South Sudan

• People in need: 9.4 million¹
• People targeted: 6.8 million
• People in need of health assistance: 5.5 million
• Requirements (US$): 52.1 million

Context

Perennial security threats occasioned by political differences between rebel Sudan People's Liberation Movement-in-Opposition (SPLA/IO) factions and the ruling government since 2013, along with localized violence and climatic shocks account for South Sudan’s social, economic, and political vulnerabilities. In 2022, the country continued to face its fourth consecutive year of incessant floods that affected 37 of its 80 counties, destroying 45 health facilities and causing massive population displacement. Localized violence in Upper Nile, Warrap, Unity and other states in 2022 further contributed to the displacement index, increasing humanitarian needs. An estimated 2.2 million people remain internally displaced in the country with an additional 2.3 million who are refugees in neighboring countries (HNO 2022).

South Sudan is also facing acute food insecurity that is exacerbated by persistent annual cereal deficits, diseases, pests and hyperinflation. The Integrated Food Security Phase Classification (IPC) projected that over half (6.6 million people) of South Sudan’s population experienced high levels of acute food insecurity (IPC Phase 3 or worse) in October and November 2022, including 2.2 million people in IPC Phase 4 (Emergency) and 61 000 people in IPC Phase 5 (Catastrophe). These numbers are expected to hit 7.8 million during the lean season April-July 2023. A combination of conflict and disasters within the context of a weak and underfunded health system is responsible for several disease outbreaks. In 2022, the country registered an explosive measles outbreak that has now spread to 15 counties in eight states. Outbreaks of cholera and Hepatitis E virus have also been recorded, and the country continues to respond to COVID-19. In addition, the country is now in preparedness mode for a possible Ebola Virus disease outbreak following an outbreak in Uganda.

Response strategy

An estimated 6.1 million of the crisis-affected population currently need health services. The Humanitarian Response Plan 2023 and the Health Cluster are targeting 3.4 million people in need who will be provided with life-saving health services through the three broad priorities.

To ensure the effective delivery of services, WHO will use its Emergency Response Framework, ensuring the three levels of the organization (Country Office, Regional Office and HQ) are adequately supporting the response. It will support the 64 Humanitarian Response Plan (HRP) partners to maintain readiness and response capacities while ensuring the Ministry of Health is equipped with the requisite technical capacity to supervise the country’s health services delivery. The strategy will entail scaling up and maintaining infectious disease surveillance capacities, providing outbreak investigation and sample collection kits and essential medicines (Interagency Emergency Health Kits) to health responders, offering capacity building to the health workforce and supporting vaccination campaigns for vaccine-preventable diseases.

WHO’s response will ensure responders are provided with technical guidelines, tools and standard operating procedures. A strong framework for coordination through the health cluster mechanism will be in place to ensure response interventions are well-aligned and avoid overlaps and duplication among partners. This will also ensure proper linkages between the emergency response strategies with the development and peace efforts, and, when possible, will provide building blocks for early recovery and the development of a resilient health system.

WHO will also leverage existing resources in the country office, its 10 field offices, and the network of technical experts to provide valuable local capacity. The network of surveillance officers across the country will be used to support disease surveillance activities. Finally, the response strategy will focus on cross-cutting issues in the humanitarian context: security and access constraints in South Sudan, the Prevention of Sexual Exploitation Abuse (PSEA) and global warming. WHO will continue to monitor and report on attacks on health facilities and use environmentally friendly mechanisms for waste disposal. WHO country office recently recruited a PSEAH focal point who is responsible for monitoring PSEAH adherence, awareness creation and capacity building of personnel on PSEAH.

Strategic objectives

Key activities

• Strengthen national and sub-national preparedness and response capacities against public health events, including through strengthening capacities in key points of entry in hazards management and through strengthening clinical laboratory practices, Infection Prevention and Control, Early Warning, Alert and Response System (EWARS), the 3rd Edition of Integrated Disease Surveillance and Response (IDSR), contact tracing and case management for priority diseases.
• Deploy Rapid Response Teams for outbreak investigation, risk assessment, alert investigation and response to disease outbreaks.
• Support suspected disease sample collection, packaging and management, including through referral to international laboratories for confirmation as well as genomic sequencing from disease alert shipments.
• Deploy vaccines to combat vaccine-preventable diseases e.g., measles, cholera and hepatitis among others.
• Deploy COVID-19 vaccines to priority locations to increase uptake of the vaccines in the country.
• Strengthen health information systems and invest in capacities for real-time IDSR/EWARS systems.
• Support health cluster partners to assess, prioritize, plan and optimize the provision of essential health care services to the most vulnerable populations through regular national and sub-national coordination meetings.
• Provide Interagency Emergency Health Kits (IEHK) to responding partners in priority locations affected.
• Provide SAM/MC kits to nutrition stabilization centers to treat children with medical complications.
• Support key functions of the Public Health Operations Center (PHEOC) to reinforce readiness and response capacities against major public health events, including monitoring and evaluation capacities of operational plans in line with the provision of the International Health Regulations (IHR) 2005.
• Deploy technical experts to provide technical support and coordinate response.
• Strengthen coordination between humanitarian and development actors towards a strong Humanitarian-Development-Peace Nexus (HDPN) while pursuing a stronger linkage between emergency response and the wider health sector response.

Funding requirements 

Overall country funding requirements, including COVID-19, by pillar (US$’000)

Success stories

South Sudan’s innovative COVID-19 vaccination strategy

South Sudan has been stepping up COVID-19 vaccination campaigns across the country. Key activities have included outreach initiatives to access hard-to-reach communities, mobilizing communities through local and political leaders, regional campaigns, house-to-house activities and rolling out widespread public communications.

Through the introduction of an innovative vaccination strategy, with the support of WHO and its partners, vaccination coverage increased significantly from less than one percent in January 2022 to 15.6 percent by October 2022. In the same period, 91 percent coverage among health care workers was achieved, alongside close to 50 percent coverage of the elderly population.

The Global Lead Coordinator of the COVID-19 Vaccine Delivery Partnership, Mr Ted Chaiban, concluded a high-level advocacy visit to South Sudan to ensure the continued acceleration of COVID-19 vaccination efforts in the country. He met with top government officials including H.E. Mr Hussein Abdelbagi, the Vice President for Social Services Cluster and COVID-19 National Taskforce Chair; Vice President Rebecca Nyandeng De Mabior; Honorable Yolanda Awel Deng Juach, the Minister of Health; Honorable Dier Tong Ngor, the Ministry of Finance and Economic Planning; Dr Victoria Achut, the Undersecretary Ministry of Health as well as Ms Sara Beysolow Nyanti, Deputy Special Representative of the Secretary-General, Resident and Humanitarian Coordinator.

“WHO, UNICEF, Gavi, the Vaccine Alliance and other partners have been instrumental in supporting the Ministry of Health in improving vaccine uptake across the country”, said Honorable Deng, the Minister of Health. “South Sudan is grateful for the visit of the Global Lead Coordinator of the COVID-19 Vaccine Delivery Partnership and the commitment demonstrated by visiting the country to boost vaccination in the country and integrate COVID-19 vaccination into primary health care services".

For more information

Dr. Fabian NDENZAKO | WHO Representative, South Sudan |+ 211920630624 | ndenzakof@who.int

Lynette SUDI I External Relations Officer: | WHO South Sudan|+ 211922645645 | sudil@who.int