Por Renan Filho · 2026-09-24A stark illustration of South Sudan’s crumbling healthcare system emerged this week when Médecins Sans Frontières (MSF) released data showing that a single surgical team in the capital Juba conducted 42 surgeries within 48 hours. The figure, drawn from the organisation’s internal records, underscores the extreme pressure on medical staff in a country where the state has all but abandoned its duty to provide basic health services.
The MSF team, operating at the Juba Teaching Hospital, reported that the workload included emergency caesarean sections, trauma repairs from armed clashes, and amputations linked to untreated infections. According to an MSF spokesperson in a statement to the press, ‘Our surgeons are working around the clock, often with minimal sleep, because there is no alternative. The Ministry of Health lacks the capacity to manage even routine cases.’ This is not an isolated spike: MSF data shows that surgical demand in South Sudan has risen by 35% since 2023, while the number of qualified surgeons has barely increased.
South Sudan, the world’s youngest nation, has been independent since 2011, yet it remains one of the most aid-dependent states on earth. Over 70% of its healthcare budget comes from international donors, according to the World Bank. The government in Juba, meanwhile, consistently fails to allocate even the modest 15% of its national budget to health that it promised under the Abuja Declaration. In the 2025 fiscal year, actual health spending was just 8.7% of the total, with much of that lost to corruption and administrative bloat.
Why this matters for the United Kingdom: British taxpayers contribute approximately £200 million annually to South Sudan through the Foreign, Commonwealth & Development Office (FCDO) and multilateral channels. Much of this money flows into health programmes. Yet the results, as the 42-surgeries-in-48-hours episode shows, are dangerously inadequate. The system is not merely underfunded; it is structurally broken. The state does not pay doctors on time, supplies are stolen and sold on the black market, and there is no incentive for local private healthcare provision to emerge because the regulatory environment is hostile to enterprise.
FORTIS analysis: The narrative that ‘more aid’ is the solution collapses under the weight of evidence. South Sudan has received over $20 billion in international assistance since independence, according to the Brookings Institution. Health indicators have barely moved: maternal mortality remains among the highest globally, and life expectancy hovers at 57 years. The problem is not a lack of money but a lack of accountable institutions. A free-market approach would prioritise removing barriers to private clinics, allowing foreign medical professionals to operate without excessive red tape, and tying aid disbursement to measurable outcomes rather than to political favours. Instead, the current model rewards inefficiency: governments that fail to deliver continue to receive funds, and NGOs are forced to pick up the pieces in an endless cycle.
Counterpoint: Critics of market-based reforms argue that South Sudan’s poverty and instability make private healthcare impossible for the majority. They point to the country’s low GDP per capita (under $1,000) and the fact that most citizens rely on subsistence farming. However, this argument ignores the success of low-cost private providers in other fragile states, such as Rwanda and Liberia, where regulatory simplifications and performance-based financing have improved access. The difference lies in political will, not in economic determinism. South Sudan’s elite, enriched by oil revenues and aid contracts, have no incentive to reform a system that keeps them in power.