Famine Looms in Upper Nile: Acute Hunger and Malnutrition Hit Crisis Levels
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Upper Nile State, South Sudan — Alarming levels of acute malnutrition and food insecurity are pushing communities in Nasir and Ulang counties dangerously close to famine. New assessments conducted in June and July 2025 highlight a critical emergency, with indicators suggesting that the region may have already surpassed some thresholds for Famine (IPC Phase 5), the most severe level of food crisis classification by the Integrated Food Security Phase Classification (IPC).
Children under five are among the most affected, with Global Acute Malnutrition (GAM) rates reaching an unprecedented 25.4% in Nasir and 23.4% in Ulang. These figures, based on mid-upper arm circumference (MUAC) assessments in accessible areas, signal a major health emergency. Additionally, up to 23% of households in Nasir and 11% in Ulang are suffering from extreme hunger, indicating massive food consumption deficits. The overall situation is expected to deteriorate until at least October, when the lean season concludes and the harvest period begins.
The humanitarian emergency in Upper Nile is exacerbated by ongoing conflict between government forces and local militias. Since February 2025, violence has displaced more than 80,000 people—over half the local population—disrupting agriculture, fishing, markets, and healthcare systems. This collapse of essential services has intensified the region’s vulnerability to starvation and disease.
The arrival of displaced people and returnees from Sudan into areas lacking adequate water and sanitation infrastructure has contributed to a rapidly spreading cholera outbreak. In Nasir alone, the case fatality rate reached 7.8% by July—far beyond the WHO’s 1% benchmark for a controlled outbreak. Ulang fared slightly better at 2.6%, but the figures still underscore a dire public health threat compounded by malnutrition.
Access constraints are severely limiting the delivery of food assistance. The World Food Programme (WFP) was unable to reach the area between March and June due to insecurity, and even after resuming operations, the distribution has remained insufficient. Air drops in May and July targeted tens of thousands of people, but logistical challenges and community-level distrust reduced the effectiveness of these operations. According to key informants, only a fraction of the population received enough food to meet half of their daily calorie requirements.
Persistent flooding and continued violence have further hindered aid access. As the rainy season peaks between August and October, the risk of isolation increases. FEWS NET and partners, including the US Geological Survey (USGS) and NASA, project flooding similar to or worse than 2024, which will worsen displacement and prevent humanitarian delivery by land or river.
The collapse of the healthcare system is another critical factor driving mortality. Médecins Sans Frontières (MSF) was forced to shut down its hospital and 13 other facilities in Ulang in June due to targeted violence. With cholera cases climbing and access to treatment limited, mortality is expected to rise, especially in inaccessible regions where disease surveillance is weak or nonexistent. By late July, Upper Nile accounted for over 21,000 of the national total of 84,606 cholera cases, with 474 reported deaths—a number likely undercounted.
The cumulative effects of conflict, flooding, and displacement are likely to result in a significantly below-average harvest between October and December. With families unable to plant or tend to crops, and fishing disrupted by insecurity, traditional coping mechanisms have eroded. The reliance on wild foods has increased, but this source is also under threat due to restricted mobility and environmental degradation.
While Nasir and Ulang are at the epicenter of the crisis, neighboring areas—including Baliet, Canal/Pigi, Fangak, Malakal, and Panyikang—are also facing Emergency (IPC Phase 4) or pockets of Catastrophe (IPC Phase 5) outcomes. In Fangak, recent attacks have displaced nearly 38,000 people, with thousands fleeing from New Fangak town to Ayod. Insecurity has left households dependent on wild food and fishing, while WFP aid deliveries remain sparse and insufficient due to logistical and funding challenges.
Reports from REACH and FEWS NET indicate that even in areas where assistance has been delivered, it falls far short of addressing needs. Without urgent action, these conditions are likely to deteriorate further, pushing more communities toward famine thresholds.
More than 83,000 people in northern South Sudan and the Greater Pibor Administrative Area are already estimated to be experiencing Catastrophe (IPC Phase 5), even when planned food assistance is considered. This includes over 22,000 people in Nasir and Ulang. The true number may be even higher given the extent of inaccessibility and underreporting in conflict zones.
Years of sustained conflict, environmental shocks, and economic instability have left communities with little to no ability to cope. If violence continues or seasonal flooding intensifies—as projected—then starvation, acute malnutrition, and preventable deaths could rise sharply, crossing into full-scale famine territory.
The risk of famine in Upper Nile is no longer hypothetical—it is an unfolding disaster. Immediate, coordinated humanitarian intervention is not only critical, it is life-saving. Government actors, international agencies, and local partners must act decisively to:
As the world watches, the fate of tens of thousands hangs in the balance. Delayed action will cost lives—swift, comprehensive support can turn the tide.
The humanitarian crisis in Upper Nile is the result of intersecting challenges: political instability, public health failures, environmental hazards, and systemic under-resourcing. The looming threat of famine is not merely a forecast but a reflection of urgent needs already on the ground. While data from inaccessible regions remain scarce, the indicators from accessible areas are enough to paint a grim picture. With the lean season deepening, lives are at stake. This is not just a call for aid—it is a call for accountability, coordination, and compassion. The time to act is now.
According to the Famine Early Warning Systems Network (FEWS NET), the food security situation in Upper Nile has deteriorated significantly, with some indicators already meeting the thresholds for Famine (IPC Phase 5).
The Integrated Food Security Phase Classification (IPC) reports that the acute malnutrition rates among children under five have reached crisis levels in Nasir and Ulang, underscoring the urgency of humanitarian intervention.
Efforts to deliver aid have also been severely constrained. The World Food Programme (WFP) faced major access issues between March and June, and subsequent air drops were only partially successful due to security concerns and limited supplies.
Meanwhile, the health system is collapsing under the weight of disease outbreaks. Médecins Sans Frontières (MSF) was forced to shut down its hospital and several facilities in Ulang, leaving thousands without access to basic healthcare during a cholera outbreak.
According to UNICEF, child malnutrition remains one of the most severe threats, particularly in remote areas where humanitarian access is limited.
To stay informed about ongoing developments and official emergency alerts, readers can follow updates on ReliefWeb, a trusted platform for humanitarian reporting.
Data from the World Health Organization (WHO) confirms that the cholera fatality rate in some parts of Upper Nile far exceeds international benchmarks for a controlled outbreak.
For a deeper look into the underlying causes and humanitarian implications of the crisis, see our full analysis on malnutrition in Upper Nile State.
