Khartoum is presented as the point of impact—and an inadequate measure of the consequences—of the August 1998 U.S. cruise-missile attack on Sudan’s Al-Shifa pharmaceutical factory. The book follows the strike outward: from medicines lost and aid delayed to a stalled peace process and rejected Sudanese intelligence offers, then to a broader argument about how military power and the language of counterterrorism reshape international politics.## The strike and its human cost The missile attack on Al-Shifa is described as a U.S. action whose effects cannot be counted only among those killed in Khartoum. The factory supplied affordable medicines and veterinary products across Sudan and produced 90 percent of the medicines most commonly used in the country. A year after its destruction, an account cited from the Boston Globe reported that shortages of vital drugs were contributing to deaths from malaria, tuberculosis, and other treatable illnesses, with tens of thousands suffering and dying, most of them children. Sudanese sanctions also prevented the country from importing enough pharmaceuticals to replace the lost production, extending the consequences of the strike well beyond the day of the bombing. The book makes the asymmetry of attention part of the story. It contrasts the relative neglect of the destruction in Sudan with the intense response that would be expected if a comparable attack had hit the United States, Israel, or the United Kingdom. The comparison is explicitly qualified: the consequences for Sudan were described as far more severe. Khartoum thus stands both for the immediate location of a missile attack and for a wider disparity in whose losses are treated as politically urgent.

Relief and a faltering peace process

The attack’s consequences were not confined to medical supplies. According to a Human Rights Watch report relayed in the book, U.N. agencies based in Khartoum evacuated their American staff, and other relief organizations also withdrew. Aid efforts were delayed, including a U.S.-directed International Rescue Committee project in a government-held town where more than fifty people from the south were dying each day. The U.N. estimated that 2.4 million people in parts of southern Sudan faced the risk of famine; interruption of relief to populations already devastated by conflict could, the report warned, produce a grave crisis. The book also describes the bombing as an interruption to a tentative political opening. A Financial Times account cited in the text said the strike appeared to halt movement toward compromise among Sudan’s warring parties and hinder a process that might have produced a peace treaty, ending a civil war that had killed 1.5 million people since 1981. That possible settlement was linked to wider prospects for peace in Uganda and across the Nile basin. The account further suggested that the attack damaged the gains expected from a shift in the Islamist Sudanese government toward pragmatic engagement with the outside world, efforts to address internal crises, an end to support for terrorism, and a reduction in radical Islamist influence. Three years later, the book notes, James Astill revisited the political cost of the attack: Sudan had been trying to emerge from military dictatorship, destructive Islamism, and seemingly endless civil war, but the missile strike was said to have plunged Khartoum back into a condition of frustrated extremism overnight. In this account, the political damage may have exceeded even the destruction of the country’s fragile medical services. The book does not attempt to rank crimes on a single scale; it distinguishes comparison of casualty totals from the broader, and more problematic, practice of ranking suffering.

A rejected channel of cooperation

The attack is connected to a consequential breakdown in U.S.–Sudanese cooperation. Shortly before the 1998 strike, Sudan held two men suspected of involvement in the bombings of U.S. embassies in East Africa and notified Washington. U.S. officials later confirmed that Sudan had offered cooperation. The United States rejected it; after the missile attack, Sudan released the suspects in anger. They were subsequently identified as agents of Osama bin Laden. Later-released FBI reports added another element to this account: the FBI reportedly wanted the men extradited, but the State Department refused. A CIA senior source characterized that refusal, together with the rejection of other Sudanese offers, as one of the gravest intelligence failures in the events leading to September 11. Sudan had offered extensive information about bin Laden, including a database on him and more than two hundred senior figures in Al-Qaeda, photographs, detailed biographies, and information about the network’s financial interests in multiple regions. The offers were rejected, according to the source quoted in the book, amid hostility toward Sudan. The source concluded that possession of the material would have improved the chances of preventing the September 11 attacks. Khartoum consequently figures not only as the target of the earlier strike but also as the setting of a rejected intelligence relationship that the book presents as consequential to later security failures.

From Khartoum to the post-September 11 order

The book places the Sudan episode within a broader critique of selective attention to state violence. It argues that the Al-Shifa bombing was quickly reduced to a footnote in accounts of state terrorism, even as its effects persisted among people deprived of medicine and assistance. The attack’s afterlife also becomes a test of how public discussion assigns responsibility: the author argues that institutional policy should not be treated as an excuse that diminishes a crime, just as speculation about an individual leader’s personal problems would not ordinarily excuse the crimes of an official enemy. Khartoum’s story then opens onto the book’s analysis of what followed September 11. The author argues that governments used the attacks to intensify repressive policies: Russia sought latitude for its actions in Chechnya, China joined the counterterrorism coalition for comparable reasons, and Turkey offered troops while invoking U.S. support for its campaign against Kurds. Israel, the author says, anticipated stronger U.S. backing for intensified repression of Palestinians. In the United States, the Bush administration used fear and appeals to patriotism to advance domestic restrictions and policies serving the interests of major corporations. These are the book’s political interpretations, presented as part of its case that counterterrorism rhetoric can conceal or facilitate other projects of power. The same argument is mapped onto military geography. The author describes the establishment of major U.S. bases in Central Asia as a post-September 11 consequence, linking them to control of regional resources, the contemporary “Great Game,” and the surrounding of energy resources in the Persian Gulf. Before the Afghanistan war, the author identifies Diego Garcia as the safest U.S. base in the network extending from the Pacific to the Azores; the new positions, in this reading, made intervention easier. The U.S. and NATO bombings are also interpreted through a strategic lens: the author suggests that the Afghanistan campaign demonstrated American military capacity, while the bombing of Serbia was justified by the need to preserve NATO’s credibility. Khartoum’s destruction therefore resonates beyond Sudan in a narrative about the reach of force, the costs of rejected cooperation, and the political consequences that official security frames may leave out.