Sudan achieved the world's largest increase in a national vaccination rate in 2025 amid continuing war, according to WHO and UNICEF. Immunization coverage for the first dose of diphtheria, tetanus, and pertussis vaccine rose by 35 percentage points, while coverage for the third dose also climbed significantly.
WHO and UNICEF highlighted this as evidence of what can be achieved when access to health services improves, even during ongoing conflict. UNICEF Sudan provided specifics in a September 7, 2026 report. Coverage for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3), a key indicator of immunization performance, rose from 39 percent in 2024 to 71 percent in 2025, while first-dose measles coverage increased from 46 to 68 percent.
Recovery amid war
WHO and UNICEF reported in a July 24, 2026 presentation that Sudan's immunization program recovered in 2025 as violence continued. When war erupted in April 2023, Sudan's vaccination system was severely damaged. Health workers were displaced, facilities closed or became inaccessible, and vaccine supply routes within the country were cut off. According to vaccine alliance Gavi, the national DTP3 coverage rate fell from 93 percent in 2022 to 59 percent by November 2023. More than 70 percent of health facilities in affected areas stopped functioning, and more than 3 million children went without protection. WHO and UNICEF note that historical estimates are revised annually, making direct comparisons with previous figures difficult. A UNICEF report from August 5, 2026 showed that the number of children reached with vaccines had fallen sharply by 2024. Sudan recorded one of the world's lowest vaccination rates and accounted for 42 percent of all unvaccinated children in the Middle East and North Africa region, contributing to disease outbreaks that killed children. According to WHO and UNICEF definitions, "unvaccinated children" refers to those who have not received a single dose of diphtheria-tetanus-pertussis vaccine; other vaccinations are not included in this category. Health facilities and cold chain infrastructure were damaged or destroyed, and millions of children were displaced, causing many to miss routine vaccinations.
What made recovery possible
UNICEF credits the recovery to an emergency expanded immunization program plan led by Sudan's Health Ministry with support from Gavi, WHO, UNICEF, and other partners. When normal supply routes were severed, a cross-border mechanism through Chad was established to transport vaccines and supplies to western Sudan, helping sustain routine immunization services. Mobile outreach teams brought vaccination services closer to families who could no longer easily reach health facilities. In parts of Darfur and Kordofan, improved security enabled teams to reach previously inaccessible communities, expanding vaccine coverage to 30 percent of the population in those areas. Gavi-financed vaccines, totaling more than 40 million doses, were delivered to Sudan, with around 30 percent routed through Chad to hard-to-reach areas. National campaigns in 2025 and 2026 vaccinated more than 12.5 million children under 15 against measles and rubella, integrating this vaccination into Sudan's routine program. A diphtheria campaign reached more than 2 million people aged 5 to 20 across six high-risk states. More than 8,000 frontline workers, including vaccination staff and cold chain technicians, received performance incentives, while 20,000 additional workers were supported during campaigns. Through Gavi's cold chain optimization platform and additional support, 946 refrigerators and 11 walk-in coolers were installed. Mohammed Al Haboub, a UNICEF immunization specialist, attributed progress to collective action under the emergency expanded immunization program plan.
In global context
Despite the recovery, Sudan's DTP3 rate of 71 percent remains below the global average. Worldwide, 85 percent of infants (110 million children) completed the full three-dose series in 2025, according to WHO and UNICEF. The number of completely unvaccinated children increased since 2019 in Yemen, Sudan, Nigeria, South Africa, and Bangladesh, with conditions worsening in Yemen and Venezuela. More than half of all unvaccinated children live in fragile, conflict-affected, or vulnerable contexts, even though these regions account for only about one-third of the world's child population.
Doctors Without Borders (MSF) teams treated at least 13,000 measles cases in Darfur alone during the first four months of 2026 following six disease outbreaks. In Tawila, measles cases dropped from 957 in January to 40 by late April following a vaccination campaign that reached more than 130,000 people. According to Miriam Alía, an MSF immunization and outbreak specialist, vaccination campaigns work, but their success does not endure without routine immunization services. Coverage has fallen far below 2022 levels nationwide due to collapsed health systems, difficult access to remote areas, and overwhelmed mobile teams. Alía notes that drastic budget cuts and deliberate bureaucratic obstruction by warring parties prevent life-saving vaccines and medicines from reaching those who need them in time.
Conditions needed to secure progress
UNICEF Sudan stated on September 7, 2026 that continued humanitarian access and further investment are essential to build on progress and reach every child, especially in conflict-affected communities. UNICEF had previously stated on August 5, 2026 that sustaining progress requires continuous funding as well as safe, lasting, and unobstructed humanitarian access to children throughout Sudan, including in conflict zones. Without these, recent gains could be lost. According to Health Policy Watch, Gavi's board decided on a new 2026-2030 strategy in December 2025 that reduces funding to WHO and UNICEF by around 30 percent while increasing support for fragile and conflict-affected countries by 15 percent. UNICEF emphasizes that continued humanitarian access and investment are essential to maintain progress. MSF stresses that vaccination campaign successes will not last without rebuilding routine immunization services.