South Sudan is currently experiencing its largest-ever cholera outbreak, with confirmed cases reported across multiple states. According to the World Health Organisation (WHO), from September 28, 2024, to April 11, 2025, 48,726 cases, including 919 deaths, have been reported.
Cholera is spreading in areas where access to clean water, sanitation and hygiene is already limited. Many of the affected locations are also host to large populations displaced by flooding or conflict. The result is a growing public health crisis, emerging in one of the world’s most under-resourced healthcare environments.
The current cholera outbreak in South Sudan arrives at a time when the country is already managing the effects of widespread displacement, climate disasters, and a fragile health system still recovering from years of instability.
Ongoing efforts are underway to limit transmission and reduce loss of life. But sustained outbreaks in displacement sites and urban centres indicate that significant risks remain.
South Sudan cholera outbreak timeline and spread
South Sudan’s current cholera outbreak was first confirmed in September 2024 in Renk, Upper Nile State. The disease has since spread across multiple states, affecting both urban centres and displacement sites.
The most recent WHO situation report found that as of April 11, 2025, the cholera outbreak in South Sudan had affected 44 counties across nine states and two administrative areas, with a total of 48,726 cases and 919 deaths reported. The counties with the highest reported cases at that time were:
- Rubkona County (Unity State): 12,154 cases (25% of the national total)
- Akobo County (Jonglei State): 2,271 cases (5%)
The largest concentration of cases so far has occurred in Rubkona County, which is home to South Sudan’s largest displacement camp — Bentiu Internally Displaced Persons (IDP) Camp. Nearly 200,000 people live in Bentiu IDP with limited access to clean water and sanitation.
The situation remains fluid. New cases continue to be reported as the rainy season also creates significant challenges.
Who is most at risk?
The risk of cholera is highest among people living in overcrowded displacement sites, areas with inadequate water and sanitation infrastructure, and communities affected by seasonal flooding.
The WHO situation report into the current South Sudan cholera outbreak also found children under the age of five account for the highest number of cases so far, representing 28% of all infections. They are followed by children aged 5 to 14 years, who make up an additional 22%. Together, that’s half of all reported cases. Limited access to clean water, oral rehydration, and healthcare services significantly increases the risk of severe illness and death in these age groups.
Many of the worst-affected counties, such as Rubkona, are host to large numbers of displaced people. These communities often live in temporary or makeshift shelters, where accessing basic services is challenging and disease surveillance is limited.
Poor sanitation, unreliable access to clean water, and low immunisation coverage all contribute to the spread of cholera. Ongoing conflict and climate-related disasters have also undermined public health infrastructure, limiting the capacity of health systems to prevent or contain outbreaks.
In this environment, the spread of cholera is not just a health issue — it is a consequence of overlapping crises that leave communities with few protections.
What’s driving the cholera outbreak in South Sudan?
The South Sudan cholera outbreak is being driven by a combination of systemic challenges that reduce access to clean water, sanitation and healthcare.
Years of protracted conflict have damaged essential infrastructure across the country, including water systems, health facilities and roads. In many affected areas, people rely on open water sources or unprotected wells that are easily contaminated.
The onset of the rainy season, between May and October, also increases the likelihood of transmission. Flooding overwhelms sanitation systems, displaces families, and restricts access to clean drinking water. It’s no coincidence that it’s in Rubkona County, where flooding and displacement intersect, that over 12,000 cases have been reported.
Public health systems are also severely under-resourced. That means cholera surveillance is limited and early detection and response is more difficult. Rural or flood-prone areas can also face significant challenges due to constrained vaccine supplies and inconsistent access to treatment.
These conditions are compounded by poverty, underfunding, and the long-term effects of climate-related disasters. For many communities, basic preventive services are out of reach — not because the solutions are unknown, but because the systems required to deliver them are fragile or failing.
How communities and organisations are responding
A coordinated response is underway to contain the cholera outbreak and reduce the risk of further spread. Health authorities, humanitarian agencies and local organisations are working across affected areas to provide clean water, improve sanitation, and strengthen access to treatment.
Oxfam is working in partnership with local organisations to provide clean drinking water, hygiene kits and sanitation services in the worst-affected areas. This includes building latrines and distributing essential supplies. In areas where markets are functioning, cash assistance is also helping families purchase hygiene items and access safe water closer to home.
These efforts are strengthened by Oxfam’s long-term presence in South Sudan, which has supported clean water access and resilience-building in many of the affected regions. Local leadership remains central to the response — not only in delivering services, but also in coordinating outreach and ensuring that resources are used effectively.
Despite these efforts, significant gaps remain. The current response is underfunded. The scale of the outbreak far exceeds available resources. Continued support is essential to sustain and expand life-saving interventions.
What happens next — and what’s needed
The cholera outbreak in South Sudan is ongoing. And with the rainy season underway, conditions for transmission are expected to worsen. Flooding can displace more families, contaminate water sources, and increase barriers to care (particularly in low-lying and remote regions).
Local and international organisations are continuing to scale up the response, but gaps remain. More funding is needed to expand access to clean water, reinforce sanitation infrastructure, and improve disease surveillance across affected counties.
Communities need more hygiene supplies, clean water points, and functioning cholera treatment units, especially in areas facing repeat outbreaks.
There’s also a growing need for cholera vaccines. While successful vaccine campaigns have been conducted in some counties, coverage remains low across the country. National health authorities and their partners have called for increased vaccine supply and greater logistical support to reach remote populations.
There are clearly urgent and significant needs. But beyond emergency response, long-term investment is also critical. The scale of this outbreak reflects deeper vulnerabilities in South Sudan’s health systems, infrastructure and humanitarian aid funding landscape. Strengthening these systems will be key to reducing the impact of future outbreaks — and protecting communities still at risk.
Oxfam continues to advocate for an increase in Australia’s humanitarian aid budget, calling on the government to support locally led responses in South Sudan and other regions facing overlapping crises. You can add your voice to the call, too. Global support is essential. Not only to meet urgent needs, but to build the foundations for a more resilient and equitable future.
How you can support the response
Oxfam is working in partnership with communities in South Sudan to provide clean water, improve sanitation, and reduce the spread of cholera. Your support can help extend this work, both in the immediate response and through longer-term efforts that build resilience.
Donate today or learn more about Oxfam’s South Sudan Appeal and help us deliver hygiene kits, restore clean water systems and fund cash assistance for families in high-risk areas.
This work is grounded in partnership. Community leaders, local organisations and public health workers are central to the response. With the right support, they can scale up their efforts and reach more people.
You can also take action by backing Oxfam’s call for increased humanitarian funding. Advocate for change and help ensure the international response reflects the scale of this crisis.
Every contribution — whether financial or political — helps extend the reach and impact of community-led responses across South Sudan.
If you still have questions, you can read more about the refugee crisis in South Sudan and the South Sudan civil war.
