THE U.S. MUST TAKE IMMEDIATE ACTION TO AID THE SUDANESE HEALTHCARE CRISIS

By: Anna Douglas Piper

Sudan is experiencing a rapidly deteriorating humanitarian crisis. The International Rescue Committee cites the escalating fighting, an economic crisis, and a near collapse of health care services, among other causes. 

The healthcare crisis presents the most urgent problem, and the United States must do more to help.

In April of 2023, conflict between the Sudanese Armed Forces (SAF) and the Rapid Support Forces (RSF) erupted into civil war. Though fighting has been concentrated in the capital city of Khartoum, reports of ethnic cleansing exist in other regions. More than 61,000 people have died. 26,000 deaths were a direct result of the violence, while the majority resulted from largely preventable diseases and starvation. 

The Sudanese conflict is the world’s worst humanitarian crisis. According to the World Health Organization, 11 million are in urgent need of life-saving health care. 

The healthcare crisis precedes the conflict, driven by long-term political and economic instability. The problem is compounded by lack of access to food, a key driver of disease. Millions are experiencing malnutrition, and famine was officially declared in the Darfur region in August of 2024. Exacerbated by the fighting, 25.6 million, over half of the population, are in desperate need of aid.

Over 70% of health facilities are currently non-functional. Sudan faces a complete lack of funding, supplies, and staff. Hospitals suffer from targeted attacks as well as repeated looting and occupation from both sides of the conflict.

"The situation in health clinics is beyond words," said Amelie Chbat, who oversees the International Committee of the Red Cross in Sudan. "The injured lack medicines, food, and water, and the elderly, women, and children are without essential treatments like dialysis or diabetes medications. And the situation is deteriorating."

Sudan’s health care system has virtually collapsed. 

The consequences are immeasurable. There is a severe strain on resources, including water, sanitation and hygiene services. Measles has killed more than 1,000 children, while a severe cholera outbreak has led to 8,000 cases and 299 deaths. Malnutrition is rampant, immunization levels are low, and care is nonexistent. Outbreaks will continue to have devastating effects, particularly for the youth. 

Humanitarian organizations have attempted to help, including the IRC, Doctors Without Borders/Médecins Sans Frontières (MSF), The Red Cross, and more. However, access to the Sudanese has been difficult. Violence and movement restrictions on organizations have constrained aid delivery, especially in the south–where need is highest. The Assessment Capacities Project (ACAPS) rated aid constraints a 5 out of 5 (extreme). 

“The cost of inaction is already unbearable,” said Dr. Tammam Aloudat, president of the MSF Netherlands board. “It can be measured in the tens of thousands of lives lost and the millions of lives that are on the line as we speak.”

The U.S. has contributed financial assistance, food, and medical services to Sudan and neighboring countries. The most recent $424 million package was announced in September 2024, bringing US aid since April 2023 to over $2 billion. However, as diplomacy fails to reduce the conflict, the capacity to target rising needs will continue to fall.

The United States must do more. 

Though U.S. officials claim to be “steadfast in [their] support for the people of Sudan,” they must do more than call on the RSP and SAF to cease hostilities and allow in aid. Existing support is not enough–America must use its global influence to end the crisis. 

International pressure must be increased on the Sudanese forces, and the U.S. can play a major role. Unobstructed aid flow into the country is vital, and solutions are necessary to allow delivery of medical support. The United States can increase support for humanitarian organizations to bolster their presence and create a reliable supply movement into Sudan.

“Sudan and its suffering people have slipped down the world's list of priorities—forgotten by the media, neglected by political will, and overlooked by the humanitarian donor institutions that should be putting this catastrophe front and center,” says Dr. Mohamed Bashir, Sudanese medical staff member.

“Amid all this, I plead with the world: Do not let Sudan slip from your attention. At times, it feels as though no one cares, as if Sudan has been deliberately deprioritized by the global decision makers, pushed aside for other crises.”

“How much longer can we tolerate this inaction?”

Engagement With China: Lessons From United States - Japan Relations

By: Anna Douglas Piper

Today, the United States and China compete across almost every facet of the global market. Whether surrounding nuclear weapons, Taiwan, or economic relations, nearly every conversation has grown tense. Cooperation has broken down since 2018, largely due to various administrations’ trade wars, specifically the Trump administration’s strategies of hostile engagement.

Attitudes coming from China reflect much of the same hostility. Advocates of aggression have grown stronger – one of the only things Democrats and Republicans agree on today is a tough stance against China. This won’t change on its own, even with the upcoming election. 

We must not fall into this trap. A pre-Trump engagement strategy is not only possible, but necessary.

The U.S. must aspire to stabilize the tense relationship and allow conflict resolution. Mutual benefits include addressing shared challenges, like climate change and nuclear proliferation. An engagement strategy aligns with U.S. principles of international cooperation and diplomacy and ensures peace and stability are supported globally. 

To examine the effectiveness of engagement in promoting a liberal world order, we can turn to historical experiences with Japan. 

The U.S. saw confidence grow under the Bretton Woods System as trade barriers were reduced and Japan experienced rapid growth. As this growth continued into the 1980s, the U.S. began to worry about Japan’s rising influence. Economists warned Congress that Japan would surpass the U.S. in economic size. By 1995, Clinton was taking relations to the brink of a trade war – the U.S. even briefly imposed 25 percent tariffs on luxury vehicles.

A breakdown in cooperation was clear. 

Many argue this supports the realist prediction that engagement will fail in the long run. However, U.S.-Japan cooperation in the 1990s continued, countering the realist theory. A 1988 bilateral deal opened Japan’s beef, orange, and cigarette markets to imports, and the collision over automobiles was averted when the U.S. withdrew luxury car tariffs a month later. 

Though the end of the twentieth century witnessed international tensions that arguably undermined liberal institutionalism, this tension did not produce a collapse of the international system. Despite tensions with Japan, cooperation remained.

The realist perspective that increasing tensions inevitably lead to trade wars does not always explain how countries will interact. To better understand U.S.-China relations, we can consider the neoliberal institutionalist prediction that countries continue to move to a liberal world order.

Moves like trade restrictions are only a partial solution to combat a rising China. Export controls by the U.S. are unlikely to succeed unless other participating countries do the same, which they won’t do for fear of Chinese retaliation. It seems to be unavoidable that restrictions will either stagnate and dissipate or the two economies will forever be separated — the latter being unrealistic. 

The conflict between China and the United States is not inevitable, but depends entirely on the next moves from both sides. It is clear, then, that the U.S. must return to increased engagement with China.

Responses may vary. Countries with close economic relationships with China, including South Korea and Japan, may view engagement positively. However, others with competitive concerns may profit from a limited U.S.-China trade flow. Additionally, regions like Taiwan may not react positively to an apparent U.S. acceptance of China’s policies. While countries may be wary of China’s growing regional influence, increased engagement is more effective than trying to convince them to confront China through other means, given fears of retaliation.

The urgency for renewed engagement is clear. Rising tensions threaten global stability and undermine U.S. efforts to pursue cooperation. Both nations have the opportunity to address pressing challenges, though it remains to be seen how China would respond to such a move. We cannot rely on the upcoming election for a change. The stakes are high, but the attitude that the U.S. adopts creates impacts far beyond the borders of Washington and Beijing.

Pakistan: A Democracy In Danger

History is repeating itself in the most dangerous fashion in Pakistan.  In an eerie parallel with Muhammad Zia-ul-Haq’s ascent to power in the 1970s, Pakistan’s current Chief of the Army Staff Asim Munir appears to have taken a few pages from his predecessor’s book. The military has established itself once again as the most powerful institution in the nation. 

The state of civil military relations in Pakistan is troubling for a myriad of reasons. For starters, in a healthy democracy the military should subordinate itself to civilian control. However, since Pakistan’s inception, the military has a long standing history of political intervention credited to weak political institutions, inadequate political leadership, and entrenchment of civil military bureaucracy. Such issues with Pakistan’s civil military relations can be traced back to British colonial policies. British generals continued to head Pakistan's military until 1951, when the authority was transferred to General Ayub Khan, who became Pakistan’s second president through a military coup. 

While the nation has always had a strong military presence, it has had weak political institutions that have failed to establish an effective political and constitutional system. This has seriously handicapped the government’s ability to properly respond to the multitude of external and internal challenges that the country faces. In this power vacuum, the bureaucratic military elite have been able to increase their authority and power over the country’s political elite. They have been able to garner so much influence, that despite the civilian government’s inability to control them, the country’s army stands out as the most trusted institution - with more than 80 percent public approval.

Recent examples of the military’s dominant role in the Pakistani political and economic sphere include the previous Prime Minister Imran Khan granting General Bajwa a position as a member of the government’s National Development Council in 2020. Additionally, Bajwa met privately with top business leaders to discuss ways to aid the failing economy, increasing the military’s role in the economic and political issues that were plaguing the nation. The then Prime Minister Imran Khan’s desire to work with the military through political concessions shows the inherent tension in civil-military relations in Pakistan. 

The true show of the overly politically involved Pakistani military happened in April 2023, when former Prime Minister Imran Khan was ousted from power after a vote of no confidence from the General Assembly. His removal from office was clear to all that it was not a matter of his incompetence or supposed corruption, but rather because the army felt threatened by his brazen imperative to disagree with them. At this point, tensions between Bajwa and Khan were at an all time high due to an ongoing dispute following Khan’s refusal to endorse the appointment of the Inter-Services Intelligence (ISI) chief that Bajwa wanted. In May 2023, Imran Khan was arrested, despite his protests that the Army was behind threats against his life and that prominent military leaders were behind ongoing plots against him. Khan’s arrest is not unusual in Pakistan’s political history - with the past five prime ministers having been either indicted or imprisoned after leaving office. In an ironic twist, Khan rose to power in 2018 due to the military’s support and saw himself removed from office in 2022 when he lost their approval. As the Carnegie Endowment For International Peace put it, “where the Pakistan Army’s will exists, it carries, and typically persists no matter the consequences.” 

Since Khan’s arrest, protests have shaken the country and the military has cracked down in terrifying ways. In June 2023, the new Chief of Staff Asim Munir fired three high ranked commanders and punished another fifteen for their conduct during pro-Imran Khan protests. Additionally, protestors from Khan’s party PTI have accused the military of human rights violations while being held in custody. Most recently, in March 2024 protests erupted once again over what many believe to have been a rigged election. The police have been accused of launching brutal retaliations to these protests and arresting over one hundred protestors in the process. 

The precarious state of Pakistan’s democracy is concerning for the future of the nation. Without healthy civil-military relations and a stable democracy, the country can never implement much needed policy reforms. Pakistan can never be a nation that serves its citizens if it remains in the clutches of a corrupt military that chooses its own power over the best interests of the people.