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International donors, the UN, Sudan’s warring parties and their allies must act now to prevent even more avoidable deaths from malnutrition in Sudan, as the already catastrophic situation is expected to worsen this year, according to Médecins Sans Frontières (MSF).

Half of Sudan’s population faces high levels of acute food insecurity (24.6 million people), among whom 8.5 million people face an emergency or famine-like situation according to the latest Integrated Food Security Phase Classification (IPC) report.

“Despite this new wake-up call, robust humanitarian and diplomatic mobilisation to act on aid deliveries has fallen far short of the needs. To provide only those in the most extreme situation with monthly food rations, 2,500 aid trucks per month would be required, whereas only about 1,150 crossed into Darfur between August and December,” says Stephane Doyon, MSF operations manager.

MSF has released data showing horrific rates of malnutrition in multiple locations, both at the height of Sudan’s lean season last year and as recently as December 2024. The conflict-driven malnutrition crisis has been exacerbated by the continued obstruction of aid by both of Sudan’s warring parties and by the neglectful inertia of the UN and aid system in Darfur. With the seasonal hunger gap coming in May, decisive action must be taken now.

“Parts of Sudan are difficult to work in. But it is certainly possible, and this is what humanitarian organisations and the UN are supposed to do,” says Marcella Kraay, MSF emergency coordinator, speaking from Nyala, South Darfur state.

“In places that are easier to access, as well as in the hardest to reach areas like North Darfur, options like air routes remain unexplored. The failure to act is a choice, and it’s killing people,”  says Kraay.

The malnutrition crisis has been acknowledged for some time, with the UN in October warning that “never in history have so many people faced starvation and famine as in Sudan today.”

Moving supplies will become an even more difficult task during the upcoming rainy and lean season, when flooded dirt roads become impossible to navigate. A wide-scale humanitarian response must be launched now, including by drastically increasing available funding and logistical capacities, securing food pipelines and prepositioning food stocks in Chad and neighbouring countries.

MSF is calling for UN agencies, international organisations, donor countries, and governments with leverage to pursue all options, including air routes, to complement and even replace road access where necessary.

Bureaucratic requirements from the warring parties have long been an obstacle to international organisations’ ability to reach and provide services to people. Rather than reacting to critical needs in a timely manner, permissions to respond are either delayed or denied altogether by the warring parties. This is impeding MSF ‘s work in South Darfur with aid trucks stuck in Chad waiting for permissions to move from the Rapid Support Forces (RSF) and their offices. A food distribution in South Darfur was also recently postponed as MSF was refused the necessary travel permits.

Warring parties must grant unhindered access for humanitarian organisations. Access must be defined by lifesaving aid reaching people who need it, not by announcements celebrating piecemeal measures that fall far short. MSF calls for the warring parties, their allies, and influential states to use their leverage to ease the obstacles that are causing deaths and suffering.  
MSF has provided data from different locations to demonstrate the depth of the malnutrition crisis. In North Darfur, where an RSF siege on its capital El Fasher is starving people and depriving them from lifesaving assistance, MSF teams screened over 9,500 children under five years old while conducting a therapeutic food distribution in Tawila locality in December 2024. They found a staggering global acute malnutrition estimate of 35.5 %, with 7% of the screened children suffering from severe acute malnutrition.

Last September, 34% of the 29,300 children screened by MSF during a vaccination campaign in Zamzam camp were found to be suffering from acute malnutrition. Since the beginning of December, repeated shelling has made it impossible for our team to carry out further assessments in the camp and has most likely exacerbated the levels of malnutrition.

MSF teams also see concerning rates of malnutrition outside of Darfur, in areas where displaced people have sought shelter, or in areas closer to the conflict. In Omdurman, Khartoum state, a conflict zone under control of the Sudanese Armed Forces, MSF carried out a nutritional screening while assisting with a vaccination campaign for children in October 2024, finding 7.1% of children screened were severely acutely malnourished.

MSF data also reveals that malnutrition is not only an issue for people close to frontlines, but also in more stable cities like Nyala, the capital of South Darfur. In October 2024, 23% of children under five screened at MSF-supported facilities in Nyala, South Darfur’s capital, and nearby locations were suffering from severe acute malnutrition. In two MSF-supported facilities, 26% of the pregnant and breastfeeding women seeking care were acutely malnourished. With WFP food distributions lacking, MSF launched a targeted food distribution in South Darfur in December 2024, providing two months’ food to about 30,000 people.

Zahra Abdullah, 25 years old, received food for her and her son, they live together in the Al Salam displacement camp outside of Nyala city.

“This is not the first war I have experienced, but it is definitely the most devastating to my life. The living conditions here are harsh, and everything is a daily struggle. The aid we receive has somewhat improved our situation. At least now, we finally have a meal in the morning,” says Zahra.

“But even so, the suffering never ends. It starts with finding clean water to drink, continues with trying to provide enough food, and ends with finding a place to sleep. Sometimes I sit alone and think: is this the life I will live forever?” she says.

For millions of people like Zahra, the time is now to act to prevent the situation from becoming ever more dire. MSF will continue to do what it can, but the scale is well beyond the organisation’s capacity to respond. We need to see a massive response now to prevent more death and starvation; timeliness is a matter of survival, not political expediency.