Top up for vaccination campaign in response to the countrywide measles outbreak in Sudan. In 2019, all the 18 states of Sudan had been affected by measles outbreak. As of 15 April 2019 a total of 2076 suspected, and 890 measles confirmed cases reported through FMOH surveillance system. This represents more than two folds increase in the number of measles cases as compared with the same period in 2018.

The technical committee of Federal Ministry of Health in Sudan, World Health Organization (WHO), Gavi, the Vaccine Alliance, and the United Nations Children's Fund (UNICEF) recommended a country wide response vaccination campaign in Sudan targeting over 13,3 million children aged 9 month to 10 years against measles, also using this opportunity to add Oral Polio Vaccine (OPV) and Vit-A supplementation. 

Taking into account the present challenges, including social unrest, access issues, fuel shortages, and cash flow constraint, the technical committee recommended a phased approach. 

The implementation of the first phase targeting 5,516, 425 children in eight states (Gedaref, Kassala, Nort Kordofan, Red Sea, South Darfur, South Kordofan, West Kordofan and white Nile) was implemented between from 8 April to 19 April (including the 2 days extension of vaccination period) . In spite significant challenges the initial reports shows a preliminary coverage of 95% (5,213,362 children under the age of 10). 

The second phase targeting 7,8 million children started on 23rd April in Blue Nile, East Darfur, Central Darfur, West Darfur, North Darfur, Northen, Sennar, and River Nile states. There is a clear recommendation to postpone the campaign in Khartoum for July, as community mobilization and transport of supplies are difficult in the context of massive daily demonstration and roads blockages. In addition, Gezira campaign is also postponed ¬¬allowing at least one month between the Yellow Fever (recently conducted) and Measles vaccination (WHO guidelines). 

A significant budget gap of USD 1,6 million is threatening the implementation of phase two. To address security and access challenges, a two days extension of the first phase was needed, and additional operational costs are needed due to difference between the calculated and real catchment population (data from 2019 year) The amount is necessary for additional 1.8 million vaccine doses (including wastages) and operational costs for covering 1,6 million children. The present situation in Sudan with social, political, security and financial instability prevents the MOH to provide the additional resources, and a request for support had been made to WHO and UNICEF. 

Failing to cover all 18 states of Sudan will jeopardize the control of the outbreak and would result in avoidable illnesses and death. Due to the time criticality, WHO and UNICEF request OCHA to support the top up for finalizing the measles vaccination campaign through the SHF Reserve. 

The USD 500,000 from SHF will be used for covering the costs of East Darfur state campaign, 419,696 targeted children aged 9 month to 10 years of age. UNICEF forwarded the needed vaccines and WHO the operational costs (from other programs): SHF fund will ensure the replenishing of the vaccine and reimbursement of funds.

Meanwhile WHO and UNICEF will advocate with bilateral donors to ensure full implementation of the much-needed measles vaccination.