Cholera is an ancient disease, but it is also one of the most preventable and treatable infectious diseases known to medicine. With safe drinking water, adequate sanitation, timely surveillance, vaccination and rapid access to treatment, countless infections and deaths can be avoided. Yet Sudan’s devastating cholera outbreak of 2024 and 2025 demonstrated how quickly those protections can collapse when war destroys the systems that keep communities safe.

According to the World Health Organization, Sudan’s latest outbreak became the deadliest recorded in the country’s modern history. Cholera spread across all 18 states for the first time, causing more than 124,000 reported cases and approximately 3,500 deaths. Behind those numbers were displaced families, exhausted health workers and communities struggling to find something as basic as clean water.

Sudan has experienced repeated cholera outbreaks for decades. Major outbreaks occurred in 2006, from 2016 to 2018 and again in 2019. Historically, heavy seasonal rains, inadequate sanitation and fragile water infrastructure helped create the conditions for transmission. But the war that began in April 2023 between the Sudanese Armed Forces and the Rapid Support Forces fundamentally changed the pattern.

Instead of following seasonal cycles alone, cholera increasingly followed the routes of conflict and displacement.

During the outbreak, medical teams observed significant increases in cases in places including Port Sudan, El-Gedaref, Khartoum and Kosti. Some of these surges occurred during the dry season, before the rains that would normally be expected to accelerate the spread of waterborne disease. This shift was a warning that the determinants of cholera were no longer simply environmental. They were increasingly connected to the destruction and disruption caused by war.

Kosti, in White Nile state, offers a particularly stark example.

In February 2025, a strike damaged the power station supplying the city. The resulting loss of electricity disrupted the water treatment system,........

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