As Sudan grapples with the aftermath of a prolonged civil war, the challenges faced by its healthcare system have grown increasingly dire. With hospitals shuttered and medicine supplies dwindling, the plight of patients—like Murtada Mohieddin, who struggles to secure life-saving insulin—highlights the urgent humanitarian crisis gripping the nation. Amid this turmoil, the emergence of unregulated drugs poses a significant threat to the well-being of those in desperate need of medical treatment.
In a modest bed within his war-torn home in the Khartoum North neighborhood of Sudan’s capital, Murtada Mohieddin, a diabetic patient in his early 50s, meticulously counts his remaining doses of insulin. His quest for treatment has turned into a harrowing struggle—not only to find the necessary medicine for his diabetes but also to ensure that it is not expired or damaged. “Sometimes the insulin is spoiled,” Mohieddin explains, noting the difficulty of assessing the quality of his limited supply. “You can check the expiration date, but it could still be damaged from poor storage.”
More than three years of civil conflict have devastated Sudan’s healthcare infrastructure. Hospitals, health centers, and pharmaceutical factories have closed, disrupting vital medical supply chains across the country. The war, which ignited as a struggle for power between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has led to the deaths of over 50,000 people, displacing approximately 14 million—nearly a quarter of the population.
This unprecedented crisis has not only crippled local pharmaceutical production but also instigated a flourishing of smuggling networks that inundate the market with unregulated drugs, often referred to as “Boko” medicines. A myriad of critical intravenous malaria medications is now smuggled across borders, typically bypassing crucial temperature controls and quality checks. Consequently, these drugs frequently spoil, leaving patients vulnerable to ineffective or dangerously toxic treatments.
Inside local pharmacies in Omdurman, a city bordering Khartoum, the issue extends beyond mere scarcity. Patients are confronted with exorbitant prices and grave quality concerns, as illicit medicines suffer from improper storage conditions. Mutawakil Hamza, a pharmacist based in Omdurman, emphasizes the dangers posed by unregulated channels. “Most malaria medicines are now brought in through smuggling,” he cautions. “These are ultimately injections for intravenous use, and this is highly dangerous to a patient’s health.”
The ongoing conflict has effectively dismantled local manufacturing capabilities, reversing years of progress in medical self-reliance. Pharmaceutical industry expert Yasser Ahmed Youssef, whose factory is located in Khartoum, contrasts the current lack of production with the previous stability when local factories provided substantial quantities of essential medicines, including those for diabetes, hypertension, and pediatric care. Currently, many production lines stand silent, leaving the population at the mercy of a shattered healthcare system.
Recent assessments indicate that 40 percent of health facilities nationwide are completely non-operational. In regions such as Khartoum, the figure rises to a staggering 87 percent, while 85 percent remain closed in North Kordofan—an area contested by both rival factions. In conflict zones like Gezira, Khartoum, Darfur, and the Kordofan regions, the shortages are particularly acute.
According to a United Nations Population Fund (UNFPA) emergency report from August 2025, the only functioning maternity hospital in the besieged city of El-Fasher faces severe medicine shortages and risks imminent closure. El-Fasher, the last SAF stronghold in western Darfur, was taken over by the RSF in late October 2025, entrapping around 700,000 civilians—primarily women and children—who have been cut off from essential food and medical supplies amid ongoing attacks.
Despite the chaos, the National Medical Supplies Fund, funded by the government, insists it is working to secure essential medicines. Officials report achieving 75 percent availability for cancer medications and adequate supplies for kidney patients, although they acknowledge that the overarching infrastructure is severely compromised. Abubakar Salouha, a department director at the fund, admits, “We have been massively affected by the ongoing war inside Sudan. The medical supplies have been severely impacted; there has been a collapse at the level of the main warehouses at the headquarters.”
International aid deliveries face immense logistical hurdles, with the World Health Organization (WHO) reporting that cross-border transit times for medical supplies can extend up to 90 days for remote regions like Darfur. These delays are exacerbated by ongoing attacks on medical infrastructure, which have seen pharmacies looted and hospitals stripped of vital medical supplies.
Recent assaults underscore the systematic destruction inflicted by both sides in the conflict. A drone attack on Al-Daein Teaching Hospital in East Darfur on March 20, 2026, resulted in the deaths of at least 64 individuals, including medical personnel, while a subsequent attack on Al-Jabalain Hospital in White Nile state killed ten staff members. Both incidents highlight the urgent need for renewed international solidarity and decisive humanitarian action.
WHO Director-General Tedros Adhanom Ghebreyesus warned on April 4 that Sudan is facing one of the most severe humanitarian and public health emergencies globally. He emphasized the crucial need for coordinated international efforts, stating, “Sudan cannot endure this crisis alone.”
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