Congo Faces Setback in Mpox Response Amid Rebel Advances

The ongoing conflict in eastern Congo, exacerbated by the advancing M23 rebel group backed by Rwanda, has severely disrupted the country’s mpox response. Health facilities in conflict zones are under attack, vaccines and medical supplies are inaccessible, and thousands of patients have fled, leaving the region’s fight against mpox increasingly difficult. With already strained resources due to other health crises, such as cholera and measles, the situation is dire, and the risk of further mpox outbreaks remains high.

Congo’s ongoing battle against mpox, a viral disease that has been wreaking havoc in several African countries, has encountered a major setback due to the worsening security situation in the eastern regions of the country. The region, which had previously been at the forefront of Congo’s efforts to tackle the outbreak, is now facing insurmountable obstacles due to the escalating conflict between Congolese troops and the M23 rebel group, which is reportedly backed by Rwanda. As the rebels advance in the area, hospitals and treatment centers have been targeted, and health workers find themselves struggling to continue essential medical services.

The Growing Crisis in Eastern Congo

The situation in the east of the Democratic Republic of Congo (DRC) has taken a grim turn with the intensification of fighting between the government and the M23 rebel group. Once considered a hotspot for mpox cases in the country, eastern Congo has now become a conflict zone where the priorities of health and security have clashed. The M23 rebels have made significant advances in recent months, taking control of key towns and regions that were crucial for the delivery of healthcare and other vital services.

These areas, particularly in South Kivu and North Kivu provinces, had already been dealing with a mounting health crisis before the resurgence of conflict. Hospitals in these provinces had seen a surge in mpox cases, and medical personnel were battling to provide care while trying to limit the spread of the disease. However, with the escalation of violence, many of these hospitals have either been destroyed, shut down, or are operating at minimal capacity due to the lack of resources and staff.

The Mpox Outbreak and Its Impacts

Mpox, a viral disease closely related to smallpox, had already been a growing concern in Africa, with cases spiking across several countries. In Congo, the outbreak had already caused significant alarm in 2024, with the total number of cases soaring to 16,255 by the end of the year, as reported by the Africa Centers for Disease Control and Prevention (CDC). By the time the first signs of the mpox crisis emerged in the eastern regions, health workers were already grappling with the complexities of managing a viral outbreak, with limited resources at their disposal.

As the health system was stretched thin, the situation worsened with the ongoing violence in the region. Thousands of patients, many of whom were already suffering from mpox, fled from their homes and hospitals in fear of the advancing rebels. Health officials and local workers reported that over 600 mpox patients had fled hospitals in various conflict zones across eastern Congo.

In Miti Murhesa, one of the hardest-hit health zones, the number of reported mpox cases had already surpassed 4,700 by the end of 2024. Despite the efforts of healthcare providers, many hospitals were forced to scale down operations as M23 forces moved deeper into key territories such as Goma and Bukavu. This is where the situation became even more dire. Patients had no choice but to either remain in danger and risk being caught in the crossfire or flee, often abandoning the medical treatment they so desperately needed.

Dr. Serge Munyahu Cikuru, the medical officer in charge of Miti Murhesa health zone, described the growing sense of disaster that has followed the rebels’ advances. “The situation has been very difficult. Insecurity has disrupted everything,” he said. “Our fear is an increase in the number of cases due to the current situation. The shortage of medicines is a major concern.”

Medical Shortages and Access to Vaccines

In the face of mounting challenges, the response to the mpox crisis in Congo has been severely hampered by a shortage of medical supplies, including vaccines and essential medicines. Although the country had initially seen an increase in vaccination coverage in other regions, the conflict zones have been virtually cut off from supplies due to disrupted transportation and blocked access.

Miti Murhesa’s treatment center, one of the few remaining functional hospitals in the area, is running low on supplies. Mubake Buroko Patrick, an mpox patient currently receiving treatment at the facility, described how the war complicated access to medicines. “The war has complicated our access to medicines,” he said. “I’m feeling a little better, but the treatment needs to be improved.” With each passing day, the situation at the treatment centers becomes more desperate, as healthcare workers struggle to make do with limited resources.

A significant challenge for the health authorities has been the difficulty of reaching the conflict zones with life-saving supplies. With international flights grounded and access routes to the eastern DRC blocked, health organizations have found it increasingly difficult to transport vital medical aid. The Africa CDC’s mpox incident manager, Dr. Ngashi Ngongo, confirmed that while there had been some progress in other areas of Congo, the situation in the east remains unresolved. In response to the mounting crisis, the Africa CDC has been negotiating for a humanitarian corridor to ensure the safe passage of medical supplies into the conflict zones.

The Search for a Solution Amidst Conflict

In response to the severe deterioration of the situation, there have been calls for a coordinated international effort to address the mpox outbreak and provide humanitarian aid to the region. Dr. Ngongo has indicated that negotiations are underway to secure a temporary suspension of hostilities in order to allow for the movement of essential supplies and personnel into the affected areas. The establishment of a humanitarian corridor would require both sides of the conflict to agree to a ceasefire, at least temporarily, to allow for the safe passage of aid workers and medical goods.

However, the likelihood of such a ceasefire remains uncertain as the political and military situation continues to evolve. With the ongoing presence of M23 rebels, backed by Rwanda, and the Congolese military’s efforts to maintain control, any agreement on a humanitarian corridor may take weeks or even months to secure. In the meantime, health workers in the region continue to face immense challenges in treating mpox and preventing further spread.

The Broader Health Crisis in Congo

The mpox crisis is just one of many public health challenges facing Congo. In addition to mpox, the eastern region of the country has been battling outbreaks of cholera, measles, and other infectious diseases. Mysterious outbreaks have also recently been reported in the northwestern part of the country, further complicating the public health response. The ongoing conflict has strained the country’s already fragile health infrastructure, making it nearly impossible for health authorities to adequately respond to all outbreaks.

In addition to the logistical and security challenges, the lack of widespread surveillance and reporting has led to gaps in data and a failure to fully track the progression of diseases. The Africa CDC reported that fewer cases are being reported in the conflict zones, even though health workers believe the situation is worsening. This discrepancy has made it even more difficult to track the scope of the outbreak and respond in a timely manner.

The Way Forward

As the situation in eastern Congo continues to deteriorate, it is crucial that international organizations, governments, and humanitarian groups come together to provide much-needed support to the region. The crisis in Congo highlights the importance of global cooperation in the face of complex health emergencies, particularly when political and security issues are involved. To mitigate the spread of mpox and other diseases, it is essential that resources be allocated to the conflict zones, and health workers must be given the protection and support they need to continue their vital work.

Moving forward, the government of Congo must prioritize the strengthening of its healthcare infrastructure, particularly in conflict-prone areas, to ensure that it can respond more effectively to future outbreaks. More investment is needed in training healthcare workers, improving surveillance systems, and ensuring that essential medicines and vaccines can reach even the most remote and dangerous parts of the country.

The situation in eastern Congo remains a pressing issue that requires immediate international attention. The global community must act now to prevent further suffering and loss of life in this already fragile region.