supplies

Stronger Food System Offers Cushion Against El Niño

Near-record food inventories, advances in agricultural technology and the emergence of major exporters such as Brazil and Russia have made the global food system more resilient to this year’s potentially powerful El Niño than during previous severe episodes.

Global agricultural production has generally outpaced consumption and population growth since the 1980s, according to the UN Food and Agriculture Organization (FAO) and analysts.

Higher-yielding crop varieties, increased fertiliser use, improved irrigation and better crop protection have significantly raised production of major staples including rice, wheat, corn and soybeans.

“Even during drought conditions, better irrigation management and crop science mean we can still produce marketable yields,” said Andrew Whitelaw of Australian agricultural consultancy Episode 3.

While El Niño can still disrupt global supplies and push prices higher, improved agricultural preparedness means the consequences could be less severe than during previous major events.

El Niño Gathers Strength

The effects are already being felt across major agricultural regions.

Drier conditions linked to El Niño have disrupted planting across parts of Asia, including India, Southeast Asia and Australia. At the same time, shortages of fertiliser and diesel caused by the Iran war have created additional risks for global agricultural production.

India is experiencing a deficient monsoon season, while Australia’s major wheat-producing regions face the prospect of drier conditions. Crops in Indonesia, Thailand and other parts of Southeast Asia are also suffering from insufficient moisture.

The situation could deteriorate further as El Niño is expected to intensify during the fourth quarter and early next year.

U.S.-based meteorologist Chris Hyde said the event could become one of the strongest on record, meaning the biggest impact from drought may still be ahead.

El Niño is associated with warmer ocean surface temperatures across the eastern and central Pacific. The weather pattern typically produces drier conditions across large parts of Asia while increasing rainfall across the Americas.

Previous major El Niño events in 1997-98 and 2015-16 caused substantial damage to crop production, contributing to food shortages, inflation and weaker economic growth.

Drought pushed up sugar and palm oil prices after damaging production in countries including Brazil, India, Indonesia, Malaysia and Thailand. Tight rice supplies also prompted some Southeast Asian producers to restrict exports.

Australia suffered lower wheat production and exports, while countries in southern Africa were forced to increase corn imports.

Record Inventories Provide a Buffer

One of the biggest differences between previous El Niño events and the current environment is the level of global food reserves.

Near-record grain inventories, drought-tolerant seeds, improved weather forecasting, precision agriculture and better irrigation could help absorb some of the production losses.

India’s crop sowing has broadly recovered from an initial delay, although rainfall during August and September will remain important for crop maturity and grain formation.

India also holds a particularly important position in the global rice market. The country accounts for around 40% of global rice exports and has accumulated such large reserves that storage capacity is being stretched.

China, meanwhile, holds nearly half of global wheat stocks. As the world’s largest wheat producer and consumer, its large reserves could reduce the need for imports if drought damages production in major suppliers such as Australia.

Global palm oil inventories are also near historic highs, although Indonesia’s expanding biodiesel programme is expected to reduce stocks in coming months.

Brazil and Russia Strengthen Global Supply

The emergence of major agricultural exporters that were far less important several decades ago has also increased the resilience of global food markets.

Brazil has become the world’s largest soybean exporter, with shipments increasing more than 13-fold since the 1997-98 El Niño period.

Russia has also emerged as a major wheat supplier, with exports reaching 48 million tons last year compared with roughly 1 million tons in 1997-98.

These additional sources of supply give global markets more alternatives if weather damages production in individual countries.

Agricultural science has also improved. Drought-tolerant corn hybrids have become widely used across Africa and the Americas, while heat- and drought-resistant wheat varieties have gained ground in India and Australia.

Short-duration rice varieties are increasingly being used across South and Southeast Asia, allowing farmers to reduce exposure to increasingly unpredictable monsoon conditions.

Technology Changes the Equation

Farmers today also have access to technologies that were largely unavailable during the 1997-98 El Niño.

Satellite crop monitoring, seasonal climate forecasts, detailed soil-moisture maps and GPS-guided fertiliser application allow farmers to make more precise decisions about planting, irrigation and inputs.

AI-powered agricultural platforms are also increasingly combining weather forecasts, soil information and crop data to advise farmers on planting schedules, irrigation, fertiliser use and pest management.

The result is a food system that can identify and respond to weather risks earlier.

FAO Chief Economist Maximo Torero said governments now have significantly better information and can prepare earlier because forecasting and market transparency have improved.

Wars Could Undermine the Resilience

Despite these improvements, the global food system remains exposed to risks beyond weather.

The wars in the Middle East and Black Sea region could undermine some of the protection provided by stronger inventories and agricultural technology.

The Iran war has disrupted fuel and fertiliser supplies, while higher fertiliser costs could reduce farmers’ ability to maintain production.

Torero warned that much will depend on how conditions develop during the second half of 2026, particularly because agricultural input use has been affected by the Strait of Hormuz crisis.

Before its blockade during the Iran war, the Strait carried around one-fifth of global crude oil and liquefied natural gas supplies. Disruptions to the waterway have therefore created additional pressure on fuel and fertiliser markets.

Analysis: Is the Global Food System Ready?

The biggest takeaway is that El Niño is no longer operating against the same fragile agricultural system that existed during previous major events.

Higher productivity, larger inventories, diversified exporters and better technology provide several layers of protection. If one major producing region suffers a drought, supplies from countries such as Brazil and Russia, combined with existing reserves, can help prevent a sudden global shortage.

However, resilience does not mean immunity.

The greatest risk comes from the interaction between climate shocks and geopolitical disruptions. A powerful El Niño could reduce production at the same time that wars restrict fuel, fertiliser and transport. That combination could rapidly turn a manageable agricultural disruption into a broader food-price problem.

For now, large inventories provide an important buffer. But if the El Niño intensifies as expected while geopolitical disruptions continue to constrain agricultural inputs, the real test will be whether those reserves and technological gains are sufficient to prevent another surge in global food inflation.

With information from Reuters.

WASHINGTON  — Fear was growing in hospitals across the country in 2009 as a frightening epidemic that came to be called the H1N1 swine flu swept across the globe.

From Galveston, Texas, where a hospital ran out of test kits, to Loma Linda University Medical Center in San Bernardino, which had to set up tents to handle a crush of patients, to New York, where hospitals scrambled to bring on extra emergency staff, it appeared the nation’s healthcare system would be overwhelmed.

The worst did not materialize. The lesson, though, was clear: The nation needed larger caches of standby medical supplies and hospitals that were better prepared to handle a surge of infected patients.

A decade later, the coronavirus crisis is exposing many of the same gaps. Inadequate supplies of protective masks, ventilators, intensive care beds and other medical resources are forcing mass closures of schools and businesses and restrictions on everyday activities as public officials rush to slow the virus so America’s medical system isn’t overwhelmed.

“So much that was predicted has come to pass,” said Marcia Crosse, former head of the healthcare section of the Government Accountability Office. Since the early 2000s, the GAO, the federal government’s leading internal watchdog, has issued a steady stream of reports about poor pandemic planning.

As the current crisis has widened, President Trump has attempted to deflect responsibility for his administration’s poor planning, suggesting the coronavirus outbreak was inconceivable.

“Nobody knew there would be a pandemic or epidemic of this proportion,” the president said Thursday.

The opposite is true. The GAO, public health experts and others issued a steady drumbeat of warnings that America would sooner or later face a widespread infectious disease outbreak or a major bioterrorism attack and was woefully unprepared.

In both 2018 and 2019, U.S. intelligence agencies issued insistent warnings in their annual Worldwide Threat Assessment.

“We assess that the United States and the world will remain vulnerable to the next flu pandemic or large-scale outbreak of a contagious disease that could lead to massive rates of death and disability, severely affect the world economy, strain international resources, and increase calls on the United States for support,” the 2019 report noted.

That is only the most recent warning. As early as 2003, the GAO cautioned that many urban hospitals lacked enough ventilators to treat a large number of patients suffering from respiratory problems that would be expected in an anthrax or botulism outbreak.

“Ventilators have long been recognized as a weak link,” said Crosse, who spent 35 years at GAO before retiring in 2018.

Today, a lack of ventilators is emerging as a potentially critical shortfall because patients hit hardest by COVID-19, the illness caused by the coronavirus, often suffer severe respiratory problems.

Federal policymakers concentrated heavily on pandemic preparedness in the aftermath of the 9/11 terrorist attacks and anthrax scare in 2001, which both exposed gaps in the nation’s emergency response system.

In 2005, the administration of President George W. Bush published a landmark “National Strategy for Pandemic Influenza.” The document, among other things, highlighted the need for plans to distribute necessary medical supplies from the nation’s Strategic National Stockpile and to support state and local efforts to “surge” medical personnel and facilities to handle an outbreak.

Medical equipment such as masks and protective clothing in particular were given high priority as planners recognized that doctors, nurses and other medical staff were most vulnerable.

After the swine flu epidemic in 2009, a safety-equipment industry association and a federally sponsored task force both recommended that depleted supplies of N95 respirator masks, which filter out airborne particles, be replenished by the stockpile, which is maintained by the U.S. Department of Health and Human Services.

That didn’t happen, according to Charles Johnson, president of the International Safety Equipment Assn.

The stockpile drew down about 100 million masks during the 2009 epidemic, Johnson said.

“Our association is unaware of any major effort to restore the stockpile to cover that drawdown,” he said.

Last month, Health and Human Services Secretary Alex Azar said that available supplies included just 12 million N95 masks and 30 million surgical masks, a tiny fraction of the 3.5 billion masks one of Azar’s deputies later testified the nation’s healthcare system would need.

Already across the country, there are signs of medical centers running out of protective equipment, compounding the challenges caused by the federal government’s inadequate supply of coronavirus testing kits.

At Sinai Health System, which serves largely low-income patients on Chicago’s South and Southwest sides, hospital officials started signing out masks and other protective equipment as carefully as they handle narcotics.

“We’ve never had to do that before,” said Karen Teitelbaum, the system’s chief executive.

These shortages are particularly appalling, said Jeffrey Levi, a professor at the Milken Institute School of Public Health at George Washington University and former head of the Trust for America’s Health, a nonprofit public health advocacy group.

“Every time we have an emergency, protecting healthcare workers has been the No. 1 policy issue,” Levi said. “To have neglected that is shocking.”

Making the case for investments in material and hospital planning has long been challenging as most people have difficulty envisioning a major disaster, acknowledged Dr. Eric Toner of Johns Hopkins University, an authority on pandemic preparedness.

Hospitals also are under pressure to keep margins thin and eliminate spending on staff and supplies that aren’t used all the time.

The budget crunch represents a particular challenge for so-called safety-net hospitals, institutions that serve many uninsured patients and those covered by Medicaid, and consequently collect less revenue. These same hospitals are now expecting a large surge in coronavirus patients but have limited resources to ramp up staffing and add intensive care beds if needed.

“Cash is very limited,” said Charlie Shields, chief executive of Truman Medical Centers in Kansas City. Shields said the finances are under even more stress since the hospital canceled elective procedures and shut down its dental services to prepare for the pandemic, moves that reduce hospital revenue.

Toner at Johns Hopkins noted these kinds of strains are why the federal government should have provided a stronger backstop.

“The argument we’ve made for 20 years is that if we want to have prepared healthcare institutions, this has to be a societal responsibility, and that means a government responsibility.”

After 9/11, the federal Hospital Preparedness Program was created in 2002 to help hospitals plan for public health emergencies and terrorist attacks.

But as time passed, the program was steadily cut. In 2007, Congress trimmed $44 million from the program’s budget. In 2014, lawmakers cut $120 million.

Overall, money for the program has been slashed by about half since 2003, said John Auerbach, chief executive of the Trust for America’s Health.

Auerbach, who was Boston health commissioner for nine years, said he and other public health officials routinely pleaded with Congress to restore the spending.

He said lawmakers frequently offered the same response: “Do we still need that?”

Ukraine’s military intelligence says North Korea is preparing to deploy a missile unit to western Russia, which would mark another major expansion of military cooperation between Moscow and Pyongyang. The report comes as Kyiv warns its dwindling ballistic missile defenses are costing civilian lives.

Andrii Cherniak of Ukraine’s Main Directorate of Intelligence (GUR) told Reuters that the deployment will involve approximately 90 North Korean personnel stationed in Russia’s Voronezh region — which borders Ukraine — alongside the Russian military’s 112th Guards Missile Brigade. Ukrainian intelligence assesses the unit could ultimately field six launchers and as many as 120 KN-23 and KN-24 short-range ballistic missiles (SRBMs), although the final composition is expected to be determined during senior-level talks next month.

The Ukrainian intelligence assessment has not been independently verified.

If confirmed, the deployment would represent a further deepening of North Korean support for Russia, after supplying Russia with ammunition, smaller numbers of ballistic missiles, and troops.

The Ukrainian Air Force today said Russia launched another major overnight strike combining drones with ballistic missiles. Preliminary figures showed Ukrainian air defenses shot down 98 of the 115 drones launched, but failed to intercept a single ballistic missile. As well as the inherent difficulty of intercepting these threats, this statistic also points to the exhaustion of its Patriot interceptor stockpiles.

The attack killed at least 17 people and injured dozens more after strikes hit multiple locations across Kyiv.

President Volodymyr Zelensky directly linked the casualties to continued shortages of advanced air-defense systems.

“Ballistic missile interceptors could have saved the lives of those killed today,” Zelensky wrote on social media. “It is very important that our partners understand that delays in supplying them, or an unwillingness to provide anti-ballistic systems, lead directly to such horrific casualties and destruction.”

Ukraine has spent months urging Western partners to provide additional Patriot batteries and interceptor missiles, which remain among the few systems capable of defeating ballistic missile threats such as Russia’s Iskander and North Korea’s KN-23 and KN-24. While Ukrainian forces routinely claim to intercept the majority of incoming drones and many cruise missiles, ballistic missiles continue to present one of the most difficult threats to defend against.

Last month, U.S. President Donald Trump suggested Washington might grant Ukraine a license to manufacture Patriot interceptors domestically before later appearing to back away from the proposal, saying the technology was “a hard thing to give away.”

According to Ukraine’s military administration, seven sites across Kyiv were struck during the latest attack, which began shortly after midnight. Zelensky said the primary targets included civilian industrial facilities, among them a brewing company and warehouses storing construction materials.

“Partners who are not yet ready to play a more active role in supplying interceptors can help by implementing new sanctions. A significant share of Russia’s ballistic missile production is still not under sanctions,” Zelensky wrote on X. “Even now. New steps are needed — from the G7, the European Union, and everyone who supports the protection of life. Thank you to those who are willing to help in this way.”

Kyiv Mayor Vitali Klitschko said rescue operations continued throughout the day.

“There may still be people under the rubble,” he said.

Emergency crews rescued two survivors from a destroyed warehouse near the city center. Klitschko said 24 people were injured, including an ambulance driver, while four remained in critical condition. The strikes also ignited multiple fires at warehouses and industrial sites, while Ukrainian authorities reported an ammonia leak triggered by one of the impacts.

The latest attack coincides with what Ukrainian intelligence says was Russia’s first use of North Korean ballistic missiles since August 2025.

Cherniak told Reuters that Pyongyang recently delivered another batch of 40 KN-23 and KN-24 missiles to Russia, along with additional personnel. He said Russia ultimately expects to receive 120 North Korean ballistic missiles and six launchers.

According to Ukrainian authorities, one of the newly delivered North Korean missiles struck the central Ukrainian village of Radushne last week, flattening a residential home and killing at least five members of the same family.

In the strike on Radushne, for the first time in a while, the Russians used a North Korean missile, according to preliminary data. Of course, more examinations will follow, and everything will be verified, but as of now – it is a North Korean ballistic missile. The alliance… pic.twitter.com/UtTTNGwBUb

— Volodymyr Zelenskyy / Володимир Зеленський (@ZelenskyyUa) July 30, 2026

Clearly, any increase in Russia’s ballistic missile inventory poses a serious challenge for Ukraine’s already strained air defenses. The situation is likely to become more difficult heading into the coming winter, when Russia normally steps up its strikes against Ukraine’s electrical grid.

The KN-23, known in North Korea as the Hwasong-11A, is a traditional SRBM that can reach out to around 800 kilometers (497 miles) and has a 500-kilogram (1,102-pound) class unitary high-explosive warhead. It offers greater range than Russia’s 9M723 Iskander SRBM, which carries a similarly sized warhead but has a range of 500 kilometers (311 miles). This weapon has also been fired from adapted railcars, a concept you can read more about here.

As for the KN-24, or Hwasong-11B, this has a range of approximately 410 kilometers (255 miles), making it more of a battlefield support SRBM, but still sufficient for Russia to strike many targets within Ukraine. It is often considered a North Korean analog of the U.S.-made Army Tactical Missile System (ATACMS).

However, the North Korean SRBMs are considered less accurate than their Russian-made counterparts and have been associated with strikes causing significant civilian casualties.

According to a report from Ukrainian state prosecutors, around half of the KN-23s that had been launched by Russia between late December 2023 and late February 2024 not only deviated from their trajectory but also exploded in midair.

An investigation by Conflict Armament Research (CAR) into the wreckage of a KN-23/KN-24 missile used by Russia in Ukraine found that the missile contained more than 290 foreign-made electronic components, with approximately 75 percent linked to U.S. companies, 16 percent to European firms, and the remainder to Asian manufacturers. This suggests that North Korea continues to obtain critical Western technology despite longstanding international sanctions and points to continued limitations in Pyongyang’s high-technology production capabilities.

🚨 🇺🇦🇷🇺🇰🇵 Analysis of the debris from one of the North Korean ballistic missiles fired by Russia at Ukraine found it was constructed with more than 290 non-domestic electronic components. Many of them were produced by US companies in the last 3 years.

This analysis was conducted… pic.twitter.com/YHwwAZG0Wo

— Colby Badhwar (@ColbyBadhwar) February 20, 2024

North Korea first began supplying KN-23 and KN-24 missiles to Russia in late 2023. Cherniak said Pyongyang delivered approximately 150 ballistic missiles between late 2023 and August 2025. Ukraine also says North Korea has supplied millions of much-needed artillery projectiles and deployed around 14,000 troops to Russia’s Kursk region under the countries’ 2024 mutual defense agreement.

Cherniak said roughly 9,500 North Korean troops remain in Kursk but are not currently engaged in combat operations against Ukraine. Zelensky said last month that Russia is seeking an additional 30,000 North Korean troops and is preparing facilities in the Voronezh region to receive them.

Overall, North Korean-supplied missiles make up only a very small fraction of the weapons used in Russian strikes on Ukraine, but there has long been concern about the direction the burgeoning military relationship between Moscow and Pyongyang could take. There have been particular concerns that Russian expertise in the development of ballistic missiles and nuclear weapons — as well as other weapons and technologies — could be provided to North Korea.

North Korea: Kim Jong-un shows unseen nuclear weapons to Russia’s defence minister

The reported new deployment comes as Russia appears to be increasing its reliance on ballistic missiles to exploit one of Ukraine’s most significant military vulnerabilities. With few signs that Russia has been able to further ramp up production of its own Iskander missiles, an increased supply of North Korean ballistic missiles would take advantage of a gap in Ukrainian air defenses and further threaten its cities, energy infrastructure, and other targets. The bigger concern is not simply another shipment of missiles, but the prospect of Russia tapping into an expanding North Korean production base financed by Moscow, allowing it to sustain high-volume ballistic missile attacks for far longer than it otherwise could.

Ukraine’s ability to defeat ballistic missiles of any origin has become increasingly constrained by the availability of interceptor missiles. Patriot remains the primary system capable of reliably engaging Iskander, KN-23, and KN-24 ballistic missiles, but the U.S.-made interceptors are expensive, produced in relatively modest numbers, and are also needed to meet U.S. and allied needs around the world. European-supplied SAMP/T batteries also provide a limited anti-ballistic capability, but have been provided in only limited numbers so far.

Global demand for Patriot interceptors has surged amid conflicts in Europe and the Middle East, straining U.S. and allied inventories and production capacity. Those constraints have become significant enough that Congress has questioned whether the Pentagon can sustain higher transfer rates to Ukraine even as Kyiv presses for more interceptors. Meanwhile, although the United States continues discussing licensed Patriot production with Ukraine, any domestic manufacturing effort would take many months—if not years—to produce missiles in meaningful numbers, leaving Kyiv dependent on allied deliveries for the foreseeable future.

Whether or not the reported North Korean missile unit deployment materializes, the operational trend is becoming increasingly clear. Russia is continuing to expand the scale and complexity of its long-range strike campaigns, pairing mass drone attacks with growing numbers of ballistic missiles specifically intended to exploit one of Ukraine’s most difficult defensive challenges. As Kyiv’s leadership continues to press for additional Patriot batteries and interceptor missiles, the consequences of those shortages are becoming increasingly evident with every large-scale strike.

Contact the author: thomas@thewarzone.com

On a modest bed inside his war-battered home in the Khartoum North neighbourhood of the Sudanese capital, Khartoum, Murtada Mohieddin, a diabetic patient in his early 50s, carefully counts his remaining doses of insulin. His search for medicine has transformed into a harrowing battle – not just to find the treatment he needs to survive his diabetes, but to ensure the medicine is not expired or ruined.

“Sometimes the insulin is spoiled,” Mohieddin tells Al Jazeera, inspecting his limited supply. “You wouldn’t know if it is ruined or expired. You can check the expiration date, but it could still be damaged from poor storage.”

More than three years of civil war have crippled Sudan’s healthcare infrastructure: hospitals, health centres and pharmaceutical factories have been shut and vital medical supply chains and storage across the country have been disrupted.

The war, which erupted as a power struggle between Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has killed more than 50,000 people and displaced 14 million – nearly a quarter of the country’s population.

The devastating conflict has paralysed domestic pharmaceutical production and collapsed vital supply chains across the country.

According to a World Health Organization (WHO) news release dated April 14, 2026, Sudan represents the world’s largest humanitarian crisis, with 21 million people lacking basic healthcare services out of 34 million needing aid.

In the void left by the closure of pharmaceutical companies, smuggling networks have flourished, flooding the market with unregulated drugs locally known as “Boko” medicines.

These include critical intravenous malaria medications smuggled across borders. Because they completely bypass strict temperature controls and quality checks during transit, these drugs are frequently spoiled, rendering them either totally ineffective or lethally toxic to patients.

A double threat

Inside local pharmacies in Omdurman, located on the outskirts of Khartoum, the crisis is not just limited to scarcity. Patients now face the double threat of exorbitant costs and life-threatening quality issues, as these illicit medicines are often severely spoiled due to a lack of proper storage and refrigeration.

Mutawakil Hamza, a pharmacist based in Omdurman, said the reliance on unregulated channels is putting lives at immediate risk.

“Most malaria medicines are now brought in through smuggling,” Hamza said. “These are ultimately injections for intravenous use, and this is highly dangerous to a patient’s health.”

Because intravenous treatments bypass the body’s natural defences and require absolute sterility, administering improperly stored or degraded smuggled injections can rapidly cause severe bloodstream infections, systemic shock, or death.

The war has effectively dismantled local manufacturing, reversing years of medical self-reliance. Yasser Ahmed Youssef, a pharmaceutical industry expert whose factory is located in Khartoum, noted the stark contrast to the pre-war era, when local factories managed to produce “very large quantities of life-saving medicines, including drugs for blood pressure, diabetes, colds, and paediatric care”.

Now, the majority of those production lines are silent, leaving the population dependent on a shattered healthcare system. According to the October 2025 Health Resources and Services Availability Monitoring System (HeRAMS) report cited in a WHO Public Health Situation Analysis from January 6, 2026, 40 percent of health facilities nationwide are entirely nonoperational.

The situation is even more drastic regionally, with 87 percent of facilities shut down in Khartoum and 85 percent closed in North Kordofan, whose control is contested between the rival sides.

In active conflict zones such as Gezira, Khartoum, Darfur and the Kordofan regions, the shortages are particularly dire.

A United Nations Population Fund (UNFPA) emergency report from August 2025 highlighted that the only functioning maternity hospital in the besieged city of el-Fasher faces critical medicine shortages and risks imminent closure.

El-Fasher, the last SAF stronghold in the western region of Darfur, was taken over by the RSF in late October 2025, trapping approximately 700,000 civilians – mostly women and children. People have been cut off entirely from food and medicine and subjected to attacks.

Collapsed warehouses and supply lines

In the government-funded public sector, the National Medical Supplies Fund maintains that it is working to secure essential medicines despite the fighting, claiming to have achieved 75 percent availability for cancer medications and fully secured supplies for kidney patients.

However, officials admit the overarching infrastructure is in ruins, with the local health ecosystem almost destroyed.

“We have been massively affected by the ongoing war inside Sudan,” said Abubakar Salouha, a department director at the fund. “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 from neighbouring countries also face enormous logistical hurdles.

The WHO’s January 6 situation analysis detailed that cross-border transit times for medical commodities can take up to 90 days to reach remote regions like Darfur from the Cameroonian city of Douala via Chad. Compounding these suffocating delays, armed groups have repeatedly targeted medical infrastructure, looting pharmacies and stripping remaining hospitals of their vital medical supplies.

Recent attacks highlight this systematic destruction by rival sides. On March 20, 2026, a drone attack on Al-Daein Teaching Hospital in East Darfur state killed at least 64 people, including medical personnel, and injured 89 others. Sudanese rights group the Emergency Lawyers reported that the army was behind the attack.

On April 2, another drone attack struck Al-Jabalain Hospital in White Nile state, killing 10 staff members, including the hospital’s director while he was performing surgery. That same day, the Family Hospital in el-Daein was looted, and patients and health workers were assaulted and expelled. Similarly, a hospital in Kurmuk, Blue Nile state, was looted on March 25, its equipment destroyed, and patients forced out. The RSF was blamed for these attacks.

“Sudan is confronting one of the gravest humanitarian and public health emergencies in the world today. The ongoing conflict has pushed the health system to the edge of complete collapse,” warned WHO Director-General Tedros Adhanom Ghebreyesus on April 4.

“These incidents are stark reminders of the urgent need for renewed international solidarity and decisive political and humanitarian action. Sudan cannot endure this crisis alone.”