By Deng Machol
JUBA, South Sudan — South Sudan’s already fragile health system is facing a renewed crisis after major donor funding cuts left more than 100 health facilities without project support, exposing the country’s heavy reliance on foreign aid and prompting urgent calls for increased domestic health financing.
Health Minister Sarah Cleto Rial revealed that the Ministry of Health currently receives just 1.3 percent of the national budget, while development partners fund an estimated 85 percent of healthcare services nationwide — a model she warned is no longer sustainable as donors scale back.
“Our budget allocation is very small,” Cleto said. “We hope it can be increased to 5 or 7 percent, which would help sustain essential services as donors withdraw.”
The funding shock has hit the Health Sector Transformation Project (HSTP) — a flagship reform initiative — particularly hard. Originally valued at $400 million, the project’s budget has been slashed by nearly half following the withdrawal of support from the United States and Sweden, according to the Ministry.
As a result, donor assistance is being withdrawn from 102 health facilities across the country after assessments found low functionality, security concerns, or duplication with nearby supported sites.
“Support will be withdrawn from 101 facilities assessed as having low functionality, security challenges, or close proximity to other supported facilities,” Cleto said. She added that six hospitals will scale down non-core services in order to focus limited resources on life-saving care.
To stretch shrinking funds, the Ministry has also ordered cuts to administrative costs and in-service training, redirecting resources toward medicines, frontline health workers, and direct patient care.
“These decisions were not taken lightly,” Cleto said. “But they are necessary to protect the integrity and sustainability of the health system.”
Despite the cuts, the Ministry stressed that affected facilities will remain open while alternative funding sources are explored.
The HSTP, running from 2024 to 2027, serves as South Sudan’s national roadmap to ensure universal access to essential health and nutrition services. The program is funded by development partners including the World Bank, Canada, the European Union, the United Kingdom, Gavi, and the Global Fund, and is implemented by the World Health Organization (WHO) and UNICEF through 28 international and national NGOs operating across 10 states and three administrative areas.
Dr. Harriet Akello, Director General for International Health and Coordination, said the government and partners are continuing engagements to identify new financing mechanisms to keep facilities operational.
“We are still engaging with partners and government to see what alternative funding arrangements can support the Ministry in running these health facilities,” she said.
Lawmakers have also weighed in, warning that donor dependency leaves the system dangerously exposed. Benjamin Malek, Chairperson of the National Legislature’s Specialized Committee on Health and Population, said the funding cuts should serve as a wake-up call.
“With these reductions, we must seriously consider increasing local financing,” Malek said. “Donors have their own limitations.”
South Sudan — one of the world’s youngest and poorest nations — continues to grapple with conflict, mass displacement, disease outbreaks, and weak infrastructure. These challenges have long made its health system dependent on external aid, a vulnerability now laid bare as international funding recedes.
