The ongoing conflict in Sudan has severely affected the nation’s healthcare system, leading to significant disruptions in drug supply chains. Murtada Mohieddin, a diabetic patient living in Khartoum North, now struggles to find reliable insulin. His search has become a perilous endeavour, with concerns about the quality and expiry of medications. He notes that even when medications seem intact, they may have been damaged during transport and storage.

Over three years of civil war have devastated hospitals, health centres, and pharmaceutical production facilities across the country. The violence erupted from a power struggle between the Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), resulting in over 50,000 deaths and displacing around 14 million individuals. The war has not only affected healthcare access but has also led to widespread shortages of essential medications.

The World Health Organization (WHO) declared on April 14, 2026, that Sudan is facing the largest humanitarian crisis globally, with 21 million people lacking basic healthcare services among a total of 34 million needing aid. The degradation of local production has led to an influx of smuggled drugs, which are often unregulated and unsafe.

Rise of Smuggled Medicines

In the absence of reliable pharmaceutical supplies, various smuggling networks have emerged, flooding the market with unregulated medications colloquially referred to as “Boko” medicines. These include crucial intravenous treatments for malaria that have been transported without adherence to essential temperature controls or storage conditions, resulting in spoiled medications that may pose additional health risks.

Pharmacists in areas such as Omdurman, near Khartoum, have reported an alarming reliance on these illegally imported drugs. Mutawakil Hamza, a local pharmacist, expressed grave concerns over the dangers posed by these smuggled supplies. He emphasised that most malaria treatments are now obtained through such channels, which significantly endanger patient safety, particularly with intravenous medications that require sterile conditions.

Administering improperly stored or degraded injections can lead to severe health complications, including bloodstream infections and systemic shock. These risks are compounded by the lack of procedural checks in the current chaotic medical environment caused by the ongoing conflict.

Challenges in Medical Supply Security

The almost complete collapse of local pharmaceutical manufacturing has reversed years of progress towards medical self-sufficiency in Sudan. Yasser Ahmed Youssef, a pharmaceutical industry expert, lamented the contrast to the pre-war era, when Sudanese factories produced large quantities of essential medicines for various health conditions. Today, most production lines are inactive, leaving the population reliant on a collapsing healthcare system.

A report from the Health Resources and Services Availability Monitoring System (HeRAMS) in October 2025 indicated that 40 per cent of health facilities in the country are nonoperational. In Khartoum, the situation is even direr, with 87 per cent of health facilities reportedly closed. In North Kordofan, 85 per cent of health centres are also shut down due to ongoing hostilities.

Emergency reports from the United Nations highlight that areas like el-Fasher, which is largely cut off, face critical shortages of medicines. The only operational maternity hospital there is at risk of closure, impacting thousands of lives. The National Medical Supplies Fund has claimed efforts to secure essential medicines, but ongoing violence severely hampers these initiatives, as armed groups continue to target healthcare facilities and supplies.

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