The Strategic Need for Infectious and Tropical Diseases Services in the Democratic Republic of Congo in the Face of Recurrent Epidemics

IN A NUTSHELL
Author's Note 
This article highlights the urgent need to strengthen infectious and tropical diseases services in the Democratic Republic of Congo, a country repeatedly affected by major epidemics including Ebola virus disease, cholera, mpox, measles, and other infectious threats. The manuscript discusses how developing specialized infectious diseases infrastructure could improve epidemic preparedness, reinforce health security, support local expertise, and strengthen healthcare system resilience

By Dr Emery Yongola Osongo

Specialist in Infectious and Tropical Diseases
Department of Infectious and Tropical Diseases, CHNU de Fann, Dakar, Senegal

The Strategic Need for Infectious and Tropical Diseases Services in the Democratic Republic of Congo in the Face of Recurrent Epidemics

 

Introduction

The Democratic Republic of Congo (DRC) remains one of the African countries most exposed to emerging and re-emerging infectious diseases. For decades, the country has experienced repeated outbreaks of Ebola virus disease, cholera, measles, poliomyelitis, mpox, yellow fever, meningitis, and other epidemic-prone infections. According to the World Health Organization, the DRC continues to face a heavy burden of communicable diseases alongside recurrent public health emergencies. WHO – Democratic Republic of the Congo Health Profile

This situation occurs in a context marked by fragile health systems, armed conflicts, massive population displacement, weak healthcare infrastructure, and limited access to healthcare services in several provinces. DRC National Health Development Plan 2024–2033

Paradoxically, while the DRC is considered one of the world’s major hotspots for infectious diseases, the country still lacks a sufficiently structured network of infectious and tropical diseases services capable of ensuring sustainable clinical care, epidemiological surveillance, training, research, and epidemic preparedness.

At a time when global health threats are becoming increasingly frequent and complex, establishing and strengthening infectious diseases services should be regarded as a national strategic priority. Such an approach would not only improve outbreak response but also strengthen the country’s health sovereignty and long-term resilience.

As emphasized by PEAH – Policies for Equitable Access to Health, low-resource countries need sustainable health policies capable of ensuring equitable access to healthcare while reinforcing the resilience of health systems against global challenges. 

The DRC Under Exceptional Infectious Disease Pressure

The DRC bears a particularly high burden of communicable diseases. Malaria, tuberculosis, HIV infection, viral hepatitis, acute respiratory infections, and diarrheal diseases remain among the leading causes of morbidity and mortality in the country. WHO – Democratic Republic of the Congo Health Profile

In addition to this endemic burden, recurrent epidemics continue to weaken the national healthcare system. Since the identification of the Ebola virus in 1976 in the former Equateur Province, the DRC has experienced multiple major Ebola outbreaks. CDC – History of Ebola Virus Disease Outbreaks

The country is also among the African nations most regularly affected by cholera outbreaks, particularly in eastern provinces and along major water basins. WHO AFRO – Cholera in the Democratic Republic of the Congo

More recently, the emergence of mpox and the COVID-19 pandemic demonstrated how rapidly infectious threats evolve in a world shaped by globalization, climate change, rapid urbanization, and increasing human-animal-environment interactions. WHO – Mpox Global Strategic Preparedness and Response Plan

In such a context, fragmented and vertical responses are no longer sufficient. Repeated epidemics clearly highlight the urgent need for a sustainable infectious disease infrastructure in the DRC.

Current Limitations in Infectious Disease Care

Despite efforts made by national authorities and international partners, major challenges persist in the organization of infectious disease care in the DRC.

In many hospitals, patients with severe infectious diseases are admitted to non-specialized wards, often without adequate isolation capacities or infection prevention and control measures. The number of physicians specifically trained in infectious and tropical diseases also remains insufficient compared to the country’s needs.

These structural limitations result in:

  • delayed diagnosis;
  • increased risk of hospital-acquired infections;
  • weak integration between epidemiological surveillance and clinical practice;
  • difficulties coordinating epidemic response;
  • excessive dependence on international expertise;
  • limited local scientific production in infectious diseases.

According to The Lancet Infectious Diseases, the COVID-19 pandemic exposed persistent vulnerabilities in African health systems when facing emerging public health crises. The Lancet Infectious Diseases – COVID-19 and health systems resilience in Africa

Why the DRC Needs Infectious and Tropical Diseases Services

Strengthening National Health Security

Specialized infectious diseases services would improve early case detection, patient flow organization, and rapid epidemic response.

These services would play a central role in:

  • outbreak management;
  • infection prevention and control;
  • patient isolation;
  • hospital-based surveillance;
  • laboratory coordination;
  • epidemiological data collection and analysis.

The World Health Organization stresses the importance of strengthening national preparedness and response capacities through the International Health Regulations framework. WHO – International Health Regulations (2005)

In a country repeatedly confronted with major epidemics, infectious diseases should be considered a strategic pillar of national security.

Building Sustainable Congolese Expertise

The DRC urgently needs a critical mass of specialists capable of addressing infectious disease challenges according to international standards while remaining adapted to local realities.

Developing academic infectious diseases services would support:

  • specialist medical training;
  • mentoring of students and residents;
  • clinical research development;
  • production of national clinical guidelines adapted to the Congolese context.

The experience of the infectious diseases department at CHNU de Fann, one of the leading infectious diseases training centers in Francophone Africa, illustrates the strategic importance of strong academic structures for regional capacity building.

Reducing Dependence on External Interventions

During major outbreaks, the DRC still relies heavily on international partners for technical expertise, logistics, and sometimes even specialized clinical care.

Strengthening national capacities would promote:

  • greater health autonomy;
  • faster emergency response;
  • sustainable local expertise;
  • improved continuity of care beyond epidemic periods.

Developing national expertise is therefore a major issue of health sovereignty.

As highlighted in the Africa CDC Strategic Plan 2023–2027, African countries must reinforce institutional capacities to improve preparedness against future health threats.

Promoting Research and Innovation

The DRC represents a major field for research on tropical infectious diseases. However, local scientific production remains insufficiently supported and valued.

Specialized services could contribute to:

  • clinical trials;
  • antimicrobial resistance surveillance;
  • vaccine studies;
  • operational research;
  • equitable international collaborations.

According to The Lancet, strengthening local research capacities is essential for improving epidemic preparedness and response in Africa. The Lancet – Responding to the challenge of the dual COVID-19 and Ebola epidemics in the DRC

What Strategy for the DRC?

The establishment of a national network of infectious and tropical diseases services should rely on a progressive and multisectoral strategy involving health authorities, universities, hospitals, and international partners.

Priority actions could include:

  1. creating pilot infectious diseases units in university hospitals;
  2. integrating infectious diseases into national health priorities;
  3. strengthening specialist training programs;
  4. developing modern isolation units;
  5. improving laboratory diagnostic capacities;
  6. supporting local scientific research;
  7. promoting One Health approaches;
  8. strengthening African and international collaborations.

Such an approach would progressively transform epidemic response into a sustainable national health security policy. 

Conclusion

Faced with recurrent epidemics and emerging infectious threats, the Democratic Republic of Congo can no longer rely solely on reactive and externally dependent responses.

The establishment and strengthening of infectious and tropical diseases services now represent a strategic necessity to improve epidemic preparedness, reinforce national capacities, promote scientific research, and sustainably protect populations.

Investing in infectious diseases in the DRC is not merely a medical or academic choice. It is a fundamental investment in health security, scientific sovereignty, and the resilience of the Congolese health system in the face of twenty-first century challenges