Famine and disease

Furthermore, famine has been confirmed in 10 locations, according to the UN World Food Programme (WFP), with more places at risk. With the rainy season looming, UNICEF warned that some localities are also vulnerable to flooding. 

The agency recalled that between 2022 and 2024, around 60 per cent of annual admissions for severe acute malnutrition occurred during the rainy season, meaning that up to 462,000 children could be affected this year if the trend holds.  

Disease outbreaks are also expected to surge. Last year, 49,000 cholera cases and more than 11,000 cases of dengue fever were reported, mainly affecting mothers and children. 

Outbreaks are worsened by the effects of the rainy season, including water contamination, poor sanitation, and increased displacement and population movement.

Funding shortfall fears

At the same time, humanitarian access to children in Sudan is deteriorating due to the intensity of the conflict and restrictions or bureaucratic impediments, whether by the Government authorities or other armed groups.

Funding for life-saving services is also critically low, putting essential health, nutrition, education and protection programmes at risk. 

UNICEF is appealing for $1 billion for its operations in Sudan in 2025, which works out to just $76 per person for the year, or 26 cents per day. Currently, $266.6 million is available, though most of the funding was rolled over from 2024 with just $12 million received this year.

Last year, UNICEF and partners provided psychosocial counselling, education, and protection services to 2.7 million children and caregivers. They also reached nearly 10 million children and families with safe drinking water and screened 6.7 million youngsters for malnutrition, providing lifesaving treatment for 422,000 of them. 

“Sudan is the biggest humanitarian crisis in the world today, but it is not getting the world’s attention,” said Ms. Russell. 

“We cannot abandon the children of Sudan. We have the expertise and the resolve to scale up our support, but we need access and sustained funding. Most of all, children in Sudan need this horrific conflict to end.” 

The conflict, between the Sudanese Armed Forces (SAF), and the paramilitary Rapid Support Forces (RSF), is the cause of a major humanitarian crisis, not only in the country itself, but also in neighbouring States. The crisis has proven to be particularly dangerous for people who have already been driven from their homes and, according to the UN refugee agency, UNHCR, thousands are fleeing the country every day.

The situation within the country is dire: attacks on Sudanese displacement camps in the North Darfur region, currently the hotspot of the conflict, have resulted in multiple civilian casualties, and the UN has made an urgent call for action to prevent widespread famine.

Out of a population of some 50 million, almost 25 million Sudanese face acute food insecurity, and the number is expected to grow. “With the rainy season starting soon, and flooding along key routes likely to compound access challenges, time is running out,” Stéphane Dujarric, the UN Spokesperson, warned

1. Over 3 million have fled the country

As of this year, Sudan is the largest displacement crisis in the world. “Today, one-third of Sudan’s entire population is displaced. The consequences of this horrific and senseless conflict spread far beyond Sudan’s borders,” said Filippo Grandi, UN High Commissioner for Refugees, in February.

In total, around 3.8 million refugees have crossed Sudan’s borders, creating a significant crisis: they are often extremely vulnerable, facing shortages of food, water, and medical care. The UN expects that number to rise by about one million in 2025.

The countries surrounding Sudan were already barely managing to cope with mass displacement before the war – just the latest in a series of conflicts and periods of instability stretching back to the 2003 Darfur crisis – erupted in April 2023.

These countries are already hosting large refugee and internally displaced populations and their humanitarian programmes are severely underfunded. Moreover, those leaving Sudan are arriving in remote locations, which makes it difficult to get access to them.

Chad and Egypt have received the biggest numbers: Egypt is currently hosting around 600,000 Sudanese and in Chad over 700,000 have been registered (the Chadian government has estimated that this number could rise to almost one million by the end of 2025).

2. Struggle to maintain basic services

Neighbouring countries are struggling to cope with the increased demand on healthcare, education and other basic services. According to the UN aid office, OCHA, the influx has overwhelmed health facilities in Chad, Egypt, Ethiopia and South Sudan, where medicines, supplies and personnel are in short supply.

The lack of clarity over the level of donor contributions this year has added an extra layer of uncertainty for those concerned. For example, it has forced UNHCR to suspend all medical treatment for refugees who crossed the northern border to enter Egypt. This means suspending procedures such as cancer surgery, heart operations and medication for chronic diseases, affecting some 20,000 patients.

3. Ideal conditions for the spread of disease

The World Health Organisation (WHO) warned in 2024 that the situation in Sudan was approaching a “perfect storm,” because of a barely functioning health system, large numbers of people sheltering in overcrowded areas lacking access to water and sanitation, food and the most basic services.

As expected, the collapse of healthcare infrastructure has led to the spread of diseases, which have crossed borders and affected neighbouring countries hosting large numbers of refugees, who have a greater vulnerability to preventable diseases, due to plummeting vaccination rates in Sudan. Humanitarian partners have reported increased disease cases and concerns for outbreaks, particularly in border areas and shelter sites.

4. Growing insecurity

The countries surrounding Sudan (Egypt, Libya, Chad, South Sudan, Ethiopia, Eritrea and the Central African Republic) were all grappling with their own domestic crises before the war, such as internal conflict, hunger and disease.

The conflict has led to increased violence and instability in border regions, and there have been reports of cross-border fighting. In Chad, the flow of weapons and the presence of armed groups have reportedly increased violence and insecurity, whilst a militia group in South Sudan is reported to have allied itself with the RSF in Sudan, one of the parties to the war.

5. Sexual violence – scars of Sudan’s war

Sexual violence is also being weaponised in Sudan’s conflict, putting millions of children at risk. The brutal reality of this violence, and the fear of falling victim to it, is pushing women and girls to leave their homes and families, only to face further dangers as they become internally displaced and cross borders requiring medical and psycho-social services..

UNICEF reported in March that girls often end up in informal displacement sites with scarce resources, where the risk of sexual violence is high. Of the reported child rape survivors, 66 per cent are girls.

Meanwhile, boys face their own difficulties. With deep-seated stigma, reporting sexual assault presents its challenges, making it harder to seek help and access services.

Shockingly, 16 of the survivors were under five years old, including four one-year-olds.

6. Economic disruption, rising regional poverty

The conflict has disrupted trade routes and economic activities, affecting the livelihoods of people in neighbouring countries, leading to increased poverty and economic hardship.

In Ethiopia and Egypt, border restrictions and insecurity along trade corridors has led to increased transportation costs and a big drop in cross-border economic activity, whilst in Chad and South Sudan, the massive influx of refugees has diverted resources from other critical areas of the economy.

“Al Ahli Hospital is out of service,” WHO spokesperson Dr Margaret Harris told UN News, after the airstrike early on Sunday morning. “The pharmacy was destroyed, many of the different buildings and services were destroyed.”

Some 40 patients whose condition is too critical to be moved from the health facility are continuing to receive care, while the 50 other remaining patients – including the child who died – were evacuated to other medical centres shortly before the attack began.

Supplies now critically low

The situation remains critical and medical supplies of all kinds are now “desperately low”, WHO’s Dr Harris said, before expressing deep concern for the safety of health personnel at the stricken hospital. Until Sunday’s strike, Al Ahli was the main hospital dealing with the casualties from Israeli airstrikes. Now, most casualties are sent to Al Shifa Hospital in Gaza City.

The UN health agency says that only 21 of Gaza’s 36 hospitals now remain partially functional. Almost all of them have been damaged in the war, sparked by Hamas-led terror attacks on Israel in October 2023 in which some 1,250 people were killed and more than 250 taken hostage.

Leading condemnation for the attack and repeating calls for a ceasefire, WHO chief Tedros Adhanom Ghebreyesus insisted that hospitals have special protection under international humanitarian law: “Attacks on health care must stop. Once again we repeat: patients, health workers and hospitals must be protected. The aid blockade must be lifted.”

Aid teams highlighted how the hospital strike has already put “an immense additional strain” on the war-shattered enclave’s remaining partially operational hospitals.

“Mass casualty events are now the norm and those hospitals that are treating trauma patients are doing so amid severe shortages of critical supplies, including critical medicine,” Olga Cherevko from the UN aid coordination office, OCHA, told UN News.

It has now been seven weeks since crossings were closed to all relief supplies meant for the people of Gaza, and nearly a month since Israeli bombardment resumed in the enclave amid disagreement between Israel and Hamas over the terms of a ceasefire extension that include the release of all hostages and the withdrawal of Israeli troops.

According to OCHA, more than 390,000 people have been displaced since Israeli bombing began again on 18 March.

In recent days, top UN officials have rebuffed Israeli assertions that there was enough food to feed all Palestinians, insisting that they were “far from the reality on the ground”. The global body’s top emergency relief official, Tom Fletcher, also stated that aid teams are “deliberately blocked from saving lives in Gaza”, leading to further civilian deaths.

According to the Gazan health authorities, well over 50,000 Palestinians have been killed and 115,688 Palestinians injured during the conflict. This includes 1,449 people killed and 3,647 injured since the escalation of hostilities on 18 March.

“Supplies that we had are rapidly running out and we’re running out of food of medicine, of shelter and every other life-critical item if the situation does not change immediately,” Ms. Cherevko stressed. “The catastrophe that is in Gaza will become worse and the needs of the people will become even higher. This cannot continue. Civilians must be protected and the crossings must be reopened immediately.”