Piloting a mobile early warning alert and response system for East and Central Darfur, Sudan

Abstract

Conflict in Sudan since April 2023 has disrupted health information systems, particularly in hard-to-reach areas like Darfur. In response to limited surveillance capacity and reports of suspected outbreaks (e.g. measles, cholera, hepatitis E), Sudan’s Federal Ministry of Health, Health Cluster partners and the WHO piloted an emergency surveillance programme using the WHO-developed Early Warning, Alert, and Response System Mobile (EWARS Mobile) in Central and East Darfur states from September 2024 to January 2025. The approach enabled simplified, offline reporting of eight priority diseases and event-based surveillance through partner-supported health facilities. A total of 158 health facilities submitted 752 weekly reports, generating several verified alerts, including suspected measles and acute flaccid paralysis. Despite resource and connectivity challenges, the system provided timely, actionable data for early detection and prompt response, and worked as a beachhead for enhanced partner coordination. The pilot highlighted the value of fit-for-purpose surveillance tools in complex emergencies and demonstrated the feasibility and utility of EWARS Mobile in conflict-affected settings. Based on improved reporting timeliness and partner engagement, the system was approved for expansion to all Darfur states in February 2025.