LocationsA silent emergency: Battling epidemics in a conflict zone
August 19, 2025
UNDP and the Global Fund are working to rebuild health systems, deliver vital medicines and supplies and restore access to care in eastern DRC.
In the quiet corridors of the Mapendo health centre in Kiwanja, in the province of North Kivu in the east of Democratic Republic of the Congo, the emergency does not shout; it whispers. Patients arrive not in waves but in steady, urgent footsteps. They carry sick children, fevers, infections, pain – and deep worry. In this region marked by instability, accessing care is a daily struggle.
Stella Sifa holds her 12-month-old baby at the Mapendo health centre in Kiwanja, Rutshuru, North Kivu. On returning to her village after six months of displacement, she found that the water had turned foul.
Stella Sifa has been here for two days with her 12-month-old baby, weakened by vomiting and diarrhoea. Stella came back to her village of Kako six months ago, returning from displacement like many others. She hoped to rebuild. Instead, the water had turned foul, and disease followed.
“There’s no clean source. We’re told to boil water, but we can’t always find firewood.”
Diseases are spreading, but no one knows just how far. Official surveillance has suffered from multiple displacements of infected people. Testing kits are nearly non-existent.
And in a region gripped by conflict, new threats are not always declared; they just appear. According to local data, cases of measles and mpox are increasing, as are suspected cases of cholera. Vaccination coverage is below 60 percent in some health zones.
Dr. Christian Bitwayiki, chief physician for the Rutshuru health zone, is clear-eyed about the emergency:
“We are facing a convergence of epidemics... HIV, TB, suspected cholera, mpox, measles – they are all rising. And we are severely lacking resources. Some medication for patients with tuberculosis are out. Children living with HIV are off treatment. Many have already fallen sick with opportunistic infections.”
Yet, health workers persist, with creativity, compassion and unshaken dedication.
This health crisis is compounded by a crisis of protection.
In a secluded corner of the health centre, an 8-year-old girl hangs thin cotton sheets. Her older sister is washing her clothes in a basin beside her, watching over her closely.
She has mpox. A type transmitted through sexual contact.
Rape, used as a weapon of war, spreads infections and trauma. There are a few facilities offering medical and psychosocial care, but the response is inadequate, and impunity persists.
Disruptions in the supply of medicines and other inputs are exacerbated by insecurity throughout the eastern part of the DRC: road closures, inaccessible areas and armed attacks. Pre-positioning stocks and securing humanitarian corridors are top priorities.
In the provincial capital Goma, about 70 km south of Kiwanja, similar stories are unfolding. François, whose name has been changed for his safety, used to walk through neighbourhoods encouraging people to get tested for HIV.
“People trusted me. They came. They wanted to know their status.”
François (not his real name) is an HIV patient coming to the Bwanya Supportive Care Centre in Goma, North Kivu. He also conducts sensitization and HIV testing in his at-risk community when tests are available.
Today, kits are scarce. But François still shows up, answering questions, listening, reassuring. “Some say, ‘Why test if there’s no medicine?’ But I remind them that we prepare now so we’re ready when treatment comes back. We don’t give up.”
Claudine (not her real name), also in Goma, understands this hope intimately. She has lived with HIV for more than a decade, quietly, with strength and grace. “My family doesn’t know. My colleagues don’t know,” she confides. “There is still stigma.”
Until recently, treatment kept her healthy. But as protective drugs ran out, she began getting sick again.
“Even so, I tell people: get tested. We must keep hope alive. We must believe tomorrow will be better.”
Claudine (not her real name) has been living with HIV for years, though nobody around her knows. With the shortage of protective medication, she can feel her immunity declining as she regularly gets sick and now fears for her life.
In a major breakthrough, UNDP and the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), working with health authorities, delivered 23 tonnes of medications to North Kivu and South Kivu provinces in June. The operation, made possible through improved logistical coordination, allowed health facilities to resume life-saving treatment and prevention services and restore hope to communities.
Community health mobilizers like François and Claudine are being re-engaged with renewed training and resources. Health facilities like the Mapendo health centre in Kiwanja will soon receive supplies. Coordination is improving, slowly, but steadily.
A staff from the Asrames Regional Medication Distribution Centre supervises the offloading of medical supplies. The distribution centre in Goma continues to function as regularly as possible, but critical shortages in medications and tests heighten risks of epidemics across the area.
To ensure sustainability, UNDP and its partners are working to:
- Strengthen local capacity in inventory management and forecasting needs
- Diversify supply routes
- Integrate the health response with the water and sanitation and protection sectors
- Establish indicators to monitor the availability of inputs
“We cannot allow people to suffer in silence,” says Dr. Jean-Claude Wema, UNDP Global Fund project coordinator in Goma. “This is not just about medicine. It is about dignity. It is about justice and restoring trust.”
UNDP and the Global Fund are working hand in hand with communities, health workers, and survivors across eastern DRC to rebuild health systems, restore access to care and prevent the next crisis before it begins.
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