CAIRO (AP) — Famine is threatening more areas in war-torn Sudan’s western Darfur region, a global hunger monitoring group said Thursday as an attack by paramilitary forces on a military hospital in the country’s south killed 22 people, including the hospital’s director and three members of its medical staff.
Since April 2023, Sudan has been in the throes of war after a power struggle erupted between the military and the powerful paramilitary Rapid Support Forces, or RSF. The conflict has triggered what the United Nations calls the world’s worst humanitarian crisis.
The Integrated Food Security Phase Classification, or IPC, released a new report saying that acute malnutrition has reached famine levels in two more towns in Darfur. It stopped short of confirming a full famine in the towns.
Last year, the group said that people in Darfur’s major city of el-Fasher, overrun by the paramilitary forces after an 18-month siege, were enduring famine.
The attack Thursday in the town of Kouik in South Kordofan province, also left eight people wounded, the Sudan Doctors’ Network, a group of medical professionals tracking the war said. It was not immediately clear how many of the casualties were civilians.
The attack was “not an isolated incident, but rather part of a series of attacks that have plagued South Kordofan,” the network said, adding that the assaults have left “several hospitals inoperable.”
The U.N. estimates that over 40,000 people have been killed in the war in Sudan, but aid agencies consider that the true number could be many times higher. Over 14 million people have been forced to flee their homes.
A harrowing report
The IPC report said famine-level malnutrition has been registered in the towns of Umm Baru and Kernoi in North Darfur province. In November, the group said that along with el-Fasher, the city of Kadugli in South Kordofan was also enduring famine. At the time, it also said 20 other areas across Sudan were at risk of famine.
In Umm Baru, nearly 53% of children between aged between 6 months and nearly 5 years suffered from acute malnutrition, the IPC said — almost double the famine threshold, which stands at 30%. In Kernoi, 32% of children are suffering from malnutrition, the group said.
“These alarming rates suggest an increased risk of excess mortality and raise concern that nearby areas may be experiencing similar catastrophic conditions,” the report said.
Since the eruption of Sudan’s civil war, the IPC has confirmed famine in a total of seven areas. The group said it could not confirm a full famine in Umm Baru and Kernoi as access and lack of data makes it difficult to confirm the other two thresholds — access to food and mortality — that need to be reached for a famine to be confirmed.
The fall of el-Fasher in October 2025 to the RSF set off an exodus of people to nearby towns, straining the resources of neighboring communities and driving up food insecurity rates, the report said.
The IPC has confirmed famine only a few times, most recently in 2025 in northern Gaza during the Israel-Hamas war. It also confirmed famine in Somalia in 2011, and in South Sudan in 2017 and 2020.
In 2024, famine had struck five other areas in North Darfur and also Sudan’s Nuba Mountains region.
The IPC report also warned that more people might face extreme hunger in Kordofan, where the conflict has disrupted food production and supply lines in besieged towns and isolated areas.
“An immediate and sustained ceasefire is critical to avert further destitution, starvation, and death in the affected parts of Sudan,” pled the Rome-based group.
According to experts, famine is determined in areas where deaths from malnutrition-related causes reach at least two people, or four children under 5 years of age, per 10,000 people; at least one in five people or households severely lack food and face starvation; and at least 30% of children under age 5 suffer from acute malnutrition based on a weight-to-height measurement — or 15% based on upper-arm circumference.
Fighting rages on
Since the RSF overran el-Fasher, which had been one of the army’s last strongholds in Darfur, fighting has recently concentrated in various areas of Kordofan. Lately, the Sudanese military began making gains in Kordofan after breaking a siege in Kadugli and the neighboring town of Dilling.
On Tuesday, the Sudanese military announced that it had opened a crucial road between Dilling and Kadugli, which had been under siege by the RSF since the start of the war. The RSF launched a drone attack Tuesday that hit a medical center in Kadugli, killing 15 people including seven children, according to Sudan Doctors Network.
Also this week, the United States and the U.N. said they are seeking to rally international support for humanitarian aid to Sudan, kicking off a new Sudan Humanitarian Fund with $700 million in contributions from the United Arab Emirates and the U.S.
The Trump administration said Tuesday it would contribute $200 million to the initiative from a basket of $2 billion it set aside late last year to fund humanitarian projects around the world. The UAE said it would contribute $500 million. Saudi Arabia and several other participants promised they would make pledges but did not specify amounts.
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Associated Press writer Fay Abuelgasim in Cairo contributed to this report.
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This story has been corrected throughout to say that the expert group did not confirm a full famine in the Darfur towns of Umm Baru and Kernoi but said that malnutrition there had reached famine-levels.
