22 December 2021 - Sudan is witnessing the fourth wave of the COVID-19 pandemic.
The first case was reported in the country in March 2020. By September 21st 2021 Sudan had more than 85,000 suspected COVID-19 cases -- of which 45,730 confirmed by lab results -- with 3,518 associated deaths. Out of 1,041 health workers tested in Sudan, 64% were positive for COVID-19.
The Sudan Ministry of Health and WHO believe that the actual number of cases is much higher due to weakness in surveillance and other factors including limited testing capacity at the onset of the pandemic and the stigma associated with the disease.
Confirmed COVID-19 cases were reported from the country’s 18 states, with the highest number from the capital Khartoum (28919) -- which represents 60% of all confirmed cases -- followed by the states of Gezira (4233), River Nile (2593) and Red Sea (2029).
The percentage of deaths among the confirmed cases (case fatality ratio) in Sudan is one of the highest in the region (7.69%). The limited capacities of COVID-19 treatment centers do not match the need.
The socio-economic impacts of the pandemic are significant, particularly among the most vulnerable and disadvantaged populations.
COVID-19 vaccination coverage is low in Sudan. Currently, 94% of the people of Sudan are not vaccinated against COVID-19. There are around two million COVID-19 vaccine doses available in the country and a further nine million doses allocated for Sudan in the first quarter of 2022 by GAVI, the vaccine alliance.
Strong support is needed from all stakeholders to rapidly escalate the immunization coverage in Sudan by working on both the supply and demand sides of the process. The Sudan immunization system demonstrated the capacity to deliver by containing the outbreak of a mutated polio vaccine virus (cVDPV2) outbreak in 2020 which had affected 58 children in 15 of the country’s states. While the date of onset for the most recent cases was 18 December 2020, no new cases were reported for 12 successive months. Therefore, I believe that focused and concerted efforts can rapidly improve COVID-19 vaccination in Sudan.
Sudan is in the midst of democratic transition, economic crisis, intercommunal conflicts, a political process facing serious challenges and a fragile health system further pressured by multiple concurrent emergencies in addition to COVID-19 including flood and outbreaks of communicable diseases such as dengue, malaria and Hepatitis E. Accordingly, the obstacles hindering COVID-19 response in Sudan are numerous, chief among them:
- Competing priorities including peace building, economic growth, and the political process. The Sudanese people are facing challenges in livelihood and obtaining basic essential services. Consequently, COVID-19 is not a high priority for them.
- High turnover of government leadership, including the Ministry of Health and EPI manager.
- A fragile health system
- Infodemic and misinformation about COVID-19 leading to high vaccine hesitancy.
- Late availability of the vaccine (March 2021) and receiving it in small tranches, with a two-months vaccine stockout from July to September 2021. The initial programme policy of focusing on vulnerable groups to reduce mortality also affected the general vaccination coverage.
- Pausing the operational support to COVID-19 vaccination after the 25 October challenge to the constitutional order strongly affected the vaccination campaign. WHO had to step in and support the operational cost of COVID-19 vaccination to save more than one million doses at risk of expiring.
WHO is supporting the COVID-19 response plan in Sudan in all the 10 pillars but focusing mainly on surveillance, contact tracing, supporting Rapid Response Teams, expanding laboratory capacity, case management, infection prevention and control and protecting the health workers by providing personal protective equipment (PPE), risk communication and community engagement, as well as rollout of COVID-19 vaccination.
In addition to immediate support of the emergency response, WHO is assisting Sudan in building a resilient health system. A high-level mission visited Sudan in April 2021 followed by another mission of international health system experts in September but due to the current situation in the country, the implementation of the recommendations is unfortunately very slow.
