Today, the Central African nation, with a ruined and overworked healthcare system, faces another deadly enemy in the coronavirus pandemic.
"It is a very difficult environment where all of these multiple diseases occur at the same time," Dr Richard Mihigo, regional coordinator of immunization and vaccine development for the World Health Organization (WHO), told CNN.
"We must not underestimate the magnitude of all these different epidemics occurring at the same time in a country where the health system itself is very weak, and in some regions broken," he said.
In a recent report, UNICEF warned that the country's health system was "survival" due to a lack of medical supplies, equipment and funds, and with almost half of the country's health facilities countries lacking basic commodities such as drinking water and sanitation. Many children are "at the mercy of life-threatening illnesses," said UNICEF.
"Our greatest fear remains the damage that this coronavirus could cause in a country like the DRC," said WHO Director-General Tedros Adhanom. "Even as the flames of an epidemic begin to die out, we are fighting another fire front."
"With regard to the COVID-19 pandemic, we are of course concerned, but we hope that if people follow government directives and are able to communicate these directives to the community, the epidemic will not spread not, "said Dr. Abdourahmane Diallo, who heads the WHO Ebola vaccination program in the DRC.
Nearly 350 cases of coronavirus and at least 25 deaths have so far been officially reported in the country as of April 22, according to Johns Hopkins University - a number still relatively small compared to other parts of the world.
This leaves a "window of opportunity" for medical teams to prepare for and prevent a higher number, said Mihigo. Currently, the majority of the cases are concentrated in the capital Kinshasa, where the authorities have implemented preventive measures, but social distancing in the densely populated city has proven difficult, he said.
"Competition for resources"
Fighting multiple epidemics at the same time also creates "competition for resources," where increased attention to fighting one disease leaves gaps in efforts to fight another, said Mihigo.
For example, when international attention focused on the fight against the Ebola virus in 2018, the measles campaign suffered a big setback in funding for an extended period of time, resulting in a "case explosion" said Mihigo. WHO has described the DRC epidemic as "the worst measles epidemic in the world".
Since 2019, more than 330,000 suspected cases of measles have been reported and more than 6,200 people have died, including at least 5,300 children, according to the UN.
Malaria, another preventable disease, infected around 16.5 million people in the DRC in 2019, causing nearly 17,000 deaths, according to the UN.
Ebola has killed more than 2,200 people in the country and infected 3,400 since the epidemic began in August 2018, mainly in the provinces of North Kivu and Ituri. The country was days away from declaring the end of the outbreak, but several new cases have since emerged.
Medical teams are also trying to stop the spread of cholera in the south of the country through vaccination and strengthening water sanitation measures, said Mihigo. Nearly 31,000 cholera cases were reported in 2019 and 540 deaths, according to the UN.
In the meantime, preventive efforts to fight polio and yellow fever have had to be put on hold as the country prepares to fight coronavirus. "This explains why we find ourselves in a situation that almost resembles a protracted situation where multiple epidemics break out at the same time," said Mihigo.
"The supply system is also an issue because you have to bring all the vaccines - against measles, yellow fever or cholera - and it is not easy to manage all the logistics of all these events happening at the same time, "he said. "This is probably the reality check that we have on the ground."
"Unless health facilities can afford immunization, nutrition and other essential services, including in remote parts of the country, we risk seeing the lives and future of many Congolese children marked or destroyed by preventable diseases, "said UNICEF representative Edouard Beigbeder. in the DRC.
Lessons Learned Help Fight Coronavirus
However, despite the setbacks, the lessons learned from the fight against these multiple epidemics and the systems that have been implemented are already helping efforts to stop the spread of the coronavirus, said Mihigo.
"During Ebola, we lost many health workers to the disease. So the country learned a lot about how to put in place strict infection control measures," said Mihigo. "I think it will be very beneficial in the fight against the crown."
Mihigo said the current environment is also different because people understand that they are facing a global pandemic and that communities are therefore more likely to adopt the recommended preventive measures.
"Now people know that it's not just something in their country, they see the news, they see how literally every country on the planet is affected," said Mihigo. "So people understand that this is a real threat."
The geographic information system (GIS) set up for polio surveillance could also be used as a tool in the fight against coronavirus, he said.
Some of the coronavirus prevention measures the government has implemented, such as limited movement between provinces, temporary border closings and limited international flights, also help, said Mihigo.
"The Covid-19 pandemic requires that we all work together. It really requires a multisectoral and associative approach and we can only succeed if we put all of our work together," said Dr Matshidiso Moeti, WHO. Regional Director for Africa, April 9.
Vulnerable "hardest hit"
According to the latest UNICEF estimates, nearly 3.3 million children in the DRC have "unmet basic health needs" and 9.1 million children, nearly one child under the age of 18 out of five need humanitarian assistance.
In addition, continued violence by militias in the northeast, including attacks on health centers, has claimed the lives of residents and health workers. Nearly a million people were forced to flee their homes in 2019 alone, the UN agency said, making access to medical care and prevention even more difficult.
In addition, the authorities warn that the virus could also "trigger economic and social devastation" and cause a food security crisis caused by disruption of agricultural production and food imports.
The World Bank predicts that sub-Saharan Africa will experience its first recession in 25 years, as economic growth is expected to fall sharply in 2020 due to the coronavirus.
"All countries must accelerate and rapidly scale up a comprehensive response to the pandemic, including an appropriate combination of proven public health and physical distance measures," said Dr Ahmed Al-Mandhari, WHO Regional Director for Eastern Mediterranean.
"Africa still has the opportunity to reduce and slow the spread of disease," he said.
