Sudan war cuts off medicine supplies, forcing diabetics to buy ‘spoiled’ insulin on black market
Mohammad Mansour
Over three years of conflict in Sudan have destroyed the healthcare system and domestic drug production, leaving patients dependent on expensive, often damaged smuggled medicines that directly threaten their lives. Diabetics struggle to find insulin that hasn’t spoiled, while smuggled drugs like IV antimalarials pose deadly risks. The WHO warns Sudan faces one of the world’s worst humanitarian crises.
On a modest bed in a war-damaged house north of Khartoum, Murtada Mohieddin, a diabetic patient in his 50s, carefully counts his remaining insulin vials. Finding medicine has become a fight for survival — not just to obtain treatment but to ensure it hasn’t expired or spoiled.
“Sometimes the insulin is already spoiled,” Mohieddin told Al Jazeera as he examined his meager supply. “You can’t tell if it’s spoiled or expired. You can check the expiration date, but it may still be spoiled from poor storage.”
More than three years of civil war have crippled Sudan’s health infrastructure: hospitals, clinics and pharmaceutical factories have closed, and supply chains and cold storage across the country have collapsed.
The conflict between the Sudanese Armed Forces and the paramilitary Rapid Support Forces has killed over 50,000 people and displaced 14 million — nearly a quarter of the population. The fighting has completely destroyed domestic drug production and severed essential supply chains.
According to the World Health Organization (WHO) on April 14, 2026, Sudan is facing the world’s largest humanitarian crisis, with 21 million people lacking access to basic healthcare out of 34 million who need assistance.
Into the void left by shuttered pharmaceutical companies, smuggling networks have thrived, flooding the market with unregulated drugs often called “Boko.” These include critical antimalarial injections smuggled across borders. Because they bypass strict temperature controls and quality checks, they are frequently spoiled, rendering them totally ineffective or lethally toxic.
A dual threat
At pharmacies in Omdurman, a suburb of Khartoum, patients confront exorbitant costs and poor-quality drugs. Mutawakil Hamza, a pharmacist, said: “Most malaria drugs are smuggled. They are IV injections, extremely dangerous to health.” Because intravenous drugs bypass the body’s natural barriers and require absolute sterility, using poorly stored smuggled drugs can cause severe blood infections, systemic shock or death.
The war has wiped out domestic production, reversing years of self-sufficiency in medicines. Yasser Ahmed Youssef, a pharmaceutical expert whose factory was in Khartoum, said that before the war, local plants produced “very large volumes of life-saving drugs, including for blood pressure, diabetes, colds and paediatrics.” Now most of those production lines are silent.
According to a report by the Health Resources and Services Availability Monitoring System in October 2025, 40% of health facilities nationwide were non-functional. The situation is worse in Khartoum (87% closed) and North Kordofan (85% closed) — both contested areas. Shortages are especially severe in conflict zones like Gezira, Khartoum, Darfur and Kordofan.
An emergency report by the UN Population Fund (UNFPA) in August 2025 found that the only operating maternity hospital in the besieged city of el-Fasher was critically short of medicines and at risk of closure. El-Fasher, the last SAF stronghold in Darfur, fell to RSF control in late October 2025, trapping about 700,000 civilians, mostly women and children, completely cut off from food and medicine.
Warehouses and supply lines collapse
The public-sector National Medical Supplies Fund claimed 75% availability of cancer drugs and 100% of drugs for kidney disease. However, Abubakar Salouha, a director at the fund, admitted: “We have been heavily affected by the war. Medical supplies are heavily compromised, and the main warehouses at headquarters have collapsed.”
International aid from neighbouring countries faces major logistical hurdles. A WHO analysis on January 6, 2026, said that shipping medical supplies to Darfur from Douala, Cameroon via Chad can take up to 90 days. Additionally, armed groups routinely loot hospitals and drug depots.
Recent attacks reveal systematic destruction. On March 20, 2026, a drone strike on Al-Daein General Hospital in East Darfur killed at least 64 people, including health workers, and wounded 89. Sudan’s Emergency Lawyers group blamed the military for the attack. On April 2, 2026, another drone strike targeted Al-Jabalain Hospital in White Nile, killing 10 staff, including the hospital director, while he was performing surgery. The same day, the Family Hospital in el-Daein was looted, with patients and staff assaulted and expelled. A hospital in Kurmuk, Blue Nile, was looted on March 25, equipment destroyed and patients driven away. RSF is alleged to be behind these incidents.
“Sudan is facing one of the most severe humanitarian and public health emergencies in the world. The conflict has pushed the health system to the brink of total collapse,” WHO Director-General Tedros Adhanom Ghebreyesus warned on April 4. “These incidents are a stark reminder of the urgent need for international solidarity and decisive political and humanitarian action. Sudan cannot endure this crisis alone.”
