Eight months of conflict in Sudan has stretched the health system to its limits with displacement, disease outbreaks, war injuries, non-communicable diseases and needs for maternal and child health rising in the face of declining capacity to meet these needs, according to the World Health Organization (WHO). We are closely monitoring the situation in Al Jazirah state after conflict spread to the outskirts of the State Capital Wad Madani on 15 December. WHO has a major operations hub in Wad Madani, where 700 000 of Al Jazirah’s estimated 5.9 million population live. The state hosts nearly half a million people displaced since 15 April, 86 400 of whom are in Wad Medani. There is an ongoing cholera outbreak in Al Jazirah state with over 1,600 cases 26 deaths as of 10 December. 24.7 million people need humanitarian aid, and 18.1 million people have been targeted for humanitarian aid as per the revised Humanitarian Response Plan launched in May 2023. 11 million people are in need of urgent health assistance, and 7.6 million of these have been targeted for response. The conflict in Sudan has displaced 6.88 million people over 5.42 million of whom have sought safety within Sudan and over 1.45 million have fled to neighbouring countries. The war has caused 12 501 deaths according to the Armed Conflict Location and Event Data Project (ACLED) data of 08 December 2023, and 26 051 injuries according to Federal Ministry of Health data (08 December 2023). Since 15 April 2023, WHO has verified 60 attacks on health care resulting in 34 deaths and 38 injuries. According to the latest projection update of the Integrated Food Security Phase Classification (IPC), 17.7 million people across Sudan (37% of the analysed population) have fallen into high levels of acute food insecurity between October 2023 and February 2024 driven by intense conflict, organized violence, and the continued economic decline in the country. About 4.9 million people (10% of the analysed population) are in IPC Phase 4 (Emergency), and almost 12.8 million are in IPC Phase 3 (Crisis). Outbreaks of infectious diseases are reported from several states, including: o Cholera: 6939 cases and 200 deaths from 9 states; o Measles: 4557 cases and 105 deaths from 11 states; and o Dengue: 6371 cases and 60 deaths from 10 states. An oral cholera vaccination campaign was conducted in Gedaref and Al Jazirah states in November targeting 2.26 million persons aged one year and older and achieving an overall 98% coverage.