‘Spoiled insulin’: Sudan war disrupts drug supplies, fuelling smuggling

As the conflict destroys local production, Sudanese patients are forced to rely on expensive, smuggled medicines.

On a modest bed inside his war-battered home in the Khartoum North neighbourhood of the Sudanese capital, Khartoum, Murtada Mohieddin, a diabetic patient in his early 50s, carefully counts his remaining doses of insulin. His search for medicine has transformed into a harrowing battle – not just to find the treatment he needs to survive his diabetes, but to ensure the medicine is not expired or ruined.

“Sometimes the insulin is spoiled,” Mohieddin tells Al Jazeera, inspecting his limited supply. “You wouldn’t know if it is ruined or expired. You can check the expiration date, but it could still be damaged from poor storage.”

The war, which erupted as a power struggle between Sudanese Armed Forces (SAF) and the paramilitary Rapid Support Forces (RSF), has killed more than 50,000 people and displaced 14 million – nearly a quarter of the country’s population.

The devastating conflict has paralysed domestic pharmaceutical production and collapsed vital supply chains across the country.

According to a World Health Organization (WHO) news release dated April 14, 2026, Sudan represents the world’s largest humanitarian crisis, with 21 million people lacking basic healthcare services out of 34 million needing aid.

In the void left by the closure of pharmaceutical companies, smuggling networks have flourished, flooding the market with unregulated drugs locally known as “Boko” medicines.

These include critical intravenous malaria medications smuggled across borders. Because they completely bypass strict temperature controls and quality checks during transit, these drugs are frequently spoiled, rendering them either totally ineffective or lethally toxic to patients.

Inside local pharmacies in Omdurman, located on the outskirts of Khartoum, the crisis is not just limited to scarcity. Patients now face the double threat of exorbitant costs and life-threatening quality issues, as these illicit medicines are often severely spoiled due to a lack of proper storage and refrigeration.

Mutawakil Hamza, a pharmacist based in Omdurman, said the reliance on unregulated channels is putting lives at immediate risk.

“Most malaria medicines are now brought in through smuggling,” Hamza said. “These are ultimately injections for intravenous use, and this is highly dangerous to a patient’s health.”

Because intravenous treatments bypass the body’s natural defences and require absolute sterility, administering improperly stored or degraded smuggled injections can r