The World Health Organization warns that hunger, poverty, malnutrition, and disease have reached alarming levels in the Democratic Republic of Congo, especially in the east, where a resurgence of fighting between armed groups and government forces has uprooted millions of people from their homes.
"DRC is the second-largest displacement crisis globally after Sudan, with more people forced to flee the violence since the start of the year," said Dr. Boureima Hama Sambo, WHO representative to the DRC.
Speaking from the capital, Kinshasa, Sambo told journalists in Geneva Friday that a combination of violence, climate shocks, and epidemics has worsened the humanitarian and overall health situation for millions of people who are struggling to find enough food to eat, a safe place to stay, and help to ward off disease outbreaks.
"Hospitals are overwhelmed with injured people," he said. "Close to 10 million people are on the move. Poverty and hunger affect a quarter of the population or 25.4 million people. The spread of cholera and other infectious diseases pose significant threats to the populations health."
United Nations relief agencies say more than two of every five children in the DRC — around 6 million children — suffer from chronic malnutrition, a condition that causes stunting, impairs cognitive development, and in cases of severe acute malnutrition, a risk of death.
Sambo said that, "Combined to malnutrition, diseases are increasing the risk of mortality, especially in children, and putting even more pressure on the health system.
"Women and girls are paying the high price of armed conflict and displacement," he said, noting that "30,000 cases of gender-based violence were reported in the DRC in 2023. These numbers are among the highest in the world."
Flooding heightens risk
Besides conflict-related challenges, the Office for the Coordination of Humanitarian Affairs, OCHA, says severe flooding has wreaked havoc in 18 of the DRCs 26 provinces, leaving more than 2 million people, nearly 60% of them children, in need of assistance.
The WHO says floods are worsening the risk of diarrheal and water-borne diseases. That, as well as the outbreak of other diseases, including cholera, measles, polio, yellow fever, anthrax, and plague, has brought an already fragile health system to its knees.
"DRC is facing its worst cholera outbreak since 2017 with 50,000 suspected cases and 470 deaths recorded in 2023," said Sambo, adding that the risk is particularly high in sites for internally displaced people where "living conditions are dire."
He said the country is also battling its largest measles epidemic since 2019, with close to 28,000 cases with 750 deaths so far this year
"The combination of measles and malnutrition has a severe health impact on children under five years of age and the lack of access to vaccines and vaccination services further exacerbate the situation," he said.
Threat of mpox grows
In addition to those problems, the WHO warns mpox — previously known as monkeypox — has been on the rise across the country over the last year, with nearly 4,000 suspected cases and 271 deaths reported.
That represents a higher case fatality than was seen during a year-long, WHO-declared international public health emergency for the disease that began in May 2022. More than two thirds of the current cases, it says, are reported in children.
Mpox, a zoonotic disease first detected in a 9-month-old in 1970 in the DRC, when the country was known as Zaire. Dr. Rosamund Lewis, WHO technical lead for mpox, says children continue to be most at risk of getting infected with and dying from the disease.
"The number of cases has been gradually increasing over time. What we saw in 2023 was more than the doubling of the number of cases compared to 2022 … There is a clear concern about the continuing spread of the disease, not only by zoonotic transmission but through person-to-person sexual contact," she said.
"What is also new about transmission in the DRC is that sexual transmission reported for Clade 1, a variant of mpox had not been reported prior to 2023. Now what we are seeing is newly reported sexual transmission in a different part of the country, which is not endemic for mpox."
Lewis said the disease is spreading in areas "where there is a lot of commercial back and forth, including cross-borders and a vibrant commercial sex trade."
The WHO reports mpox has expanded to previously unaffected provinces, such that almost all provinces. including Kinshasa, now are reporting cases. It warns that "represents a threat to neighboring countries and beyond."
WHO representative Sambo observed that humanitarian needs in the country are soaring, with close to 20 million people requiring health assistance this year. Despite all the compounding challenges, he said the WHO has been scaling up its health response since last year.
For example, he said the WHO vaccinated almost 5 million people against cholera in November, most in the eastern provinces, and vaccinated millions of people against a deadly measles outbreak last year. Next week, he said the WHO plans to start a polio vaccination campaign in all 26 provinces.
However, he said that continuing such lifesaving programs will be difficult to do if the health response remains severely underfunded, noting that less than 14 percent of the WHOs $624 million appeal for this year has been received.
He urges the world not "to turn a blind eye to a situation that could have severe knock-on effects for security and health in the region."
