Sudan, a country of about 52 million people, faces severe public health challenges shaped by decades of conflict, economic instability, and underfunded health services. Sudan has a predominantly young population, with a median age of 18.5 years (as of 2025). The total life expectancy for males and females at birth was estimated at 63 and 70 years, respectively, and this is considered the average for least developed countries.The under-five mortality rate declined from 128 deaths per 1,000 live births in 1990 to 77 in 2015 and 52 in 2025. The maternal mortality ratio was 360/100,000 in 2015 compared to 720/100,000 in 1990.
Sudan has a high incidence of debilitating and sometimes fatal diseases, the persistence of which reflects difficult ecological conditions, high levels of malnutrition, an inadequate health-care system, and conflict and violence. Sudan is also susceptible to non-communicable diseases, natural and manmade disasters. Drought, flood, internal conflicts, and outbreaks of violence are quite common, which bring about a burden of traumatic disease and demand for high quality emergency health care.
In 2018, the Human Rights Measurement Initiative estimated that Sudan was achieving only about 62% of its expected performance in ensuring the right to health, given the country's income level. Following the war in Sudan after 15 April 2023, many health facilities, staff and related infrastructure in the country have been severely impacted, with large sections of the population unable to receive health treatment.
History of health care The history of medical research and providing professional medical health care in Sudan can be traced back to 1903 when the Wellcome Research Laboratory was established in Khartoum as a part of Gordon Memorial College.
The reorganization of the services dealing with scientific research in Sudan in April 1935 made the Stack Medical Research Laboratories the official research organ of the Sudan Medical Service, and Dr. E. S. Horgan-Archibald's successor was appointed Director of the laboratories and assistant director (Research) Sudan Medical Service. The Wellcome Tropical Research Laboratories ceased to exist as such, but thereafter continued to operate as the Wellcome Chemical Laboratories. After being placed under the control of the Agricultural Research Service for the following four years, they were transferred back to the Sudan Medical Service in 1939.
Since 1969, the National Public Health Laboratory (NPHL) has been the country's major centre for medical education, training, and research. In the 2020s, the laboratory faced severe challenges during the Sudanese revolution and the 2023 Sudan conflict, forcing a relocation to Port Sudan due to war-induced destruction. Many health facilities, staff and related infrastructure in the country have been severely impacted, with large sections of the population unable to receive health treatment.
Situation in the 21st century Sudan, with an increasingly ageing population and high population growth, faces a double burden of disease, with rising rates of communicable and non-communicable diseases. The Sudan Household Survey 2010 showed that 26.8% of children aged 5 to 59 months had diarrhea, while 18.7% were sick due to suspected pneumonia in the two weeks before the survey was done. Protein energy malnutrition and micronutrient deficiencies continue to be a major problem among children under 5, with 12.6% and 15.7% suffering from severe wasting and stunting, respectively. The most common micronutrient deficiencies are iodine, iron and vitamin A. Concerning the MDGs, 73 [range: 59–88] (Both sexes) out of every 1000 children born do not live to see their fifth birthday. The Maternal mortality ratio per 100,000 live births was estimated at 730 [380–1400] deaths per 100,000 live births in 2010. The MDG target for malaria has been achieved, although it remains a major health problem. In 2010, malaria led to the death of 23 persons in every 100,000 population, while in total, over 1.6 million cases were reported. The annual incidence of new TB cases for 2010 is 119 per 100,000, half of them smear-positive. TB case-detection rate of 35% is well below the target of 70%, but the treatment success rate of 82% is close to the WHO target of 85%. With respect to AIDS, the epidemic is classified as low among the general population, with an estimated prevalence rate of 0.24%, and classified as a concentrated epidemic in two states.
In July 2011, South Sudan separated from Sudan and became an independent country.
Statistics +Vital statisticsPeriodLive births per yearDeaths per yearNatural change per yearCBR*CDR*NC*TFR*IMR*1950–1955452 000233 000219 00046.524.022.56.651601955–1960510 000251 000259 00046.723.023.86.651541960–1965572 000268 000304 00046.621.824.76.601471965–1970647 000281 000365 00046.520.326.36.601371970–1975737 000298 000438 00046.218.727.56.601261975–1980839 000317 000522 00045.117.128.16.521161980–1985950 000339 000611 00043.615.528.06.341061985–19901 043 000361 000682 00041.714.427.36.08991990–19951 137 000374 000763 00040.113.226.95.81911995–20001 242 000387 000855 00038.612.026.65.51812000–20051 324 000373 000951 00036.510.326.25.14702005–20101 385 000384 0001 001 00033.89.424.44.6064* CBR = crude birth rate (per 1000); CDR = crude death rate (per 1000); NC = natural change (per 1000); IMR = infant mortality rate per 1000 births; TFR = total fertility rate (number of children per woman)
+ Ten leading causes of death 2000 2010See Table 1 in 2021 Disease % of total Disease % of total Disease % of total Malaria 19.1 Septicaemia 7.0Ischaemic heart disease Viral pneumonia 6.1 Pneumonia 5.5COVID-19 Malignant neoplasms 4.7 Other heart diseases 5.2Preterm birth complications Iron deficiency anaemias 4.4 Circulatory system 5.0Stroke Streptococcal septicaemia 3.8 Malaria 4.4Lower respiratory infections Heart failure 3.6 Heart failure 4.1Birth asphyxia and birth trauma Tuberculosis 3.4 Renal failure 4.1Road injury Severe malnutrition 3.4 Malignant neoplasm 3.9Malaria Meningococcal infection 3.2 Malnutrition 3.7Measles Coronary heart disease 3.1 Diabetes mellitus 2.6Congenital anomalies
+Life expectancy in yearsPeriodLife expectancyPeriodLife expectancy1950–195544.51985–199055.11955–196047.11990–199556.01960–196549.21995–200057.61965–197051.22000–200559.41970–197553.12005–201061.51975–198054.02010–201563.61980–198554.52015–202065.1
Health policies, systems and financing The socioeconomics of Sudan began deteriorating after the separation of South Sudan. There is still conflict in Darfur, South Kordofan and Blue Nile states. Sudan's economy has suffered a great deal from this: first, from a fall in oil prices and, more recently, from the loss of revenue from South Sudan for oil transportation. In addition, there are continuing sanctions and a trade embargo. Due to these occurrences, funds for health have been cut, adding to the fragility of the health sector. In the past, the health financing system in Sudan has undergone several changes, from a tax-based system in the late 1950s to the introduction of user fees along with social solidarity schemes such as the Takaful system. The social health insurance scheme was implemented in 1995. The private sector also grew exponentially, leading to increased out-of-pocket spending from households. In 2006, free emergency care for the first 24 hours was announced, and the free finance policy for children under 5 and pregnant women was adopted in 2008. Sudan has also reviewed health system financing using the OASIS approach as a prelude to framing its national strategy for health financing. Also, the country has embarked on developing detailed roadmaps for providing universal health coverage to its population.
Health services in Sudan are provided by the Federal and State Ministries of Health, military medical services, police, universities, and the private sector. The districts or localities which are the closest to people are mainly pro policies. Plans in Sudan are produced at three levels: federal, state, and district (also called locality), providing primary health care, health promotion, and encouraging community participation in caring for their health and the environment. They are responsible for water and sanitation services as well. This well-established district system is a key component of the decentralization approach pursued in Sudan, which in turn gives a broader space for local management and administration and allows for overcoming the leadership and supervision efforts by superior bodies.
There is one Federal Ministry of Health (FMOH) and 18 State Ministries of Health (SMOH). The federal level is responsible for the provision of nation-wide health policies, plans, strategies, overall monitoring and evaluation, coordination, training, and external relations. The state level is concerned with state's plans, strategies, and work with federal guidelines for funding and implementation of plans. Meanwhile, the localities are mainly concerned with implementation and service delivery.
The Federal Ministry of Health, Ministry of Veterinary and Animal Resources, and Agriculture and Corps Ministry are members of what is called the Public Health Council, which is the main national legislative body providing regulatory instructions, particularly those regarding zoonotic diseases. A major product of this council is the Public Health Act of 1975. Nevertheless, states and localities are empowered to set their own regulations and laws based on their needs. Additional regulatory bodies are available, including the Medical Council and the Allied Health Council, which are in charge of doctors' and health providers' certification and licensing.
Health service delivery A 2017 review of Sudan’s health system described the structure and performance of health service delivery at that time. According to this assessment, Sudan followed the classical three-tier arrangement of primary, secondary, and tertiary care. Primary health care (PHC) served as the first point of contact and included dressing stations, dispensaries, PHC units, and health centres, with the latter acting as referral points for the lower-level facilities. PHC was intended to provide essential services for the wider community. A standard service package introduced in 2003 covered childhood vaccination, nutrition, reproductive health, integrated management of childhood illnesses, treatment of common diseases, and provision of essential medicines, most of which were delivered through the public sector.
Secondary and tertiary care were provided by a mix of public and private facilities, although private services were concentrated mainly in urban areas. Secondary care encompassed screening, diagnostic, and therapeutic services in health centres and hospitals, while major surgery, rehabilitation, and subspecialty services were largely offered in larger public hospitals, including teaching and specialist hospitals. Patients could often access higher-level hospitals directly without referral, reflecting weaknesses in the referral system.
The 2017 review observed that the number of hospitals had been rising over the previous decade. Health promotion was identified as a key component of primary health care, but remained limited despite widespread health challenges such as communicable diseases, malnutrition, and non-communicable diseases. PHC services were under-utilised. At that time, about 81.6% of PHC units offered childhood vaccination and 67.3% provided family planning, figures that had improved over previous years but were still below recommended levels. The report also noted that while secondary and tertiary facilities had been increasing, the number of PHC units was declining, either because they had stopped functioning or were not keeping pace with population growth.
Impact of the 2023 conflict