JUBA, March 26, 2024 — A measles crisis is mounting in South Sudan’s Western Equatoria state, just as health authorities are struggling to overcome an outbreak of yellow fever.
Since the beginning of February, 460 cases of measles have been recorded as of March 24 in three health facilities in Yambio and Nzara counties, with seven deaths among children under five years old. Ninety percent of these patients have never been vaccinated against measles.
With measles cases on the rise and vaccination coverage alarmingly low, Doctors Without Borders/Médecins Sans Frontières (MSF) urges health authorities and the World Health Organization (WHO) to launch an immediate vaccination campaign to prevent the disease from spreading further.
Measles: A persistent emergency in South Sudan
“When my child fell sick, he had a high fever, diarrhea, and cough,” said Victoria John, mother of 18-month-old Mark Emmanuel, who has measles. “While at home, I gave him Paracetamol but there was no improvement. We then brought him to the MSF facility where he received treatment for three days. If I didn’t come to the facility, I know my child was going to die.”
Measles has become a persistent emergency in South Sudan, with recurring outbreaks challenging health care systems and endangering communities. More than 12,000 cases have been recorded since 2022; South Sudan recorded more than 400 cases last week alone.
To respond to this emergency, MSF teams are treating patients with measles in Nzara and Yambio Counties at Gangura and Sakure health centers, as well as at Yambio State Hospital. Our team in Yambio intends to increase the number of beds for measles patients from 32 to 40 due to the rapidly increasing number of measles cases. MSF is also intervening in the community to look for children with potential measles symptoms and refer them to health facilities.
Twenty percent of children treated for measles at MSF-supported facilities are over the age of five, highlighting the need for a reactive vaccination campaign to reach this group of older children who did not receive measles vaccinations as part of the existing expanded immunization program.
Recovering from a yellow fever outbreak
The measles outbreak is a double blow for a region still struggling to deal with yellow fever after the most recent outbreak—the fourth in just six years—was declared by health authorities in December 2023. As of mid-March, 78 suspected cases and three confirmed cases were recorded, causing six deaths. In collaboration with WHO, the Ministry of Health launched a yellow fever vaccination campaign, immunizing around 357,000 people across three counties in Western Equatoria state. The campaign resulted in a reduction in suspected and confirmed cases, a testament to the efficacy of mass vaccination campaigns.
“Large-scale vaccination campaigns are vital—both in Western Equatoria state and Northern Bahr el Ghazal state, where the current measles outbreaks are ongoing—to halt further spread of the disease and prevent more outbreaks,” said MSF head of mission Zakaria Mwatia. “South Sudan’s fragile health system cannot bear the burden of recurrent outbreaks.”
Low vaccination coverage in South Sudan has a significant impact on the population, particularly children, who are highly vulnerable to diseases such as measles that can lead to serious health complications and deaths. Given the gravity of the health threats posed by both measles and yellow fever, MSF calls for increased efforts to raise community awareness about the diseases and to adopt best practices to stop them from spreading.
“It is imperative that the Ministry of Health and other health organizations, including WHO, intensify their efforts to expand vaccination coverage across the country and especially in areas most prone to disease outbreaks,” urged Mwatia.
