EU Scramble for Anti-Russia ‘Drone Wall’ Hits Political, Technical Hurdles 

A Russian drone flies over the city as Ukrainian servicemen fire towards it during Russian drone and missile strikes, amid Russia's attack on Ukraine, in Kyiv, Ukraine September 28, 2025. (Reuters)
A Russian drone flies over the city as Ukrainian servicemen fire towards it during Russian drone and missile strikes, amid Russia's attack on Ukraine, in Kyiv, Ukraine September 28, 2025. (Reuters)
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EU Scramble for Anti-Russia ‘Drone Wall’ Hits Political, Technical Hurdles 

A Russian drone flies over the city as Ukrainian servicemen fire towards it during Russian drone and missile strikes, amid Russia's attack on Ukraine, in Kyiv, Ukraine September 28, 2025. (Reuters)
A Russian drone flies over the city as Ukrainian servicemen fire towards it during Russian drone and missile strikes, amid Russia's attack on Ukraine, in Kyiv, Ukraine September 28, 2025. (Reuters)

Just hours after some 20 Russian drones entered Polish airspace last month, European Commission President Ursula von der Leyen said it was time for Europe to build a "drone wall" to protect its eastern flank.

Drone incidents over airports in Denmark and Germany in the following weeks reinforced European leaders’ view that the continent urgently needs better protection against such threats.

But the "drone wall" proposal remains in flux, according to more than half a dozen officials and diplomats familiar with internal EU deliberations who spoke to Reuters about the project.

"Our capabilities are really, for the time being, quite limited," said European Defense Commissioner Andrius Kubilius, who is playing a leading role in fleshing out the proposal.

Kubilius told Reuters the EU would need to draw heavily on Ukrainian expertise, honed over nearly four years countering waves of Russian drones.

The drone project is a test of the EU's ambitions to play a greater role in defense – traditionally the preserve of national governments and NATO – as well as Europe's ability to take more responsibility for its own security, as demanded by US President Donald Trump.

The Commission, the EU’s executive body, has been trying to win over southern and western European governments, which argued the original idea was too focused on the bloc’s eastern border when drones could pose a threat across the whole continent.

The proposal is also caught up in a power struggle over who should control major European defense projects, with Germany and France wary of handing power to the Commission, diplomats say.

Some EU officials questioned the name "drone wall", arguing it implies a false promise of security when no system will be able to repel every drone.

To try to win more support, the Commission has broadened the original concept – from an integrated thicket of sensors, jamming systems and weapons along the eastern border to a continent-wide web of anti-drone systems.

As first reported by Reuters on Tuesday, the Commission plans to switch to the term "European Drone Defense Initiative" in a defense policy "roadmap" to be unveiled on Thursday.

If it goes ahead, the project would be a bonanza for makers of anti-drone systems – from startups in the Baltic states to bigger defense industry players such as Germany’s Helsing and Rheinmetall.

The Commission has not said how much the proposal would cost, but geopolitical consultancy RANE said it could generate billions of euros in orders.

But without broad support from European governments, the plan will struggle to secure access to EU funding, experts said.

"The path to realization remains long and fraught with constraints," said Matteo Ilardo, RANE’s lead Europe analyst, pointing to big challenges “in terms of cost, scale and cross-border integration”.

JETS VS DRONES

Baltic countries, along with Poland and Finland, pitched the idea of a “drone wall” to the European Commission last year, a spokesperson for Estonia's border guard told Reuters.

The countries applied for funding from an EU civilian border management fund, with the aim of deploying sensors and drones to combat people smuggling, the spokesperson said.

The project initially failed to gain traction at EU level.

But the idea evolved into a more defense-focused concept after Ukrainian Deputy Prime Minister Mykhailo Fedorov gave a presentation to von der Leyen in April in Brussels on how Ukraine counters Russian drone attacks, EU officials said.

The Russian incursion into Polish airspace on September 9 highlighted how ill-prepared EU countries currently are to tackle the threat posed by swarms of drones, adding to the sense of urgency.

NATO deployed F-35 and F-16 fighter jets, helicopters and a Patriot air defense system collectively worth billions of dollars to respond to Russian Gerbera drones - based on Iranian Shahed models – that cost a tiny fraction of the price.

"A 10,000-euro drone shot down with a million-euro missile - that's not sustainable," Kubilius told a defense conference in Brussels on Tuesday.

FRENCH, GERMAN SCEPTICISM

Once the Commission has fleshed out its proposal, EU governments will decide whether to give it the green light.

Diplomats say smaller countries see more value in having the Commission as a coordinator on such projects. But big countries such as France and Germany, which are used to handling large procurement initiatives themselves, want to retain control.

Neither German Chancellor Friedrich Merz nor French President Emmanuel Macron has so far embraced the proposal.

At an EU summit in Copenhagen earlier this month, Macron said the threat of drones was “more sophisticated, more complex” than the idea of a drone wall suggested.

Countries wanting to cooperate on an anti-drone system can use national budgets and the EU’s 150-billion-euro SAFE loans scheme for defense projects.

But if the EU gives the project the status of a European Defense Project of Common Interest, countries involved would have access to a broader range of EU funding.

The EU would also have to agree on who would run the project – member countries, the Commission, another EU body or some combination of all of those.

MACHINE GUNS, CANNONS AND ROCKETS

Drawing on lessons from Ukraine, the sensors for the project would likely include cameras, acoustic systems that can detect drone engine noise, specialist radars and radio-frequency detectors, according to interviews with more than a dozen EU officials and industry executives.

“We need to have a layered system that is able to detect, classify, engage and eliminate the target,” said Leet Rauno Lember, chief operating officer of Estonia's Marduk Technologies.

Weapons to counter any attack would include a mix of machine guns and cannons, rockets, missiles and interceptor drones – which can slam into enemy drones or explode close to them – as well as electronic jamming systems and lasers, they said.

Artificial Intelligence is already being used to help identify and target incoming drones and its use in the field is expected to grow, industry executives said.

“There is no one-size-fits-all solution. There is no single technology silver bullet,” said Dominic Surano, director of special projects at Nordic Air Defense, a Stockholm-based firm that has developed a ground-based mobile interception system.

Defense experts said the project would require constant updates as drone warfare is evolving rapidly, with each side constantly adapting to changes made by the other.

It is a story of “counteraction against counteraction,” said Taras Tymochko, a specialist in interceptor drones at Come Back Alive, a Ukrainian charity that has purchased hundreds of millions of dollars worth of military equipment for the country’s armed forces.

Tymochko said Ukrainian forces are experienced users of interceptor drones, which destroy targets by exploding next to them. But they had to evolve quickly.

The first Ukrainian interceptor drone to destroy a Shahed in early 2025 stopped being effective after four months because the Russians realized they could outrun it by increasing the Shahed’s speed from 170 kph to more than 200 kph, Tymochko said.

Now interceptors need to be able to fly between 30 and 50 kph faster than enemy drones to catch them, he said.

Tymochko said training and time on the job was also vital. Top interceptor pilots succeeded because of their experience more than reliance on automated guidance systems, he said.

FIRMS LINING UP

Defense and tech companies have swiftly embraced the drone wall concept, pushing their products as part of the solution.

Some – such as Germany’s Alpine Eagle and Quantum Systems - have even drawn up their own blueprints of how layers of ground and air-based systems would work.

Rheinmetall, Germany’s largest defense company, said a major challenge is detecting small drones and defending against swarm attacks, which have become a feature of the war in Ukraine.

“Cannon-based drone defense must be the focus, as this is the only cost-effective measure,” the company said.

Rheinmetall said it received recent orders from Germany, Denmark, Hungary and Austria for its mobile Skyranger system, which combines sensors and a cannon.

Drone producer Nordyn Group argued that using drones to intercept others was a cost-effective solution.

Ossian Vogel, a co-founder of the German company, warned against developing a “zoo” of different systems that soldiers would have to learn to use.

Many of the systems being proposed are already on the market, so the EU and its member countries would have to determine which systems to buy, where to use them and how to link them all together, officials and industry executives said.

Any such setup would have to fit into NATO’s broader air and missile defense systems, experts said.

“The EU and NATO need to work hand in glove on this one,” said Camille Grand, a former senior NATO official who is now Secretary General of the European Aerospace, Security and Defense Industries Association.

Some officials and executives, like Jan-Hendrik Boelens, CEO of Alpine Eagle, which has developed an airborne early-warning and interception system, said the EU idea could be “up and running within a year if the political will is available”.

Others are more skeptical.

“We are not talking about a concept which will be realized within the next three or four years ... (or) even more,” German Defense Minister Boris Pistorius told a security forum in Warsaw last month.



Trump Shattered Canada’s Old US Relationship. Carney is Building a New One in Europe

FILE- Canada's Prime Minister Mark Carney, front left, speaks with European Commission President Ursula von der Leyen at the European Parliament in Strasbourg, eastern France, Thursday, Sept 17, 2026. (AP Photo/Pascal Bastien, File)
FILE- Canada's Prime Minister Mark Carney, front left, speaks with European Commission President Ursula von der Leyen at the European Parliament in Strasbourg, eastern France, Thursday, Sept 17, 2026. (AP Photo/Pascal Bastien, File)
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Trump Shattered Canada’s Old US Relationship. Carney is Building a New One in Europe

FILE- Canada's Prime Minister Mark Carney, front left, speaks with European Commission President Ursula von der Leyen at the European Parliament in Strasbourg, eastern France, Thursday, Sept 17, 2026. (AP Photo/Pascal Bastien, File)
FILE- Canada's Prime Minister Mark Carney, front left, speaks with European Commission President Ursula von der Leyen at the European Parliament in Strasbourg, eastern France, Thursday, Sept 17, 2026. (AP Photo/Pascal Bastien, File)

For nearly four decades, Canada built its economy around closer integration with the United States. President Donald Trump has turned that dependence into leverage, imposing tariffs, threatening Canada’s sovereignty and openly seeking to pull Canadian industrial production south.

Canadian Prime Minister Mark Carney has moved on. Rather than return to trade talks or wait for the next US president to restore the old relationship, he is urgently building a future in which Canada is less dependent on America, The Associated Press said.

Last week, Carney embraced the prospect of Canada becoming the European Union’s first associate member, not as a step toward full membership, but as a way to reduce Canada’s dependence on any single country without ceding control over its own decisions.

“There is now a price to be paid for access to the United States market,” Carney said Sunday, pointing to tariffs, US investment commitments and demands for domestic policy changes.

Carney told the European Parliament on Thursday that countries need enough economic strength to keep any one power from dictating their choices.

Building options beyond the US

He carried that argument into a meeting Sunday with French President Emmanuel Macron in Saint-Pierre-et-Miquelon, the French territory just off Newfoundland’s coast.

“Canada and Europe will build an alliance for the future that will strengthen our collective resilience so we can live our lives as we choose based on the values that we share,” Carney said while standing alongside Macron.

Carney’s relentless schedule reflects the urgency of his push to build alternatives to the United States.

He began last week in Toronto hosting some of the world’s biggest investors, flew to Strasbourg, France, for European Commission President Ursula von der Leyen’s State of the European Union address, raced to Liverpool, England, to meet Britain’s new prime minister and returned to Strasbourg to address the European Parliament.

He met Macron in Saint-Pierre-et-Miquelon before flying back to Ottawa to meet Norwegian Prime Minister Jonas Gahr Støre. On Monday, he is set to open a new session of Parliament before heading to New York for the United Nations General Assembly.

Europe becomes the alternative

Trump has suggested Canada’s closer relationship with the EU could amount to a “hostile act” and threatened “very heavy tariffs” on Europe if he judged the move unfriendly.

Canada could become a test case for other middle powers trying to avoid being pushed around by larger countries. In his speech at the World Economic Forum in Davos, Switzerland, in January, Carney argued that “middle powers must act together,” warning that “if you’re not at the table, you’re on the menu.”

Støre echoed Carney on Sunday, saying tariffs should not become “a weapon to be used against countries, because we will all end up losers.”

The next major step in shaping that proposed relationship is an Oct. 29-30 Canada-EU summit in Montreal.

Unwinding 40 years of dependence

For Canada, that means undoing some of the reliance developed over nearly 40 years.

The 1989 Canada-US Free Trade Agreement and later NAFTA deepened integration, creating cross-border supply chains in autos, energy and manufacturing. Roughly 70% of Canada’s exports went to the US Europe remains nowhere close to replacing the US market.

Carney walked away from trade negotiations in August rather than accept terms he said Ottawa could not live with. The talks remain suspended, and Carney said Friday that leaving the table was the right decision.

“It was easy business, but it meant we relied too much on one economic partner,” Carney said recently. “That time is over.”

Investment chair wants to ‘crank the non-US’

Dominic Barton, Carney’s pick to chair Invest in Canada and a former global head of McKinsey & Co., said diversification does not mean abandoning the United States.

“We can’t complacently count on it,” Barton said. “It’s not about, let’s not do stuff with the US It’s let’s crank the non-US Let’s be way more ambitious on that side.”

Barton, a former Canadian ambassador to China, said Canada has been too inward-looking.

“We are not very global,” he said, calling Trump’s pressure a “jolt” Canada should use to build more global companies.

Carney wants to double non-US trade over the next decade and aims for a free-trade deal with India by year’s end. He said Canada’s tariff-free access to 1.5 billion consumers could double within six months.

Canada sells the trust America is losing

Carney is trying to turn growing doubts about the US as a predictable place to invest into a Canadian advantage. His pitch to global capital is increasingly clear: where Trump’s America uses tariffs and uncertainty as leverage, Canada offers stability, rule of law and reliability.

“The most sought after commodity today is trust,” Finance Minister François-Philippe Champagne said. “The world has changed and America has changed. And I think the world has taken notice.”

Trump may ultimately have done Canada a favor by forcing the country to confront its dependence, Barton said.

“Maybe in 20 years, we’ll thank Trump for shaking us out of our complacency,” Barton said. “Let’s use the moment.”

The ambition has limits. EU “associate membership” does not yet exist, and Europe cannot quickly replace a US market that buys nearly three-quarters of Canadian exports.

But Carney is hardly alone in concluding that Canada must rely less on the United States.

Former Conservative Prime Minister Stephen Harper, from the opposition Conservatives, said the government “had no choice but to take this path.”

That conclusion was particularly difficult for Harper as “one who has long been and known to be a great admirer of America” and who regarded Canada’s close relationship with the US as “among this country’s most precious assets.”

The current US administration now views the countries’ economic integration as incompatible with Canada maintaining its sovereignty, he said.

“Thus, to maintain that sovereignty, we must pursue diminished reliance on the United States,” Harper said. “I do find this all very sad, just as equally necessary.”


Voluntary Return or Pushed Out Against their Will? Migrants in Tunisia Go Home

African migrants during a protest demanding to be repatriated because of the harsh conditions they are living under in Tunisia (AFP)
African migrants during a protest demanding to be repatriated because of the harsh conditions they are living under in Tunisia (AFP)
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Voluntary Return or Pushed Out Against their Will? Migrants in Tunisia Go Home

African migrants during a protest demanding to be repatriated because of the harsh conditions they are living under in Tunisia (AFP)
African migrants during a protest demanding to be repatriated because of the harsh conditions they are living under in Tunisia (AFP)

Less than a year after arriving in Tunisia, Michael Oppona had not planned to return to Ghana.

But, faced with increasingly harsh pressure from local authorities, he is among thousands of sub-Saharan migrants seeking to head home.

Many, like Oppona, have registered for a free return to their countries of origin.

But humanitarians say many migrants and refugees are being pushed out against their will.

Oppona, 37, had crossed the Sahara with his wife and two toddlers before arriving in Tunis but Europe proved out of reach after a 2023 deal with Tunis to curb migrant departures.

"The people here, the government... they treat us like we're not human," said Oppona, waiting for a "voluntary return" appointment near the International Organization for Migration headquarters in Tunis.

Many sub-Saharan migrants in Tunisia face increasingly harsh conditions following a speech by President Kais Saied in 2023 in which he said "hordes of illegal migrants" were posing a demographic threat.

The IOM told AFP it had helped 4,965 migrants return to their countries of origin from January 1 to August 31.

The IOM's program is separate from a namesake program run by the Tunisian government, and operates a major "return hub" near the city of Sfax.

Authorities did not respond to several requests by AFP for interviews and a visit the center.

In June, a Tunisian National Guard official told AFP that nearly 5,000 migrants had been sent to their home countries in the preceding 12 months and that "near-daily" return flights were now scheduled.

But humanitarian sources say these returns should not be considered "voluntary", arguing that socio-economic and political pressures including racism were deliberately forcing migrants to leave Tunisia.

"These are clearly expulsions," one source said.

Humanitarian sources also said migrants were at times coerced to leave even when it was unsafe for them in their home country.

"Authorities say that migrants stay at the so-called 'return hubs' for about two weeks, whereas we know that that process can take months, especially with people without documentation," one said.

The sources also said the conditions in which migrants were held were unclear, adding that some might have been sent to the wrong country.

"We've seen that more people have been arriving in Libya lately," one said.

UN experts in July said they were alarmed by an "alleged system of mass detention, expulsion and trafficking" at the Tunisia-Libya border.

Neither Tunisian nor Libyan authorities have commented on the allegations.

The humanitarian sources to whom AFP spoke also raised concerns over the lack of official information regarding the government's return program.

"We don't know how the authorities have been repatriating people who hold no documents, for example," one source said.

More than 40 global NGOs have said that refugees and migrants in Tunisia faced harsh mistreatment, including rape, according to testimonies they gathered.

In a joint statement in July, the NGOs -- including Human Rights Watch and Amnesty International -- said "refugees, asylum seekers and migrants have faced racist violence" in Tunisia, added to "arbitrary detention, collective expulsions, abuse, torture and other ill-treatment".

Their statement marked the three-year anniversary of a controversial deal the European Union signed with Tunisia to provide Tunis with financing, equipment and training to stop irregular departures.

The groups said the deal came at "a significant cost to human rights and dignity" and called the EU "complicit".

Campaigners say Tunisia's crackdown on organizations that supported migrants, compounded by the suspension of the UN refugee agency's operations in 2024, have barred thousands from receiving help.

Using pseudonyms, 24-year-old Moussa and 22-year-old Karim from Guinea also waited for an IOM "voluntary return" appointment in Tunis.

The two friends said they came to Tunis three years ago with one aim: to cross to Europe.

"But it's impossible to go now, and impossible to stay," said Karim.

Moussa said there was "more pressure now", his voice shaking.

"You're not free. The police prevent you from going anywhere -- to work or get something to eat," he said.

"So why not go back home?"


Can Sudan's Health Sector Rise from the Rubble?

Entrance to the Trauma and Emergency Complex at Omdurman Hospital (Asharq Al-Awsat)
Entrance to the Trauma and Emergency Complex at Omdurman Hospital (Asharq Al-Awsat)
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Can Sudan's Health Sector Rise from the Rubble?

Entrance to the Trauma and Emergency Complex at Omdurman Hospital (Asharq Al-Awsat)
Entrance to the Trauma and Emergency Complex at Omdurman Hospital (Asharq Al-Awsat)

Between hospitals that have reopened after being destroyed and looted, and facilities still struggling with shortages of electricity, equipment, medicines, and staff, two contrasting pictures of Sudan's health system are emerging after more than three years of devastating war.

In Khartoum, major referral hospitals have begun gradually resuming operations as residents return and fighting recedes from large parts of the capital. Elsewhere, however, the picture is much bleaker in Darfur, Kordofan, and other areas, where ongoing fighting, funding shortages, and difficulties accessing facilities continue to deny large segments of the population access to healthcare.

Data from the World Health Organization indicates that around 37 percent of health facilities in Sudan are not functioning, while around 21 million people need medical services, amid shortages of medicines and rising costs of accessing treatment.

At the same time, the organization is monitoring improvements in some states as early recovery efforts and the rehabilitation of facilities begin. This contradiction makes the question more complex: "Has Sudan's health system actually begun to recover, or is what is happening merely a partial restoration of services in areas where the war has receded?"

Hospitals Recovering

At Omdurman Teaching Hospital, one of the capital's largest referral hospitals, signs of a return to activity are evident. Its Director General, Abdel Moneim Ali Al-Qasim, told Asharq Al-Awsat that the hospital suffered extensive wartime destruction affecting its infrastructure, equipment, electrical networks, cables, and generators. In 2024, rehabilitation began on the emergency department to allow it to receive patients, while other parts of the hospital remained destroyed.

With support from the King Salman Humanitarian Aid and Relief Centre and its national partner, Kafaat Organization, the hospital received a 730-kilovolt-ampere generator in July 2025, along with intensive care, emergency, and laboratory equipment. Al-Qasim said the support was worth around $1 million.

According to Al-Qasim, the stabilization of the electricity supply had a direct impact on services. The waiting time for laboratory test results fell from four to six hours to around one hour and 15 minutes. Around 500 surgical procedures were performed during the first month of the support, before the number rose to between 1,000 and 1,500 procedures per month, averaging between 40 and 50 procedures a day.

The hospital currently receives around 600 patients a day. Eleven of its 15 intensive care beds are now operational, while the remaining four are being prepared for service.

The hospital also received an integrated oxygen production unit and opened a prosthetics center with a production capacity of up to 50 prosthetic limbs per month during a single shift. That capacity can be doubled by operating two shifts.

But the return of activity does not mean the problems are over. According to its director, the hospital still suffers from a shortage of wards and a need for fuel, in addition to unstable electricity. The return of residents is also increasing pressure on facilities that have resumed operations.

Buildings Have Returned... But Shortages Remain

The same picture is repeated at Bahri Teaching Hospital, which was rebuilt and reopened after suffering extensive destruction during the war. Its Director General, Ahmed Al-Bashir, told Asharq Al-Awsat that the hospital, with a capacity of 640 beds and 20 operating rooms, still needs intensive care equipment to increase its capacity to handle cases around the clock, as well as a backup power source.

The hospital also needs to complete its sewage system and connect it to the public network, or provide tankers to dispose of wastewater. Meanwhile, the administration is seeking to convert the emergency complex into a continuing vocational training center to make up for some of the staff the hospital lost during the war.

These details reveal one of the major challenges of rebuilding the health system: repairing a building and reopening its doors does not necessarily mean restoring its full capacity to provide services.

A Bleaker Picture Outside Major Hospitals

A short distance from the major referral hospitals that have begun to resume operations, the picture can be very different, even within Khartoum State itself. In Fattasha, west of Omdurman, Eman waited for three days while her son suffered from a high fever and worsening cough because the nearest health facility could not provide the services he needed.

Eman said in testimony published by the United Nations Children's Fund, UNICEF, in December 2025 that the area's only health center had just one health worker and offered no vaccination, nutrition, medicines, pharmacy, or laboratory services. The mother had no choice but to wait for a UNICEF-supported mobile clinic that visits the area twice a month. Despite the time that has passed since that testimony, the same hardship continues, revealing the wide gap between the return of major hospitals in the heart of the capital and those on the outskirts of the state.

The gap becomes even clearer outside Khartoum. At Al-Thawra Health Center in New Halfa locality, Kassala State, Noor, who is pregnant with her eighth child, says she previously had to buy the iron supplements prescribed by doctors during pregnancy. At times, however, she stopped taking them because she could not afford them.

In testimony published by UNICEF in July 2025, Noor said that the free provision of medicines had become a major relief for the family after the cost of treatment had prevented her from obtaining the medication.

At the same center, Aisha, a mother who received medicines for her children, said that receiving treatment for free represented significant assistance given the economic circumstances facing families.

In White Nile State, families face another problem: distance. In January 2026, UNICEF documented the journey of Zahra and her nine-month-old daughter, Amina, to obtain vaccinations.

Zahra takes around two hours to reach the nearest health facility from her home. Previously, she had been forced to travel to the city of Al-Jabalain in search of the service.

In the same area, another mother named Amina arrived with her two-year-old daughter, Aisha, after the child developed severe diarrhea and vomiting and became so weak that she could no longer walk. After being admitted to a stabilization center and receiving treatment and therapeutic milk, the girl began to regain her strength.

El Fasher... Giving Birth Under a Tree

The hardship reaches its most severe levels in areas affected by war and displacement. Amani, a displaced mother from North Darfur, recounted how she was forced to move with her family to escape fighting in El Fasher while she was in the final months of pregnancy.

In testimony published by UNICEF in August 2025, she said the family went days without food or water or anyone to help them. During their displacement journey between Sharika and Tawila, she went into labor, with no hospital or health workers nearby.

Amani gave birth to her daughter by the roadside, under a tree and on a small mat, with the help of her mother and some local residents. She said that during the delivery she did not know whether she would live or die, or what would happen to her children if she died.

After giving birth, she was too weak to carry her newborn or continue the journey. She was forced to stop for about a week before she was able to reach Tawila with her family.

Her experience represents the exact opposite of the picture presented by hospitals resuming activity in Khartoum. In areas affected by war, the issue is not simply the quality of services or the availability of equipment, but whether a health facility exists at all.

Disagreement Over the Definition of "Collapse"

These disparities lie at the heart of the disagreement over how to characterize the condition of the sector. Médecins Sans Frontières has warned that cuts to aid funding are pushing more health facilities to close and depriving millions of Sudanese of essential care.

The organization says the Sudan Humanitarian Response Plan, which amounts to $2.87 billion, had received only around 41 percent of the required funding as of August 11.

Sudanese Health Minister Haitham Mohamed Ibrahim, however, believes the Médecins Sans Frontières report focuses largely on the organization's activities and working conditions. He told Asharq Al-Awsat that it "does not by itself reflect the reality of the health sector in the country."

Omdurman Hospital Director Abdel Moneim Al-Qasim likewise rejects describing the system as "on the verge of collapse." He says the sector is indeed suffering from a major shortage of resources, but has begun to recover gradually as a result of efforts by the state and national, regional, and international organizations.

Bahri Hospital Director Ahmed Al-Bashir agrees that "the description of collapse is inaccurate," while acknowledging at the same time the need to expand support for referral hospitals and provide specialized equipment and medical specialties.

Health workers inside Omdurman Teaching Hospital (Asharq Al-Awsat)

Cancer Patient Searches for Medicine

For patients, recovery is not measured solely by the number of hospitals that have reopened, but by whether they can find the treatment they need when they reach them. In July 2026, Naela Hamad, who has cervical cancer, was receiving chemotherapy at Khartoum Oncology Hospital, known as "Al-Dhura," while her daughter, Ithar Al-Sir, was searching outside the hospital for a medicine needed alongside the treatment that was not available there.

Ithar said in testimony documented by Reuters that the family found the medicine outside the hospital for around 180,000 Sudanese pounds, or about $45 at the time, at the prevailing market price. Her mother needs it with each chemotherapy dose every 21 days.

The costs do not end with the medicine. She said she also pays 40,000 pounds for the bed where her mother receives her dose, asking how the family can afford these expenses when there is no work or income.

Naela says the family had previously struggled to afford food and is now struggling to obtain both food and medicine, while her home was destroyed and she was forced to stay with neighbors.

Reuters quoted Mona Abdel Rahman, head of pharmacy at Khartoum Oncology Hospital, as saying that some patients' doses had been delayed by two weeks or more after the free provision of some medicines stopped because they could not afford to buy them themselves.

The economic crisis is also affecting diagnostic services. Medical laboratory specialist Al-Tayeb Youssef told Asharq Al-Awsat that the rise in the price of the dollar has directly affected the sector, given laboratories' reliance on imported reagents and supplies purchased in foreign currency.

He added that many laboratory owners who returned to Khartoum had been forced to start "from scratch" after losing their premises and equipment and having to face the costs of maintenance, rent, and purchasing equipment again.

The high costs have prompted some laboratory owners to purchase equipment through partnerships and pool it at a single location rather than having each laboratory maintain its own equipment. This is viewed as a temporary solution that helps keep services running.

Expensive Medicine and Factories on the Road to Recovery

The situation in the pharmaceutical market is not very different. Pharmacist Mahmoud Al-Naeem told Asharq Al-Awsat that rising prices and complaints from citizens have worsened since the war, as a result of the destruction of several local pharmaceutical factories, disruptions to external supply chains, and the reliance on imports requiring foreign currency.

He noted that the National Medicines and Poisons Board has begun encouraging the registration of new pharmaceutical products and companies, considering that increased competition could help lower prices.

Some factories in Khartoum have begun returning to production, although they are operating below full capacity. This opens the door to gradual relief if local production and supply chains stabilize.

Epidemics... A Risk That Has Not Gone Away

Alongside destruction, funding shortages, and the high cost of treatment, the health system faces the threat of epidemic diseases. The director of Omdurman Hospital says rates of watery diarrhea, malaria, and dengue fever among the cases treated at the hospital have declined, with epidemic-control campaigns continuing and an isolation center established to handle cases of cholera, dengue fever, and other diseases.

The director of Bahri Hospital says malaria, as an endemic disease in Sudan, cannot be tackled by hospitals alone. It requires coordination among the federal health system, states, localities, and communities, from awareness, prevention, and vector control to diagnosis and treatment.

These risks remain more severe in areas affected by displacement and fighting, where disease and malnutrition coincide with weak water and sanitation services and difficulties accessing health facilities.

Thus, the current picture may not show a sector that has completely collapsed, but neither does it show a health system that has overcome the effects of the war. In Khartoum, hospitals have returned to service, surgeries and intensive care and laboratory services have resumed, and rehabilitation and oxygen production projects have begun. In Kassala and White Nile, there are examples of facilities that have regained their ability to provide free services or services closer to local populations.

But Eman is still waiting for the mobile clinic to treat her son, Zahra still travels two hours to reach a health center, Amani gave birth to her daughter under a tree while fleeing the war, and Naela reached one of the capital's largest cancer treatment centers only to find that the medicine she needed was unavailable.