For more than 30 years, Action Against Hunger has served communities across South Sudan, and they know when they come to our locations, they’ll get treatment. Mothers walk for hours through dangerous terrain, carrying malnourished children who desperately need our help. They trust us. They’ve learned to depend on us. But now, for the first time in decades, we have no answers for them.
The closure of USAID on1 July has shattered that lifeline that kept thousands of South Sudanese children alive. The specially-formulated, energy-dense paste that we use to treat severe acute malnutrition, known as ready-to-use therapeutic food (RUTF), delivers essential nutrients that can bring a child from medical crisis to health in as little as 45 days. This medicine has revolutionised our fight against child mortality, improving survival rates from 25 per cent to over 90 per cent.
With USAID supporting approximately 50 per cent of the global RUTF supply, the termination of 90 per cent of all USAID contracts has left us facing an impossible situation: nutrition sites without nutrition supplies, and children who will die without them.
A Perfect Storm
South Sudan is no stranger to crisis. Our latest IPC projections show 7.7 million people – 57 per cent of the analysed population – facing high levels of acute food insecurity, with 2.3 million children under five acutely malnourished. In the counties where we operate – Duk, Fangak, Aweil East, and Gogrial – we’re seeing some of the worst conditions in the country, with pockets reaching catastrophic levels.
But this time is different. While we’ve weathered conflict, flooding and economic collapse before, we’ve never faced the complete breakdown of our primary supply chain for life-saving therapeutic food. RUTF stocks in Upper Nile State are now critically low, with supplies having dwindled for nearly a month, putting over 60,000 malnourished children at immediate risk.
The timing couldn’t be worse. We’re expecting less than 50 centimeters of rain in the coming three months, which would devastate crops and farms and drive malnutrition rates even higher. Meanwhile, the ongoing crisis in neighbouring Sudan continues to push refugees across our borders, with families arriving dehydrated, traumatised and severely malnourished after witnessing war crimes and walking for days through dangerous territory.
The Human Cost
Nutrition programming represents 70-80 per cent of our work in South Sudan. When RUTF stocks disappear, our nutrition nurses and community volunteers have nothing to offer families who travel great distances to reach us. They will keep coming – our logos are visible, our signs promise help – but we’ll have no supplies for them.
We’ve already been forced to make devastating cuts. Our emergency response team, which could deploy to five locations during crises like cholera outbreaks or flooding, has been completely shut down. We’ve reduced our field sites from 86 to 32 locations, forcing people to travel even longer distances. Our workforce has been slashed from hundreds to a skeleton crew, with some staff stretched across multiple sites.
In South Sudan, funding for nutrition response has been slashed by nearly half, leaving one in two severely malnourished children without treatment. Across 39 counties, over 800,000 acutely malnourished children will not receive care in 2025.
Beyond Immediate Healthcare
The impact extends beyond immediate health care. Years of peace-building work – helping communities stop fighting, supporting rice farming cooperatives, fostering social cohesion – are now at risk. When basic services collapse, conflicts reignite. The fragile progress we’ve made in bringing communities together will be undone.
The USAID logo has become a household brand for our communities; a symbol of hope and American partnership. They still believe in the US as their “big brother” who has stood with South Sudan for years. But the reality is that severely malnourished children are 11 times more likely to die than healthy children, and without RUTF, we’re powerless to help them.
Our staff, who have lost their jobs, return to their communities frustrated and defeated. They were often the breadwinners for their families, working on bare minimum wages because they believed in serving their people. Now they join the ranks of the unemployed in a country with no social safety net.
Looking for Solutions
We’re exploring alternatives – local production, partnerships with other donors, and government support. But no donor can fill the gap left by USAID, which represented such a significant portion of global humanitarian nutrition funding.
After three decades of service in South Sudan, we’ve seen children survive against impossible odds thanks to American generosity and innovation. RUTF has been called “God’s food” by the communities we serve, and for good reason – it literally brings children back from the brink of death.
Every 11 seconds, a child dies from malnutrition-related causes. These aren’t abstract statistics, they’re preventable deaths of children who could be saved. Recent research published in The Lancet warns that the White House’s cuts to international aid may lead to approximately 14 million preventable deaths by 2030.
But today, looking a mother in the eyes when both of us know her child won’t make it to their next birthday because we have no medicine to offer – this is a devastating reality we should never have to face.
The humanitarian system will recover, but not in time for the children who need treatment today. The clock is ticking, and children’s lives hang in the balance.
Clement Nkubizi is the Country Director for Action Against Hunger in South Sudan.
Image by Nicolas Ossard.
