JUBA – 9 December 2025 – People in South Sudan are facing a deteriorating humanitarian situation while at the same time international interest and support continue to decline, says a new report titled Left Behind in Crisis: Escalating Violence and Healthcare Collapse in South Sudan by Médecins Sans Frontières (MSF).
Drawing on routine medical data as well as testimonies from patients, caretakers, community members, and healthcare staff living in areas where MSF works, it shares the human impact of a faltering health system and humanitarian response.
This year, violence between government and opposition forces, and non-state armed groups steeply increased, marking the worst escalation since the signing of the 2018 peace agreement. Escalating violence, attacks on health facilities by all parties to the conflict, and access constraints are further impeding the delivery of healthcare and aid. According to UN since January, new waves of violence have displaced over 320,000 people and 2,000 have been killed. In Malakal, between April and November 2025, MSF teams treated 141 trauma patients, including women and children, many with gunshot wounds.
In flagrant violation of international humanitarian law, 2025 also saw a sharp increase in attacks on health facilities by all parties to the conflict. MSF alone experienced eight targeted attacks on its facilities and staff in Central Equatoria, Jonglei and Upper Nile, forcing the closure of two hospitals in Ulang and Old Fangak. On 3 December, our facility was hit by an airstrike in Pieri town, Jonglei State. On the same day, after Pieri, MSF teams witnessed additional airstrikes in Lankien, where MSF also runs healthcare facilities.
Communities are facing multiple overlapping crises: conflict, large-scale displacement, flooding, malnutrition, and disease outbreaks – including the largest cholera outbreak in the country’s history. International support, however, continued to decline in 2025 despite people’s living situations and access to essential services getting worse.
The Health Sector Transformation Project (HSTP), a multi-donor initiative launched in July 2024, remains South Sudan’s main vehicle for healthcare delivery. Led by the government with WHO, UNICEF, and other partners, the project originally aimed to support 1,158 health facilities across 10 states and three administrative areas. However, due to funding constraints, 816 facilities are currently supported under the programme, and even these still face persistent shortages of medicines and staff.
“I travelled from Keurdeng, it took one hour. There is a small health facility [in Keurdeng], but it does not have all the medication – sometimes they finish supplies very fast. I took the child to the health centre, but there was no medication,” a female caretaker in Toch told MSF teams.
Malaria remains a major challenge, continuing to be the leading cause of morbidity and mortality in South Sudan, particularly for women and children. Despite this, for the second year in a row, 2025 saw nationwide stockouts of malaria drugs during peak season. Without timely treatment, malaria can quickly become deadly. Between January and September 2025, MSF teams treated 6,680 people with severe malaria who required hospitalisation.
For years, people in South Sudan have faced some of the world’s highest medical and humanitarian needs. In 2025, the situation in South Sudan has worsened significantly. Rising needs require urgent action: international donors must uphold their commitments to support health and humanitarian efforts, and shortcomings in existing programmes must be urgently addressed.
At a minimum, the timely delivery of essential medicines, supplies, and salaries for health workers need to be ensured. Amidst escalating violence, humanitarian access, protection of civilians, and respect for health facilities must be guaranteed. MSF also calls on South Sudan’s government to raise the national health budget in line with its Abuja Declaration commitment of allocating 15 per cent to health. Currently, only 1.3 per cent of the national budget is allocated to health.
“The situation in the country is catastrophic,” says Lamberg. “The urgent needs of people in South Sudan demand coordinated action, renewed commitment, and genuine international solidarity. The world can’t look away, especially not now.”
