Democratic Republic of the Congo

Ebola, mpox, and other viral hemorrhagic fever surveillance dominate One Health attention given the country's recurring role as a global epicenter for these outbreaks, closely tied to forest-edge wildlife contact.

Recurring mpox and Ebola outbreaks, severe conflict-driven displacement in the east, and chronic underfunding of basic primary care represent the dominant and often simultaneous health burdens.

Decades of conflict and underinvestment have left large parts of the health system dependent on international humanitarian financing rather than domestic budget allocation, particularly in the conflict-affected eastern provinces.

Deforestation and expanding human settlement into forest habitat are directly linked to the country's repeated zoonotic spillover events, including mpox and Ebola.

Formal veterinary infrastructure is minimal outside a small number of urban centers, leaving most human-wildlife contact points effectively unmonitored for spillover risk.

Flooding along the Congo River basin and increasing rainfall variability compound existing displacement and disease outbreak risk, particularly in already-fragile conflict-affected regions.

The DRC's national outbreak response institute has built genuinely world-class Ebola and mpox response experience through repeated real-world deployment, representing significant transferable regional health security capacity.

Sustaining outbreak response capacity while stabilizing basic primary care financing amid continued conflict in the east remains the government's core, and extremely difficult, balancing act.

The DRC remains heavily dependent on international humanitarian and health security financing, with outbreak response funding often surging reactively rather than sustaining readiness between emergencies.

The World Health Organization, the Africa CDC, Gavi, the Global Fund, and major humanitarian actors including MSF and UNICEF maintain substantial and often emergency-driven programs.

The gap between the DRC's genuinely sophisticated outbreak response expertise and its chronically underfunded routine primary care and surveillance system between outbreaks is the country's most consequential structural weakness.

The DRC has arguably the most experienced outbreak responders in the world and some of the least financed routine health infrastructure. Closing that gap, financing readiness rather than only emergencies, would change outbreak trajectories across the whole Central African region.