Displacement and kidney care disruption in Sudan: lessons from a fragile health crisis

To examine the disruption of kidney care services in Sudan following the 2023 conflict, highlighting the compounded risks faced by dialysis and transplant patients during crises, and offering evidence-based strategies for future emergency preparedness.

The conflict in Sudan exposed deep systemic weaknesses in an already under-resourced nephrology infrastructure. Hemodialysis centers were damaged or shut down, supply chains collapsed, and patient displacement became widespread. Over 70% of patients experienced treatment interruption and many died due to missed dialysis sessions or transplant rejection. Emergency responses were delayed and uncoordinated. In contrast, experience from Ukraine and Gaza disasters illustrate how registry-based evacuation and cross-border planning can save lives. Egypt's subsequent collaboration with WHO and KSrelief (King Salman Humanitarian Aid and Relief Center) offered a late but instructive model for regional support.

Sudan's crisis demonstrates how kidney patients suffer disproportionately from adverse effects of disasters when health systems collapse. Displacement may become a survival tactic in the absence of formal evacuation or support plans. Embedding kidney care into disaster response-through registries, mental health support, cross-border agreements, and sustainable NCD programming-is urgently needed. Global momentum, such as WHA78's kidney resolution, must now translate into national preparedness for fragile settings.