Sudan

How It Started

In Sudan, a multitude of factors significantly impedes public health campaigns, including disease control, elimination, and eradication.

In 2017, Sudan’s Federal Ministry of Health asked the Carter Center’s Conflict Resolution Program to support durable peace in areas where conflict hampers disease control. 

Our Work and Methods

The Center has conducted research, convened stakeholders, and begun programming to simultaneously fight disease and wage peace in two distinct corners of Sudan.

Our Impacts

The Carter Center has worked to develop and support a grassroots mechanism for conflict management, which reduces conflict and makes the area accessible to public health workers.

Through conflict prevention and mitigation efforts, the Center creates an enabling environment for public health campaigns.

How It Started

Following the general elections and referendum, The Carter Center maintained a presence in Sudan and South Sudan to observe each country’s political environment and transition.

Our Work and Methods

We tracked developments related to democratic processes, remaining outcomes of the peace agreement, and a possible constitutional review process.

We observed, analyzed, and commented on the drafting of a transitional constitution as well as critical pieces of legislation that would become the backbone of the world’s newest democracy.

Our Impacts

• Four reports by the Center’s Sudan Observation Mission examine how civic actors are navigating the war, adapting their roles, and envisioning the country’s future.

How it Started

Rising food prices and eroding economic opportunity sparked protests across Sudan in December 2018, leading to the ouster of President al-Bashir following 30 years of rule.

Our Work and Methods

The Carter Center meets with government, military, and civil society leaders. We are  monitoring the transition and considering activities to sustainably support democracy and lasting peace.

How it Started

Since gaining independence in 2011, South Sudan has experienced ongoing tensions with Sudan over oil pipeline access, revenue sharing, disputed border territories, and mutual support of armed groups operating in each country.

Our Work and Methods

In 2013, The Carter Center launched a series of non-governmental dialogues between prominent civil society leaders from Sudan and South Sudan to create lasting peace and further normalize relations between the two countries.

Our Impacts

The initiative created a forum for key individuals to voice their opinions and devise their solutions.

How it Started

The Carter Center observed national elections in Sudan in 2010 and the January 2011 referendum on the self-determination of Southern Sudan that resulted from the Comprehensive Peace Agreement.

Our Work and Methods

We deployed long-, medium-, and short-term observing missions to witness the balloting, counting, and tabulation processes for the national elections.

Our Impacts

• In 2011, the Center supported five organizations that recruited, trained, and deployed more than 3,000 observers across all of Sudan’s 25 states as well as Kenya, Uganda, and Ethiopia.

Support included technical and financial assistance to conduct a survey to gauge the integrity of the voter registration process.

How it Started

The end of the civil war didn’t bring peace to Sudan. In 2003, conflict erupted in Darfur and escalated quickly. In 2011, a second conflict broke out in the country’s southeast between the government and remnants of the SPLM/A.

Our Work and Methods

The Carter Center convened meetings of government officials, opposition leaders, and civil society members to discuss possible paths to peace and conducted various behind-the-scenes efforts to help end the conflict.

How it Started

During Sudan’s second civil war, conflict between Sudan’s government and the SPLM/A was complicated by hostilities between Sudan and Uganda. For years, the Lord’s Resistance Army, linked to the Sudanese government, terrorized northern Uganda, notably using child soldiers.

Our Impacts

In 1999, President Carter and The Carter Center negotiated the Nairobi Agreement between Sudan and Uganda. Both sides committed to stopping support for forces acting against the other and agreed to reestablish full diplomatic relations, opening the door for improved regional relations. 

The Center assisted Sudan and Uganda with the agreement’s implementation by convening meetings between the two governments and other stakeholders.

How it Started

The Carter Center’s long-term commitment to peace and health in Sudan began in the late 1980s during the height of the Second Sudanese Civil War between the central government and the Sudan People’s Liberation Movement/Army (SPLM/A). No solid statistics exist, but experts estimate that the war claimed between 1 and 2 million lives, mostly from illness induced by war and famine.

Our Work and Methods

In 1989, President Carter began a direct mediation effort between the Sudanese government and the liberation army. In 1995, President Carter secured a ceasefire from President Omar al-Bashir and SPLM/A leader Dr. John Garang to allow for the treatment of Guinea worm and other diseases, including polio and river blindness.

Our Impacts

• The “Guinea worm cease-fire” lasted almost six months.

• The Comprehensive Peace Agreement was signed in January 2005 by the government of Sudan and the SPLM/A. The Center provided training to both sides and supported the mediation effort led by the Intergovernmental Authority on Development.

How It Started

The Carter Center began assisting Sudan’s River Blindness (onchocerciasis) Program in 1995, formally establishing a presence in 1997 after the Center secured funding from the Lions Clubs International Foundation.

Our Work and Methods

We have worked with Sudan’s National Onchocerciasis Task Force in key focus areas in Sudan: Abu Hamad, Galabat, Khor Yabus, and Radom. Our strategy is based on increasing the mass distribution of Mectizan® (ivermectin, donated by Merck) from annual to every six months as a part of the country’s shift from control to elimination.

Our Impacts

We began conducting mass drug administration in 2007 and continued for more than a decade, coordinating cross-border elimination activities with Ethiopia. Instability in the region has slowed progress.

According to the World Health Organization, 9.7 million people are living in areas of Sudan where lymphatic filariasis is endemic. The WHO’s target is to eliminate LF as a public health problem by 2030.  

How It Started

In 2022, The Carter Center expanded its support to the Sudanese Federal Ministry of Health to help eliminate LF. This effort was made possible through a grant from the Reaching the Last Mile Fund, a multi-donor initiative housed within the END Fund and spearheaded by His Highness Sheikh Mohamed bin Zayed Al Nahyan, president of the United Arab Emirates.

Our Work and Methods

The Carter Center assists with health education and the mass administration of the drugs Mectizan® (donated by Merck & Co. Inc.) and albendazole (donated by GSK). However, the civil war that broke out in April 2023 has severely hampered or halted public health initiatives.

How It Started

Since 1999, The Carter Center has assisted the full SAFE strategy (Surgery, Antibiotics, Facial cleanliness, Environmental improvement) in Sudan in collaboration with the government and funding partners. The trachoma elimination target date is 2030. Insecurity and increasing inflation have made program implementation difficult and costly. Nevertheless, The Carter Center has pledged to continue supporting the national program.

Our Work and Methods

The Carter Center has assisted Sudan with trachomatous trichiasis surgeries, distribution of medical treatments, and worked with stakeholders to raise awareness and develop health education materials.

Our Impacts

• More than 9 million doses of azithromycin (donated by Pfizer, Inc.) and tetracycline eye ointment through mass drug administration campaigns.
• More than 200 individuals in South Sudanese refugee camps have received surgical services, and more than 420,000 Ethiopian and South Sudanese refugees were treated with antibiotics in addition to receiving health education.
• 13,089 surgeries to prevent immediate blindness.

Current Status: Indigenous Transmission Stopped, 2002
Certification of Dracunculiasis Elimination: Pending

How it Started

Our work to eradicate Guinea worm disease began in 1995, but civil war impeded access to many endemic areas. President Carter then brokered the “Guinea worm ceasefire,” allowing health workers to distribute medicine and preventative health measures. 

Our Work and Methods

The Carter Center and its partners distributed pipe filters to at-risk populations and conducted a targeted health education campaign that included flip charts, radio advertisements, and community demonstrations.  

Our Impacts

• Millions of pipe filters distributed.
• Indigenous transmission stopped in 2002.

How it Started

The Carter Center worked with the Sudan Federal Ministry of Health in the Public Health Training Initiative, a joint effort to improve the training of health professionals who work directly with women and children.

Our Work and Methods

The initiative focuses on improving the learning environment of adult students and mid-career professionals such as nurses and midwives.

How it Started

The Carter Center worked in Sudan from 1986 to 1992 to teach small-scale farm families superior farming techniques to increase grain crop yields. Led by the late Nobel Peace Prize laureate Dr. Norman Borlaug, the program was a joint venture between The Carter Center and the Sasakawa Africa Association.

Our Work and Methods

The program provided farmers with credit for fertilizers and enhanced seeds to grow test plots, often yielding 200% to 400% more crops. 

The program identified less costly, more efficient harvesting methods and local markets for these surpluses. The five-year project in Sudan was completed in 1992.

Our Impacts

• Participating farmers went on to teach others, creating a ripple effect to stimulate self-sufficiency.

• Wheat production increased by more than 950% from 1985-86 and 1991-92.