In 2004 the Sudanese state of Darfur continues to be the site of a growing crisis. Conflict continues between the Sudanese government and rebels of the Sudan Liberation Movement (SLM) and Justice and Equality Movement (JEM).

The Darfur conflict erupted in Feburary of 2003 when the SLM and JEM took up arms against Khartoum, accusing the Arab-dominated government of marginalising and persecuting black African tribes in the region.

The government reacted by arming Arab militia (known as janjaweed) who have been attacking the black Fur, Masalit and Zaghawa. The janjaweed have murdered and raped and uprooted more than 1.6 million civilians from their villages, according to the United Nations.

The conflict has left more than 70,000 people dead since it erupted 22 months ago, aid agencies say.

There have been multiple allegations of rape being systematically used as a weapon to force black African Darfuri tribes to leave the region. Hundreds of thousands more Darfuri may die of starvation if they do not receive humanitarian aid. The US Congress has declared a campaign of genocide to be in progress, and at the beginning of August a UN Security Council resolution called for the Sudanese government to resolve the humanitarian crisis.

Despite UN efforts, includding ceausefire agreements, humanitarian and security protocols, fighting continues in Darfur between government forces and the Janjawid militias on the one hand, and the two rebel groups - the Sudan Liberation Movement/Army (SLM/A) and the Justice and Equality Movement (JEM).

The crisis in Darfur arose just as a long civil war between the government in Khartoum and southern rebels has come to a negotiated close.

Western donors have cut off aid to the government in Khartoum in response to allegations of atrocities during the civil war. The government in Khartoum has also been linked to terrorist organizations, including Al Qaeda. Western donors (including USAID) have provided extensive humanitarian assistance in the rebel-held south of the country, and are currently providing aid in the western state of Darfur.

In spite of all of these difficulties it must be noted that some important malaria-related research has been conducted in Sudan during the last several years. Malaria risks are high throughout Sudan, except along its northern border with Egypt and along the Red Sea coast. The malaria mortality rate in Sudan for children ages 0-4 is 408 per 100,000. Chloroquine-resistant P. falciparum and insecticide-resistance in mosquitoes are growing problems in Sudan.

Sudan's tuberculosis death rate is 49 per 100,000 of all ages. The HIV surveillance system in Sudan is poor and estimates of HIV prevalence in the country range from 1-5 percent.

Sources: The Guardian, July 22, 2004; IRIN Webspecial on the Sudan Peace Process; The Economist, August 31, 2002; United Nations Statistics Division; USAID Health Assessment for Southern Sudan (June 10, 2003); www.Allafrica.com 2004

The WHO has identified Sudan as one of 16 countries in which over half of the world's TB cases occur. The DOTS treatment program for TB is being implemented in the country, and WHO estimates that 81 percent of all TB cases are detected and treated under DOTS protocols.

The government of Sudan is also participating in the Roll Back Malaria campaign, and has designated $4 million to anti-malarial activities in 2002.

Sources: United Nations Statistics Division

Demographic data contained in this section was obtained from the following sources: The Population Reference Bureau’s 2009 World Population Data Sheet was used for total population, life expectancy at birth, infant mortality, fertility, birth rate, death rate, % of married women 15-49 using modern methods of contraception, % of population 15-49 with HIV/AIDS in 2007/2008, and the GNI PPP per capita (2008). Literacy rates were found in the Population Reference Bureau’s publication 2005 Women of Our World. HIV prevalence data for 2001 and 2003 was obtained from the UNAIDS Barcelona 2002 report; HIV prevalence and orphan data for 2005 was obtained from the UNAIDS Report on the Global AIDS Epidemic 2006. Data on the % women who have discussed AIDS prevention with their husband or partner can be found in ORC Macro and USAID’s Women’s Lives and Experiences: Changes in the Past Ten Years (Research Findings from the Demographic and Health Surveys). Childhood malaria mortality data was accessed in 2003 from the United Nations Statistics Divisions’ Millennium Indicators. Tuberculosis data was obtained from the United Nations Statistics Division’s Millennium Indicators: MDGInfo 2006. In some cases information was unavailable.

Between 1998 and 2000 there were reports of government planes bombing civilian hospitals in rebel-controlled territories. A 2003 USAID assessment of the health infrastructure in the south of Sudan concluded that only 30% of the population had local access to health care, and the drug supply system in the south of the country was completely dependent on NGOs. As a result of the war only 400 out of 800 health clinics in southern Sudan are able to operate.

Sources: USAID Health Assessment for Southern Sudan (June 10, 2003), IRIN, March 11, 2004

Juba Teaching Hospital

Tropical Medicine Research Institute (TMRI) ( website )

University of Khartoum, Institute of Endemic Diseases

1. The Population Program of the David and Lucile Packard Foundation has announced a goal of supporting programs in Khartoum State to increase the prevalence of modern contraceptive use from 16 percent to 24 percent in five years, reduce the spread of HIV/AIDS, and otherwise improve reproductive health services. The Packard Foundation has requested proposals for grants to achieve these outcomes. Source: Packard Foundation

2. The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) has approved grants totaling about $50 million to fight HIV/AIDS, tuberculosis and malaria in Sudan. The final grant agreements have not yet been signed, so no funds have been disbursed. The grants include:
   • $7.8 and $8.8 million HIV/AIDS.
   • $14.2 million for malaria

     Source: GFATM