"The conflict in Sudan is severely putting at risk the health and wellbeing of Sudan's 24 million children," Mandeep O'Brien told AFP in an interview late on Thursday.
The fighting will not only have a serious impact on the future of Sudan, but will also "heavily (affect) the wider region," O'Brien said.
Since mid-April last year, Sudan has been gripped by a war pitting army chief Abdel Fattah al-Burhan against his former deputy, paramilitary commander Mohamed Hamdan Daglo.
The war has claimed at least 12,190 lives according to an estimate by the Armed Conflict Location & Event Data Project.
The United Nations says more than 7 million people have been displaced. They include 3.5 million children, O'Brien said, leaving Sudan facing "the largest displacement crisis in the world."
'Sudan needs peace'
If the deadly power struggle continues, the impact on the country — already one of the poorest in the world — will be "unthinkable," O'Brien said.
"Sudan needs peace to avert a generational catastrophe," she said.
"The future of the country is at stake: almost 20 million children in Sudan will not go to school this year without urgent action."
Few areas of the country, which has 48 million inhabitants, have been spared from violence, shortages and looting, with 14 million children in need of emergency humanitarian aid, O'Brien said.
Even before the war, a third of Sudan's population faced a hunger crisis while 7 million children were not in school, particularly in rural areas where almost two-thirds of the population live.
The war has only added to the challenges posed by poverty and repeated conflicts in the country, which ousted longtime leader Omar al-Bashir in 2019 but saw a brief democratic transition abruptly ended by a coup in 2021.
Today, millions of children are at risk from "killing, maiming, child recruitment, violence (and) rape," O'Brien said.
The U.N. and aid and rights organizations have repeatedly condemned the use of child soldiers in Sudan by paramilitaries and tribal militias.
Women's rights activists also say rape has plagued the country for decades, often affecting young women and girls. Rape has also been used as a weapon in the latest conflict — particularly by Daglo's Rapid Support Forces (RSF), according to the U.N.
With much of the country's infrastructure destroyed, 7.4 million children lack access to safe drinking water and 3.5 million under the age of five are at high risk of water-borne diseases such as cholera, O'Brien said.
According to UNICEF, some 700,000 children are suffering from severe acute malnutrition and 100,000 need life-saving treatment for acute malnutrition.
Around 1.3 million babies will be born in 2024 "requiring skilled support for safe delivery to protect the lives of mothers," O'Brien said, but the war has left most of the country's hospitals unable to operate.
Cycles of violence
However, peace in Sudan appears to be a long way off. In its annual report published on Thursday, Human Rights Watch (HRW) said the conflict had "resulted in massive abuses against civilians."
The failure to prosecute human rights violations in the country over the past two decades of conflict had created impunity that had "fueled repeated cycles of violence in Sudan," it added.
HRW said that Arab states and African governments had resisted efforts at the U.N. Human Rights Council to enforce accountability, while Western nations "were initially reluctant" to push for it or to commit the same level of resources they had done for Ukraine.
A majority of the council did eventually vote to create a mechanism for evidence gathering and preservation, but the Sudanese government has made clear it will not cooperate, said HRW.
Peace negotiations have so far amounted to little.
Since the beginning of January, Daglo has been on a diplomatic tour and even embraced Sudan's former civilian prime minister Abdalla Hamdok — a man he had helped oust — in an effort, analysts said, to build legitimacy with the international community.
On Thursday, Daglo said he had presented U.N. Secretary-General Antonio Guterres over the phone with his "vision to end the war" and "rebuild the Sudanese state on a new equitable basis."
On the same day, activists reported bombardments in Sudan's vast western region of Darfur and 33 civilians killed in air strikes in the capital Khartoum.