Country: Sudan Source: Insecurity Insight Please refer to the attached file. Insights and recommendations to enhance civilian protection, food security and access to health care 15 April 2026 marks three years of civil war in Sudan in which conflict, violence and lack of respect for international humanitarian law (IHL) have degraded food and health care systems and disrupted access to life-saving humanitarian aid. Food security is a major concern during this war. Between February and May 2026, 19.1 million people are projected to experience high levels of acute food insecurity (IPC Phase 3 or above). Insecurity Insight’s monitoring of violent events showed an alarmingly high rate of conflict incidents affecting the food system, with violence at markets reported in at least 283 incidents as well as incidents of cattle looting and killing and attacks on civilians growing food, selling or buying food reported in high numbers. Health needs are also high throughout the country. As of March 2026, two out of three people in Sudan no longer have access to essential health services and 80% of hospitals are out of service in affected areas. Insecurity Insight’s monitoring found that at least 175 health workers have been killed and at least 183 health facilities reportedly damaged and destroyed, with hospitals across Sudan affected. From the start of the conflict on 15 April 2023 to 31 December 2025, Insecurity Insight recorded 1,754 incidents of violence impacting food security, health care and humanitarian aid. The lack of protection of vital civilian infrastructure is a driver of escalating humanitarian needs across Sudan. This brief identifies trends and recurring patterns within the recorded incidents of conflict violence, highlights how the conduct of hostilities contributes to creating humanitarian needs, and provides insights into anticipating them. It also provides a list of actionable and practical recommendations in service of sustaining international action to mitigate harm. Key Findings From the start of the conflict on 15 April 2023 to 31 December 2025, Insecurity Insight recorded 1,754 incidents of violence impacting food security (870 incidents), health care (710 incidents) and aid operations (174 incidents). Violence affecting food systems is widespread and systematic. Violence at markets was the most frequently recorded form of violence across all forms of violence during the recording period. The most frequently recorded categories of violence were: violence at markets (283 incidents); health care facilities damaged and/or destroyed (183 incidents); attacks on people carrying out food-related activities (181 incidents); livestock being looted or killed (137 incidents); and health care workers being killed (135 incidents). Food-related activities refer to any activities that fall within the food system ecosystem, including the production, sale and purchase of food or foodstuffs. Individual incidents often involved multiple victims and losses, such as in July 2024 when 200 heads of cattle were looted during one incident in Dar As Salam, North Darfur, and in May 2025 when at least 6 health workers were killed and 15 injured in one incident in El Obeid city, North Kordofan state. Health workers and facilities have been heavily impacted, with at least 175 health workers killed and 183 facilities damaged or destroyed, reducing the capacity of the health care system to respond to high levels of physical and psychological harm caused during the conflict. National staff across the food, health and aid sectors bear the overwhelming burden of risk in frequency and severity of violence, including killing, injury, kidnap and arrests. At least 174 incidents involving aid workers being killed, injured, kidnapped or arrested were recorded, with some incidents involving multiple victims. Between April 2023 and December 2025, at least 157 aid workers were killed in 103 incidents. Aid workers were killed by firearms, drone strikes, and shelling while travelling in convoys, inside aid premises, within refugee or displacement camps, and during the delivery of aid operations and distributions. Sieges, blockades, and administrative restrictions have severely limited access to food, health care, and aid, contributing to worsening humanitarian conditions, including famine risk. The impacts of conflict are compounding and long-term, with damage to infrastructure, livelihoods, and services continuing to affect food security and health outcomes beyond immediate incidents. An anticipatory mindset and data-driven approach is essential. Patterns of harm are predictable and preventable.