With US Distracted, India Must Lead Charge to Help Ease Sudan's Cholera Crisis

Whille Gaza starves in public, a major healthcare crisis in Sudan has gone largely unnoticed, writes C Uday Bhaskar.

To add to the misery that the 51 million people of Sudan are already facing amid protracted conflict, a virulent cholera outbreak has been spreading and has been described as the worst of its kind in decades.

(Photo: Twitter/WHO)

Even as global attention is focused on the heart-rending starvation deaths of babies and children in Gaza and the raging war in Ukraine, the rapidly unfolding human tragedy in Sudan has gone largely unnoticed.

Sudan is in the middle of a bitter civil war that began in April 2023 after a bloody power struggle between the Sudanese army and the paramilitary Rapid Support Forces (RSF), leading to a massive humanitarian crisis. Since this conflict began, it has been estimated that more than 60,000  people have died, 12 million displaced from their homes, and about 4.5 million refugees have sought shelter in neighbouring countries.

To add to the miseries that the Sudanese people, a population of 51 million, are already facing, a virulent cholera outbreak is spreading and has been described as the worst of its kind in decades.

What's Happening in Sudan?

Doctors Without Borders/Médecins Sans Frontières (MSF), which works in the country, has reported that since the outbreak was declared by the Sudanese Ministry of Health one year ago, there have been 99,700 suspected cases and more than 2,470 related deaths (as of 11 August) and this figure is increasing.

The outbreak was declared as a major public health challenge in August  2024 and has since spread to 84 localities.

This rapid outbreak  of cholera is fueled by contaminated water sources, damaged sanitation systems and displacement from war -  with almost 90 percent of hospitals in conflict zones deemed non-functional. Heavy rains and flooding since June 2024 have worsened basic human security conditions (lack of sanitation)  thereby further contaminating drinking water.

Malnutrition is exacerbating the crisis, with 40 percent of Sudanese children affected, adding to theie existing vulnerability.

UNICEF has warned that over one million children are at risk in Khartoum alone. Immediate response efforts include vaccination campaigns reaching 7.4 million people and water treatment initiatives but experts caution that the collapse of an inadequate health system and limited access to clean water hinder effective containment of the outbreak.

To summarise, the cholera outbreak situation is very critical, with risk of further spread to neighboring countries like Chad and South Sudan.

The WHO has sought to provide necessary assistance by way of supplying vaccines but the scale of the human displacement in Sudan and the limited protection period that vaccinations offer has made the challenge of containing the infection even more difficult.

Troubled History of Conflict

It merits recall that undivided Sudan was the largest country in Africa by area (2.5 million sq km) and rich in natural resources. These included substantial oil reserves, vast amounts of gold, copper, iron ore, natural gas, large tracts of arable land and more significantly, vital water resources from the Nile.

However, the country was plagued by political instability and civil wars since it acquired independence in 1956  and the first Sudanese civil war lasted till 1972.

The causes for this prolonged conflict arose from tensions between the Arab-Muslim dominated government in Khartoum and the predominantly non-Arab, Christian, and animist populations in southern Sudan. The grievances of the southern regions included political marginalisation, economic neglect, and attempts at Arabisation and radical Islamisation in the backdrop of a festering civil war.

The 1972 Addis Ababa Agreement ended the war, granting southern Sudan regional autonomy and representation in the national government. However, the agreement’s implementation was shaky, setting the stage for future conflict and the ultimate secession of the southern provinces which became a new nation – South Sudan in 2011.

The human security situation in Sudan is grim and the country needs sustained external assistance. A US-led initiative, the Advancing Lifesaving and Peace in Sudan (ALPS) group met in Geneva on 14 August, focusing on the broader political crisis and the humanitarian issues exacerbated by the ongoing civil war.

This group  comprising the US, Switzerland, Saudi Arabia, Egypt, the UAE, the African Union and the United Nations has  secured commitments from the Sudanese Armed Forces (SAF) and Rapid Support Forces (RSF) to open two key humanitarian access routes: the Western border crossing in Darfur at Adre and the Dabbah Road from Port Sudan. These routes are critical for delivering emergency food, medicine, and supplies to areas like Darfur, where cholera cases are rising.

However, the aid committed is modest and the immediate emergency help to quarantine the cholera outbreak is of a much higher order.

An emergency infusion of US $5 million has been made available but the total requirement is more than $50 million.

India's Role as Regional Sherpa

With the UN already overwhelmed, resource deprived (the US has cut funding)  and plagued by bitter discord among the major powers over Ukraine and Gaza, it is unlikely that they can reach a swift consensus on helping Sudan in an effective manner.

Given the turbulence triggered by US President Donald Trump and the cessation of humanitarian aid to nations like Sudan, there is a strong case for India, Japan and China to demonstrate their commitment to the Global South.

It is an opportunity to test their ability to work together, when a humanitarian crisis is to be responded to and the US is distracted with its own domestic kerfuffle.

Sudan can be an opportunity for a few like-minded nations with appropriate resources and human resource competence to step in with vaccines, medicines, doctors and paramedics to quarantine the cholera outbreak so that it does not spread. Concurrently complementing the efforts of the WHO, UNHCR  and MSF would be invaluable.  

India should lead the Sherpa effort and burnish its own profile as a first responder to regional human security challenges - in this case the cholera outbreak in Sudan.

This is not only essential to curtail the current spread from becoming a larger humanitarian crisis. It's also a significant area for India to showcase its soft power as a regional 'big brother' when it comes to global health crisis. India's vaccine diplomacy during the Covid-19 pandemic is exemplary of how such a move can enhance its global influence and strengthen international relations. 

Port Sudan on the Red Sea beckons an aid flotilla. The world must remember that, after all, it could have been the Quad.

(C Uday Bhaskar is a leading expert on strategic affairs. He is currently Director, Society for Policy Studies. This is an opinion piece. All views expressed are the author’s own. The Quint neither endorses nor is responsible for them.)