Médecins Sans Frontières’ (MSF) report, Left Behind in Crisis: Escalating Violence and Healthcare Collapse in South Sudan, highlights the growing barriers to healthcare amid a deteriorating humanitarian situation. Preventable deaths, particularly among women and children, are increasingly common. The report draws on MSF’s direct observations, routine medical data, and testimonies from patients and staff in the areas where the organization operates. Case studies on malaria, cholera, and the ongoing Sudan crisis illustrate overlapping crises rooted in chronic deficiencies in health and essential services. In 2025, political tensions, violence, and insecurity surged, further limiting access to healthcare and basic services. Clashes between government forces, opposition groups, and non-state armed actors, especially in Upper Nile, Jonglei, Unity, Central Equatoria, and Warrap states, included unprecedented attacks on civilians, occurring amid declining international attention and support.
MSF has maintained a presence in South Sudan since 1983, and the country continues to be one of its largest operational contexts. The organization works across six states and two administrative areas, filling critical gaps in healthcare. In 2024, MSF teams provided over 800,000 outpatient consultations and hospitalized 84,800 patients, underscoring the scale of need. Despite these efforts, health services in the country are overwhelmed, with many primary care facilities non-functional, frequent drug shortages, delayed staff payments, and hospitals lacking the capacity for life-saving surgery or emergency maternal care. While these gaps predated recent funding cuts, reduced support has exacerbated structural weaknesses and threatens to worsen the healthcare crisis further.
Conflict has intensified the challenges in healthcare delivery, particularly in regions outside government control. Many facilities have closed, staff have fled, and insecurity has hindered the delivery of medical supplies. Targeted attacks on health facilities and personnel have risen sharply, notably in the Equatorias and Upper Nile. In 2025, MSF alone experienced eight such attacks, leading to the closure of two hospitals in Greater Upper Nile and suspension of primary care activities in Jonglei, Upper Nile, and Central Equatoria.
South Sudan faces overlapping crises of conflict, displacement, flooding, and disease outbreaks, placing additional strain on already limited services. MSF responded to these compounded emergencies by opening 12 new projects in 2025, compared with five in 2024, addressing cholera, malaria peaks, flooding, and displacement. These crises are interconnected, reflecting long-standing gaps in health, water, sanitation, and hygiene services.
MSF calls for urgent international action to address the worsening humanitarian situation. Donors must maintain funding and ensure it reaches communities effectively, prioritizing investment in health and essential services. Health facilities require timely delivery of essential drugs, adequate staffing, and comprehensive care, including secondary services such as surgery and emergency maternal care. The Government of South Sudan must increase its health budget in line with the Abuja Declaration, allocating 15 percent to health.
A shift in humanitarian approach is also critical, with agile and context-sensitive delivery models needed for conflict-affected regions. Protection of civilians and health facilities must be guaranteed under international humanitarian law, ensuring safe passage for medical referrals, supplies, and humanitarian personnel. Donors, regional actors, and the government must reaffirm commitments to humanitarian protection, accountability, and neutral assistance, ensuring that health and humanitarian services are delivered without discrimination or obstruction.
