In transition: current health challenges and priorities in Sudan

Abstract

A recent symposium and workshop in Khartoum, the capital of the Republic of Sudan, brought together broad expertise from three universities to address the current burden of communicable and non-communicable diseases facing the Sudanese healthcare system. These meetings identified common challenges that impact the burden of diseases in the country, most notably gaps in data and infrastructure which are essential to inform and deliver effective interventions. Non-communicable diseases, including obesity, type 2 diabetes, renal disease and cancer are increasing dramatically, contributing to multimorbidity. At the same time, progress against communicable diseases has been slow, and the burden of chronic and endemic infections remains considerable, with parasitic diseases (such as malaria, leishmaniasis and schistosomiasis) causing substantial morbidity and mortality. Antimicrobial resistance has become a major threat throughout the healthcare system, with an emerging impact on maternal, neonatal and paediatric populations. Meanwhile, malnutrition, micronutrient deficiency and poor perinatal outcomes remain common and contribute to a lifelong burden of disease. These challenges echo the United Nations (UN) sustainable development goals and concentrating on them in a unified strategy will be necessary to address the national burden of disease. At a time when the country is going through societal and political transition, we draw focus on the country and the need for resolution of its healthcare needs.

The first laboratory-confirmed imported infections of SARS-CoV-2 in Sudan

“…This risk is predicted to be intensified by the lack of data and information sharing in a timely manner, particularly during health emergencies. 16 , 17 Additionally, the Sudanese population was desensitized about the risk of COVID-19 by the statement of the former Minister of Health, ‘We managed to get rid of Omar al-Bashir. How come we cannot get hold of this tiny coronavirus?’, which might have given the wrong impression that the COVID-19 pandemic could be easily managed in Sudan.…”

“… 10 Furthermore, they have poor sanitation and personal hygiene, further increasing their risk of COVID-19. 8 , 17 Nonetheless, the Sudanese government advised residents of Khartoum State to secure their essential needs before the implementation of a 24-h lockdown order issued starting on 18 April. This has now been changed to a 12-h curfew between 06:00 and 18:00 h daily.…”

Why social accountability of medical schools in Sudan can lead to better primary healthcare and excellence in medical education?

“…Therefore, the social accountability of medical schools that reflect the social mission may be different from medical schools to another according to the health concern in different parts of the country, e.g., noncommunicable diseases are more in the north of Sudan than east Sudan, where there is a high prevalence of the communicable disease. [ 37 38 39 40 ] Sickle cell disease is also an important issue in the west of Sudan. [ 41 ] Tropical and infectious diseases are an important challenge for health authorities in the southern part of Sudan.…”

Building resilient and responsive research collaborations to tackle antimicrobial resistance—Lessons learnt from India, South Africa, and UK

“…In many LMICs, additional challenges impede the research, implementation and evaluation of effective strategies to tackle AMR, especially at the organisational level (Charani et al, 2019a;Cox et al, 2017;Charani et al, 2019b;Pulcini et al, 2019). These include the lack of a robust healthcare infrastructure (e.g.…”

“…In many LMICs, additional challenges especially at the organisational level, including the lack of robust healthcare infrastructure (e.g. staff workforce, access to clinical microbiology laboratory facilities and mechanisms for disease surveillance) impede the research, implementation and evaluation of effective strategies to tackle AMR ( Charani et al, 2019a , Cox et al, 2017 , Charani et al, 2019b , Pulcini et al, 2019 ). Governments completely or partially control activities that promote, restore, and maintain health; in most cases, governments are the primary funders and the providers of health services.…”