Knowledge Management Series for Health: Outbreak Response in a Fragile System: Cholera Knockout in South Sudan (March 2026)

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Context of Cholera in South Sudan

Cholera remains a significant public health threat in South Sudan, particularly in areas with limited access to safe water, sanitation, and timely healthcare. The country has experienced repeated outbreaks over the past decade, often exacerbated by population displacement, flooding, and fragile health infrastructure.

The current outbreak started in September 2024 in the northern town of Renk in Upper Nile state, which has been hosting refugees and returnees fleeing the conflict in Sudan and often living in congested transit centres with limited water, sanitation, and hygiene (WASH) facilities (see links to previous factsheets on cholera at the end of this factsheet). This outbreak, which has lasted for more than 15 months, is the largest ever in the county in terms of case burden and geographic spread. As of February 17, 2026, the outbreak had totalled 98 401 cases and 1624 deaths, a case fatality rate (CFR) of 1.7%, of which 825 are health facility deaths (HF CFR: 0.8%), reported across 9 states and all three administrative areas (that is Ruweng, Greater Pibor, and Abyei)

The 30-Day Cholera Knockout Plan

While cases had declined steeply towards the end of 2025, a few counties in Unity (Rubkona, Mayom, and Mayendit), Jonglei (Duk), Eastern Equatoria (Ikwotos), Warrap (Tonj North), Upper Nile (Renk), Northern Bahr-el-Ghazal (Aweil Centre and Aweil South), and Central Equatoria (Juba) continued to sporadically report new cases. To interrupt the transmission chain of the current outbreak before the end of 2025, a 30-Day Cholera Knockout Plan was initiated with data from Weeks 42 and 43 of 2025 as benchmark.

Goal: The overall goal of the plan was to interrupt all remaining cholera transmission in South Sudan within 30 days (by the end of Week 47 of 2025) through focused, integrated, and time-bound interventions.

Source: https://reliefweb.int/report/south-sudan/knowledge-management-series-health-outbreak-response-fragile-system-cholera-knockout-south-sudan-march-2026