DR Congo: Cholera epidemic rapidly spreading across the country

The coming rainy season may increase risk of transmission

The situation continues to worsen, spreading to new health zones, including provinces where cholera was not previously endemic. Floods, conflicts, and displacement, as well as inadequate sanitation and water supply systems, have contributed to fueling widespread epidemics of water-borne diseases. As the rainy season approaches, the situation is likely to deteriorate, further increasing the risk of disease transmission and contamination.

“The rapid spread of the epidemic across the country this year is of particular concern to us, especially during the rainy season,” says Jean-Gilbert Ndong, MSF physician and medical coordinator in DRC. “We fear further outbreaks if urgent measures are not taken.” 

Since January 2025, MSF has stepped up our response to the disease in several provinces of the country. Teams remain mobilized in the most affected areas, such as Fizi (South Kivu) and Kongakonga (Tshopo). Since January, we have carried out 16 emergency interventions with the Ministry of Health, treating more than 35,800 patients and vaccinating more than 22,000 people against the disease.

“At this critical stage, only a general mobilization will make it possible to contain the disease and slow down the alarming spread of epidemic outbreaks,” says Ndong. 

Cholera response is struggling to keep pace with the spread

The cholera response faces major obstacles, including insufficient funding by the Congolese government, limited presence of humanitarian agencies, and lack of coordination in the emergency response mechanism. At the same time, weak surveillance and case identification systems, a lack of medical personnel and supplies, and limited vaccine distribution further compromise the implementation of a rapid, effective, and sustainable response.

Early treatment of cholera is key

Cholera is a highly contagious bacterial infection. Although it is treatable and preventable, without proper care it can quickly become fatal. According to the World Health Organization, the fatality rate in treatment centers should remain below 1 percent; DRC is currently experiencing a fatality rate exceeding 3 percent. Poor hygiene conditions, insufficient access to clean water, and lack of sanitation can all contribute to the disease’s spread. This poses a particular challenge in densely populated areas, especially in large cities such as Kinshasa and in rural areas with high concentrations of people who are internally displaced.

MSF teams have had to step up their efforts to fill the gaps left by the weak emergency response mechanisms of the health authorities and other agencies. To slow the spread of the disease, MSF is helping the Ministry of Health to deliver medical care in specialized treatment centers, training community health workers, setting up chlorination points, and strengthening water and sanitation systems.

“We call for coordinated and urgent action to ensure the rapid provision of medical care, including unimpeded access and sustainable investment in access to safe drinking water and sanitation,” says Berg.

Despite efforts, access to health care is limited

While MSF teams race to respond to outbreaks, access to cholera patients is hampered by significant challenges: logistical difficulties, security risks, administrative barriers, and supply issues. For example, the months-long closure of Bukavu and Goma airports has hampered the main routes for transporting supplies to the east of the country.

In the Fizi health zone in South Kivu, the presence of humanitarian partners remains limited and virtually none are specifically involved in the cholera response.

“Persistent insecurity, marked by clashes between armed groups along the main roads, hinders movement and delays the delivery of assistance, forcing teams to make long detours to avoid risky areas,” says Berg.

Access to health care is also a huge challenge for communities. Long distances, lack of transport and security concerns make it difficult to reach medical facilities. Once there, these centers are often under-equipped and unable to meet people’s basic needs, leaving the communities most at risk without essential care.

Cholera must be placed at the top of the national agenda as a major threat to public health in DRC. MSF calls for coordinated action to ensure the rapid provision of medical care, including the availability of vaccines, unhindered access, and sustainable investment in access to safe drinking water and sanitation.