The Clinton administration justified the attack by claiming al-Shifa was secretly producing chemical weapons and had links to Osama bin Laden, but those claims were never substantiated.

The attack destroyed a facility that had supplied most of Sudan’s pharmaceutical needs and exported medicines to other African and Middle Eastern countries.

The consequences were severe in a country where access to foreign medicines was unaffordable for much of the population.

Al-Shifa had opened in 1997 with the participation of heads of state, foreign ministers and ambassadors and was promoted as the “Pride of Africa.”

Its operation was expected to increase Sudan’s domestic pharmaceutical self-sufficiency from about 3 percent to more than 50 percent.

The factory produced 90 percent of the medicines used to treat Sudan’s seven leading causes of death, including malaria and tuberculosis, as well as virtually all of Sudan’s veterinary medicines.

Its products cost about 20 percent of comparable medicines on the international market, while the government distributed 15 percent of its production free to low-income people.

The factory’s pharmaceutical production was also known to the US government.

US officials at the United Nations had previously approved medicines produced by al-Shifa for shipment to Iraq under the “Oil for Food” program.

The destruction of the factory therefore eliminated a major source of medicines in an impoverished country and deprived large numbers of people of access to treatment.

Werner Daum, Germany’s ambassador to Sudan from 1996 to 2000, later wrote that “several tens of thousands seems to be a reasonable guess” for the number of people who died as a consequence of the factory’s destruction.

The Clinton administration’s justification for the attack centered on allegations that al-Shifa was a secret chemical weapons facility linked to bin Laden.

The US government claimed that a secret CIA soil sample contained traces of EMPTA, a chemical that can be used in producing nerve agents but also has civilian applications.

The factory’s operators and engineers rejected the US allegations.

Henry Jobe, the US plant designer, said the facility could not have been used to manufacture chemical weapons.

Tom Carnaffin, the British engineer who supervised its construction, told the Chicago Tribune that “it just isn’t equipped to cope with the demands of chemical weapon manufacturing.”

The allegations concerning bin Laden’s alleged connection to the factory also came under scrutiny.

The Clinton administration initially designated the factory’s owner, Salaheddin Idriss, as a terrorist frontman for bin Laden and froze his Bank of America assets.

Eight months later, following a lawsuit, the US government quietly unfroze the accounts and invoked sovereign immunity.

Sudan subsequently requested that the United Nations Security Council conduct an on-site investigation into the factory and its alleged links to chemical weapons production and bin Laden.

The United States vetoed a resolution calling for such an investigation.

The attack came amid years of deteriorating relations between Washington and Khartoum.

After Sudan opposed the 1991 US war against Iraq and pursued policies that challenged US regional interests, Washington imposed sanctions, restricted loans and trade, supported secessionist movements and backed proxy conflicts.

Donald Peterson, who served as US ambassador to Sudan from 1992 to 1995, said that policymakers had previously backed away from options involving direct US intervention.

The 1998 embassy bombings in Kenya and Tanzania provided the Clinton administration with a pretext for military action against Sudan, despite the absence of evidence that Sudanese nationals had carried out the attacks or that the bombings were connected to al-Shifa.

The United States simultaneously launched an attack on Afghanistan following the embassy bombings, which Washington attributed to bin Laden.

The attack on al-Shifa consequently became one of the most consequential US military strikes against Sudan, destroying critical pharmaceutical infrastructure while the country was already facing severe humanitarian conditions.

The United States did not publicly acknowledge responsibility for any resulting humanitarian consequences or provide compensation for the destruction.

The attack has remained a largely overlooked episode of US military intervention in Africa, despite the factory’s central role in Sudan’s healthcare system and the long-standing dispute over Washington’s justification for destroying it.