Congo (Democratic Republic): Score Justification Summary

2026

1.1 Antimicrobial resistance (AMR)

1.1.1 AMR surveillance, detection and reporting

1.1.1a National plan for AMR priority pathogens

Score: 100

The Democratic Republic of Congo (DRC) has a national AMR plan for the surveillance, detection, and reporting of priority AMR pathogens.

The National Plan to Combat Antimicrobial Resistance (2018), enacted by the Ministry of Public Health, Hygiene and Social Security, was valid from 2018 to 2022. ¹ ² This plan is the latest available national AMR plan for the DRC on the World Health Organization's (WHO) library of national action plans. ³ ⁴

There is no evidence that a new plan has been enacted on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the DRC legal database. ⁵ ⁶ ⁷

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

The Democratic Republic of Congo (DRC) has a national laboratory system which tests for priority AMR pathogens, namely mycobacterium tuberculosis.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the national laboratory system for human health in the DRC is composed of both public and private laboratories operating at the different levels of the health pyramid (p. 35). ⁸ The National Institute of Biomedical Research (INRB) is capable of conducting several tests (p. 22; pp. 36-37). ⁹

The INBR comprises seven laboratories dedicated to virology, parasitology, bacteriology, medical entomology, clinical biology, pathology, and immunology, and includes both an Animal Research Centre and a Data Centre. ¹⁰ ¹¹ ¹² ¹³ ¹⁴ The bacteriology laboratory can test for mycobacteriaum tuberculosis, Buruli ulcer, cholera, bacillary dysentery, and cerebrospinal meningitis. ¹⁵ The parasitology laboratory undertakes research and testing on malaria, molecular biology, trypanosomiasis, and complex morbidity. ¹⁶

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) conducts environmental detection or surveillance activities (e.g. in soil, waterways) for antimicrobial residues or AMR organisms.

According to the Annual Report (2024) of the National Institute of Biomedical Research (INRB), since July 2024 the INBR, through its Pathogen Genomics Laboratory, has integrated environmental monitoring of monkeypox (Mpox) in community and hospital wastewater in order to complement clinical monitoring of Mpox in humans and animals, following a strategy similar to that implemented for SARS-CoV-2. ¹⁷ Supported by the Bill & Melinda Gates Foundation, with technical assistance from Biosurv International and Imperial College London, the project aims to expand to other viral pathogens with epidemic potential (p. 10). ¹⁸ During its initial phase, a wastewater collection system was established, building on existing sites used for environmental poliovirus surveillance. In addition, new sites in both hospital-based and community-based were created to meet the requirements of the project. Until December 2024, 26 community sites have been set up in eight of the 26 provinces of the DRC for environmental monitoring of Mpox. At each site, wastewater samples are collected every two weeks, resulting in 52 samples per month. Since the project’s launch, 360 samples have been collected. In parallel, efforts have been undertaken to optimise DNA extraction protocols from wastewater samples. ¹⁹ However, it does not include antimicrobial residues or AMR organisms, but rather pathogens. ²⁰

According to the Annual Report (2020) of the INRB, in relation to environmental surveillance the laboratory analysed 197 samples received from 17 sampling sites across seven provinces of the country. All of these sites were productive, as at least one non-polio enterovirus was isolated at each, and one case of vaccine-derived poliovirus type 2 (VDPV2) was detected at the Pakadjuma site in Kinshasa. The PV2 virus from Pointe Hollandaise Poto-Poto in Congo-Brazzaville was, at that time, undergoing sequencing at the regional laboratory (NICD) in South Africa. ²¹ However, it does not include antimicrobial residues or AMR organisms, but rather pathogens. ²²

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), data on antimicrobial resistance (AMR) are collected locally for common pathogens, from both hospitalised individuals and community cases. However, data collection is not always standardised and suffers from weaknesses in national coordination and/or quality management (p. 19). ²³ As an area requiring strengthening, the report recommends incorporating environmental monitoring results into national AMR surveillance reports (p. 20). ²⁴

1.1.2 Antimicrobial control

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 50

The Democratic Republic of Congo (DRC) has a national legislation in place requiring prescriptions for antibiotic use for humans.

Pursuant to Article 18 of Ministerial Order No. 1250/CAB/MIN/SP/010/CPH/OMP/2015 of 28 September 2015 of the Ministry of Public Health, Hygiene and Social Security, authorized pharmaceutical establishments must check for medical prescriptions to sell medicine that are required to have prescription. ²⁵ Since 2007, the Ministry of Public Health, Hygiene and Social Security has banned the sale of antibiotics without medical prescription. ²⁶

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) recommended the DRC to develop a continuing education plan for antimicrobial prescribers (p. 21). ²⁷

Nevertheless, there is evidence of gaps in enforcement. According to the Director of Pharmacovigilance, Clinical Trials, and the Fight Against AMR in the DRC, "Antibiotics remain widely consumed in the DRC. In fact, the challenge is to get people to seek medical advice before taking any antibiotics. By raising awareness, we emphasize the risks of taking antibiotics and antimicrobials without a medical prescription". ²⁸

According to a paper titled "A qualitative study on community use of antibiotics in Kinshasha, Democratic Republic of Congo" (2022), inappropriate use of antibiotics is a widespread practice and is influenced by lack of adequate knowledge of antibiotic use, indications and risks, prevalent self-medication, and financial barriers to accessing appropriate health care. ²⁹

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a national legislation or regulation in place requiring prescriptions for antibiotic use for animals.

Pursuant to Article 18 of Ministerial Order No. 1250/CAB/MIN/SP/010/CPH/OMP/2015 of 28 September 2015 of the Ministry of Public Health, Hygiene and Social Security, authorized pharmaceutical establishments must check for medical prescriptions to sell medicine that are required to have prescription. ³⁰ Since 2007, the Ministry of Public Health, Hygiene and Social Security has banned the sale of antibiotics without medical prescription. ³¹ However, there is no mention of its use for animals. ³² ³³

There is no evidence that a there is a national legislation on the theme on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the DRC legal database. ³⁶ ³⁷ ³⁸

1.2 Zoonotic disease

1.2.1 National planning for zoonotic diseases/pathogens

1.2.1a Laws/plans on zoonotic disease

Score: 100

The Democratic Republic of Congo (DRC) has both national legislation and plans for zoonotic diseases prioritization, detection, and reporting.

Pursuant to Article 8 of the Domestic Animals Health Policy (Decree of 28 July 1938), any owner or holder of an animal showing, during life or after death, signs of a listed contagious priority disease must immediately report it to the nearest territorial or veterinary authority; this obligation also applies to animals that have been in contact with infected animals or have been exposed to conditions of contamination. The duty to report further extends to veterinarians, meat inspectors, slaughterhouse managers, doctors, civil servants, and agents of the agricultural, territorial, police, and customs services who, in the course of their duties, detect or suspect the presence of any such contagious disease. ³⁹ Article 1 lists several zoonotic diseases such as rabies, anthrax, rinderpest, foot-and-mouth disease, pasteurellosis, contagious bovine pleuropneumonia, sheep pox, and others. ⁴⁰

The Domestic Animals Health Policy also covers prophylactic measures, such as mandatory veterinary visit, isolation and slaughter of sick animals, census and marking, destruction of corpses, prohibition of movement, and others, as per Articles 11 and 12. ⁴¹ It also has specific measures for each disease, as described in Articles 28 to 91. ⁴²

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) underscores that the Democratic Republic of Congo has in place a surveillance network for animal diseases. The main prioritised zoonotic diseases under surveillance by both the animal health and human health networks are Ebola virus disease (EVD), mpox, Rift Valley fever (RVF), rabies, highly pathogenic avian influenza (H5N1), salmonellosis, tuberculosis, brucellosis, anthrax, yellow fever, and COVID-19. ⁴³ The surveillance networks in animal and human health are supported by national, provincial, and university diagnostic laboratories. ⁴⁴

The JEE further notes that the DRC maintains: (i) a list of prioritised zoonotic diseases, (ii) an electronic real-time surveillance and notification system for animal diseases and zoonoses (FAO EMA-i), (iii) surveillance plans for zoonoses (including rabies, mpox, Ebola virus disease, and highly pathogenic avian influenza), (iv) a manual of standard operating procedures for the implementation of zoonoses policy, and (v) trained multisectoral teams for zoonotic outbreak response, including African Volunteers Health Corps-Strenghtening and Utilizing Response Groups for Emergencies (AVoHC-SURGE), Electronic Immunization Registry (EIR), FLTP (Frontline and Intermediate levels), and Frontline In-Service Applied Veterinary Epidemiology Training (ISAVET). It also highlights the existence of a national multisectoral communication strategy on the six groups of prioritised zoonoses. ⁴⁵

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 0

The Democratic Republic of Congo (DRC) does not have a national legislation or equivalent document which includes for risk identification and reduction for zoonotic disease spillover events from animals to humans.

The Domestic Animals Health Policy (Decree of 28 July 1938) establishes measures to limit the movement of people and animals in the event of an outbreak of zoonotic diseases, pursuant to Article 12, Section (e). ⁴⁶ Specifically regarding to swine fever, Article 84 provides that the competent territorial authority shall prescribe measures concerning the identification and isolation of infected or suspect individuals, as well as to the use and disinfection of premises, stables, enclosures and pastures. ⁴⁷ Nevertheless, there is no specific provisions that is explicitly aimed at reducing spillover events from animals to humans. ⁴⁸

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) does not mention such legislation or document for risk identification and reduction specifically for zoonotic disease spillover from animals to humans. ⁴⁹

The One Health Strategic Plan 2022-2027 (2021) does not have specific measures for risk identification and reduction for zoonotic disease spillover events form animals to humans. ⁵⁰

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

The Democratic Republic of Congo (DRC) has national plans that account for the surveillance and control of multiple zoonotic pathogens of public health concern.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) includes provisions for the surveillance and control of multiple zoonotic pathogens of public health concern, specifically Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ⁵⁴ The PNM states that in 2022, of 21 epidemic-prone diseases under surveillance in the Democratic Republic of Congo, seven (cholera, mpox, Ebola virus disease, measles, yellow fever, plague, and meningitis) reached epidemic status, compared to eight in 2021 (p. 14). ⁵⁵

The plan outlines disease-specific measures to enhance surveillance and control, such as pre-positioning provinces with IT tools for surveillance, holding daily routine epidemiological surveillance meetings for COVID-19, Ebola, cholera, mpox, measles, and rabies, including at the national-, provincial- and local-levels. ⁵⁶ For control, it includes measures to verify all alerts within 24 hours, establish rapid response teams, and organize workshops to design or update emergency intervention kits. ⁵⁷

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) also underscores that the country maintains an established network for the surveillance of both animal and human diseases, in which priority zoonotic diseases under surveillance include Ebola virus disease, mpox, Rift Valley fever, rabies, highly pathogenic avian influenza (H5N1), salmonellosis, tuberculosis, brucellosis, anthrax, yellow fever, and COVID-19. ⁵⁸ The JEE further highlights that the DRC has a well-defined information reporting system known by all surveillance actors, as well as a central Epidemiological Intelligence Center for receiving and analysing alerts (pp. 49-50). ⁵⁹ The surveillance of zoonotic diseases is conducted by the National Epidemiological Surveillance Service (SENES), under the purview of the Ministry of Fisheries and Livestock. ⁶⁰

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

The Democratic Republic of Congo (DRC) has an agency functioning as a multi-sectoral co-ordinating mechanism dedicated to zoonotic disease that functions across ministries.

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) underscores that the DRC has a mechanim for multisectoral collaboration on zoonoses. ⁶¹ Since 2011, the “One World, One Health” platform has facilitated policy development and promoted multidisciplinary and intersectoral collaboration, in which the platform is overseen by a National Committee and corresponding Provincial Committees. It also includes a sub-framework for coordination and collaboration known as the GTM Zoonoses, led by the National Epidemiological Surveillance Service (SENES) of the Ministry of Fisheries and Livestock. ⁶² According to the World Organization for Animal Health (WOAH), SENES has reinforced the multi-sectoral collaboration between the sectors of human health, animal health, and the environment. ⁶³

According to the One Health Strategic Plan 2022-2027 (2021), the national committee is the One Health Coordination Commission (CCUS), created by Ministerial Orders Nos. 405/MINESU/CAB.MIN/MML/CB/JN/2011 and 406/MINESU/CAB.MIN/MML/CB/JN/2011 of 9 November 2011 (p. 26). ⁶⁴ The CCUS is a technical body responsible for facilitating, coordinating, and harmonising actions aimed at implementing the “One Health” strategy, with the objective of improving preparedness for, prevention of, detection of, and response to epidemics and epizootics in a multidisciplinary and multisectoral context. ⁶⁵ Nevertheless, both Ministerial Orders are not publicly available on the Legislative Portal of the DRC or the Food and Agriculture Organization (FAO) database. ⁶⁶ ⁶⁷

In December 2022, FAO, through its Emergency Centre for Transboundary Animal Diseases (ECTAD), supported the official establishment of the CCUS Permanent Secretariat, which was set up to assist the National Coordinator of the One Health Coordination Commission in managing the CCUS and operationalizing the One Health approach in the DRC, was inaugurated under the auspices of the Ministry of Higher and University Education (MINESU). ⁶⁸

1.2.1e Presence of One Health strategic plan

Score: 100

Congo (Democratic Republic) has the Plan Strategique "Une Sante" (2022-2027) ("One Health" Strategic Plan (2022-2027)"). ⁶⁹ The aim is that this plan will be successfully implemented with a view to establishing multi-sectorality in all areas of animal (wild, domestic), human and environmental health and thus improving the management of zoonotic diseases, antimicrobial resistance, food safety and security.

1.2.2 Surveillance systems for zoonotic diseases/pathogens

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo has a national mechanism for owners of livestock to conduct and report on disease surveillance to a central government agency.

Pursuant to Article 8 of the Domestic Animals Health Policy (Decree of 28 July 1938), any owner or holder of an animal showing, during life or after death, signs of a listed contagious priority disease must immediately report it to the nearest territorial or veterinary authority; this obligation also applies to animals that have been in contact with infected animals or have been exposed to conditions of contamination. The duty to report further extends to veterinarians, meat inspectors, slaughterhouse managers, doctors, civil servants, and agents of the agricultural, territorial, police, and customs services who, in the course of their duties, detect or suspect the presence of any such contagious disease. ⁷⁰ Article 1 lists several zoonotic diseases such as rabies, anthrax, rinderpest, foot-and-mouth disease, pasteurellosis, contagious bovine pleuropneumonia, sheep pox, and others. ⁷¹

According to Article 9, in such cases the competent territorial authority must inform the public by means of a notice posted at its offices and must notify local residents through public announcements. ⁷² Immediately upon receiving a declaration of the existence or suspicion of a notifiable disease listed in Article 1, the competent territorial authority is required to dispatch an official veterinarian, or authorise one, to examine the affected or suspected animal. ⁷³ Nevertheless, the Domestic Animals Health Policy does not specify the mechanism for reporting to the competent territorial authority. ⁷⁴

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country has an electronic real-time surveillance and notification system for animal diseases and zoonoses, namely the Event Mobile Application (EMA-i) developed by the Food and Agriculture Organization (FAO). ⁷⁵ In April 2024, FAO, through its Emergency Centre for Transboundary Animal Diseases (ECTAD), organised a workshop to evaluate the implementation of EMA-i and conducted training sessions on the updated version of the platform, EMA-i+. ⁷⁶ However, data entry into the system is carried out at the level of veterinary clinics. ⁷⁷ ⁷⁸

There is no further evidence of such mechanism on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of Agriculture and Food Security. ⁷⁹ ⁸⁰ ⁸¹

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is no evicence that the Democratic Republic of Congo (DRC) has legislation that safeguards the confidentiality of information generated through surveillance activities for animal owners.

The Democratic Republic of Congo ratified the African Union Convention on Cybersecurity and the Protection of Personal Data on 4 April 2023 through Ordinance-Law No. 23/008 of 10 March 2023. ⁸⁴ ⁸⁵ According to the Convention, personal health data is classified as sensitive data. ⁸⁶ Pursuant to Article 195 of Ordinance-Law No. 23/008, the processing of personal health data is prohibited, except in cases where such processing is necessary for the protection of public health and safety, including measures to address serious cross-border health threats, among other authorised purposes. ⁸⁷ However, there is no specific mention as to whether it includes information generated through surveillance activities, and specifically for animal owners. ⁸⁸

1.2.2c Wildlife zoonotic disease surveillance

Score: 0

The Democratic Republic of Congo (DRC) conducts surveillance of zoonotic disease in wildlife. However, there is no evidence that it regularly conducts surveillance of poultry and livestock.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the Ministry of Environment and Sustainable Development oversees the movement of wildlife and its derivative products to reduce the risk of spreading and transmitting zoonotic pathogens. ⁸⁹ The document also notes as a strength the ability of farmers to manage sick animals at the farm level, but it identifies areas for improvement, including revising the regulatory framework governing animal movement and increasing the number of qualified personnel in the field. ⁹⁰

According to a report submitted in 2023 related to the Convention on International Trade in Endangered Species of Wild Fauna and Flora, the DRC created a team composed of doctors, veterinarians, and experts in ecology and natural resource management within the Congolese Institute for Nature Conservation (ICCN) to develop and implement the One Health strategy within the protected areas network (p. 24). ⁹¹ It also points out that in order to "identify and reduce the risk of transmission and spread of zoonotic diseases, a health information system using real-time reporting tools will be implemented to ensure coordinated epidemiological surveillance" (p. 25). ⁹²

During 2024, the National Institute of Biomedical Research (INRB) collected biological sample in the blood and tick sampling from pigs and cattle on farms and slaughterhouses in the Provinces of Gemena, Kindu, Mbuji-Mayi, Yanonge, Kinshaha City, and Goma (p. 20). ⁹³ It also included tick identification and extraction of non-engorded or partially engorded ticks (p. 21). ⁹⁴ In 2023, the INBR conducted studies in farms, slaughterhouses and veterinary clinics across the DRC, including blood and milk sampling from goats, cattle, pigs, and horses, ticks, and rodents (p. 18). ⁹⁵ However, there is no evidence that it is conducted regularly. ⁹⁶ ⁹⁷

1.2.3 International reporting of animal disease outbreaks

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is publicly available evidence of a mechanism for reporting notifiable diseases to the World Organisation for Animal Health (WOAH).

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC shares surveillance data with the WOAH (p. 41). ⁹⁸

According to the JEE (2019), the DRC notifies zoonotic diseases to the WOAH through a WOAH focal point in charge of health information and the Directorate of Animal Health under the Ministry of Fisheries and Livestock (p. 32). ⁹⁹ Furthermore, the WOAH focal point notified the WOAH via the World Animal Health Information System (WAHIS) in 2019 on bovine tubercullosis, cysticercosis, wild rabies, PPR, contagious bovine pleuropneumonia (CBPP), and African Swine Fever (p. 33). ¹⁰⁰ Nevertheless, it pointed out the absence of standard operating procedures and legal standards governing the notification to the WOAH (p. 33). ¹⁰¹

1.2.4 Animal health workforce

1.2.4a Number of veterinarians per 100,000 people

Score: 2.82

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 3.64

1.2.5 Private sector and zoonotic disease

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo (DRC) includes mechanisms for working with the private sector in controlling or responding to zoonoses in its national plans.

The National Strategic Development Plan 2024-2028 (PNSD) (2024), enacted by the Ministry of Planning, and Development Aid Coordination, does not include such mechanisms specifically for the health sector or controlling and responding to zoonoses. ¹⁰² The One Health Strategic Plan 2022-2027 (2021) does not present such mechanisms either. ¹⁰³

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the RDC receives funding from donors to support the implementation of the Expanded Program on Immunization (EPI). ¹⁰⁴ In addition, representatives of private laboratories and university laboratories and laboratories in sectors such as fisheries, livestock and the environment, as well as technical and financial partners are part of the National Laboratory Committee. ¹⁰⁵ Nevertheless, there are no details of the National Laboratory Committe and its remit on controlling or responding to zoonoses on the official websites of the Ministry of Health, Hygiene and Social Security, the National Biomedical Research Institute (INRB), or the Congolese legal portal. ¹⁰⁶ ¹⁰⁷ ¹⁰⁸ There is no evidence of other mechanisms on those websites either. ¹⁰⁹ ¹¹⁰ ¹¹¹

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) has mechanisms to enable funding from the private sector, both with financial resources or allocating personnel, but they are not taylored to control or respond to zoonoses in general, but rather public health emergencies.

1.3 Biosecurity

1.3.1 Whole-of-government biosecurity systems

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo (DRC) has in place a record of the facilities in which especially dangerous pathogens and toxins are stored or processed, including details on inventories and inventory management systems of those facilities.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), laboratories in the DRC are not subject to systematic risk assessment, and there is no register of laboratories handling dangerous pathogens (p. 28). ¹¹² Nevertheless, the main reference laboratories, namely the National Biomedical Research Institute (INRB) and the Central Veterinary Laboratory (Labovet), have developed a list of dangerous pathogens that they handle or that are stored in their sites, even though the DRC has not defined quantified biological safety and security requirements (p. 28). ¹¹³

However, there is no evidence such list is publicly available on the websites of the INRB or Labovet. ¹¹⁴ ¹¹⁵ There is no evidence of such registry or list on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the DRC legal database. ¹¹⁶ ¹¹⁷ ¹¹⁸

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has in place legislation or regulations related to biosecurity which address requirements such as physical containment, operation practices, failure reporting systems, and/or cybersecurity of facilities in which especially dangerous pathogens and toxins are stored or processed.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has developed biosafety and biosecurity guidelines for its human and animal health facilities and has disseminated them in several provinces. However, a comprehensive biosafety and biosecurity manual has not yet been finalised (p. 28). ¹¹⁹ The report also notes that although some laboratories conduct annual certification of microbiological hoods, the absence of a regulatory and legal framework for biosafety and biosecurity has resulted in a poorly developed and inconsistently implemented quality management system for laboratory services (p. 28). ¹²⁰

According to the Biological Weapons Convention National Implementation Measures Database, the DRC has measures for the control of activities that may involve biological agents and toxins, which are incorporated in Law No. 11/009 of 9 July 2011, which outlines fundamental principles relating to environmental protection. ¹²³ Pursuant to Articles 37 and 38, any industrial, commercial and agricultural facility whose operation presents either dangers to health, public health, or the environment are subject to prior declaration or authorization duly documented by a national or provincial operating permit. ¹²⁴ In addition, Article 58 states that any person or company that produce or holds biomedical or pharmaceutical waste must manage it in accordance with safety provisions, while Article 59 mandates the State to take necessary measures to minimize the production of hazardous waste on national territory, ensuring that any person responsible for hazardous waste management has appropriate facilities or sites and technical resources. ¹²⁵ Nevertheless, it is not specific for dangerous pathogens and toxins, and there are no further details related to physical containment, operation practices, failure reporting systems, and cybersecurity of those facilities. ¹²⁶

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has an established agency (or agencies) responsible for the enforcement of biosecurity legislation and regulations.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC does not have a multisectoral regulatory text on biosecurity and biosafety that defines management and coordination bodies and includes measures for security, risk assessment, and biological risk management (p. 29). ¹²⁷

According to the Biological Weapons Convention National Implementation Measures Database, the National Biomedical Research Institute (INRB), in collaboration with the Mérieux Foundation, has organised training activities on biosecurity and biosafety. These include training on sampling techniques, storage and transportation of respiratory samples, and training for laboratory personnel in biosafety and biosecurity protocols. ¹²⁸ However, there is no reference to a designated agency responsible for enforcing these protocols. ¹²⁹

There is no evidence these biosafety and biosecurity protocols are publicly available on the INRB's website. ¹³⁰ The INRB, established by Decree No. 13/006 of 22 January 2013, is mandated to contribute to improving the health of the Congolese population through the implementation and promotion, across the entire territory, of biomedical investigations necessary for research, diagnosis, surveillance, prevention, and treatment of epidemic and/or endemic human diseases (Article 3). ¹³¹ Pursuant to Article 5, the INRB is responsible for coordinating and monitoring all biomedical research activities within the Ministry of Public Health. ¹³² The decree does not contains provisions granting the INRB a mandate to enforce biosecurity legislation or regulations. ¹³³

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no evidence that the Democratic Republic of Congo has taken action to consolidate its inventories of especially dangerous pathogens and toxins into a minimum number of facilities.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), laboratories in the DRC are not subject to systematic risk assessment, and there is no register of laboratories handling dangerous pathogens (p. 28). ¹³⁴ Nevertheless, the main reference laboratories, namely the National Biomedical Research Institute (INRB) and the Central Veterinary Laboratory (Labovet), have developed a list of dangerous pathogens that they handle or that are stored in their sites, even though the DRC has not defined quantified biological safety and security requirements (p. 28). ¹³⁵

There is no evidence of such actions on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ¹³⁶ ¹³⁷ ¹³⁸ There is no evidence on the Biological Weapons Convention National Implementation Measures Database either. ¹³⁹

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 100

There is publicly evidence of in-country capacity in the Democratic Republic of Congo (DRC) to conduct Polymerase Chain Reaction (PCR)-based diagnostic testing for Ebola, which would preclude culturing a live pathogen.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the National Institute of Biomedical Research (INRB) is capable of conducting tests for Ebola, monkeypox, measles, polio, SARS-CoV-2, avian influenza, anthrax, rabies, and filoviruses (p. 22; pp. 36-37). ¹⁴⁰

According to the Annual Report (2023) of the INRB, the Multi-Pathogen Laboratory can conduct PCR-based diagnostic testing for Ebola – in 2023, it tested a selection of 800 samples using RT-PCR technique. ¹⁴¹ It also tests for anthrax, but there is no evidence it uses PCR-based diagnostic. ¹⁴²

1.3.2 Biosecurity training and practices

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is no evidence that the Democratic Republic of Congo (DRC) requires biosecurity training, using a standardized, required approach, such as through a common curriculum or a train-the-trainer program, for personnel working in facilities housing or working with especially dangerous pathogens, toxins, or biological materials with pandemic potential. However, there is ad hoc training.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has not developed any training or plan for biosafety and biosecurity, although some ministry officials have been trained on biosafety and biosecurity concepts by a partner, and training modules are available (p. 30). ¹⁴³ Additionally, there is a lack of quantified training needs on biosecurity and biosafety based on staff training plans established by reference laboratories, and there is a need to rewrite and mobilize funds to distribute a new manual on biosafety and biosecurity. ¹⁴⁴ Nevertheless, the country offers ad hoc training by the African Society for Laboratory Medicine (ASLM) and the Food and Agriculture Organization (FAO) for ministry officials on biosafety and biosecurity, as well as biosafety and biosecurity modules for training laboratory staff and provincial laboratory managers on the concepts by the INRB. ¹⁴⁵

In August 2024, the Africa Center for Disease Control and Prevention (CDC), with the INRB, launched a hands-on training on molecular testing, sequencing, and reporting of monkeypox (Mpox) cases; the training covered a combination of theoretical and hands-on training in the collection and handling of Mpox-suspected specimens, isolation of nucleic acid, detection of Mpox virus (MPXV) using RT-PCR assay, sequencing, data analyses, and reporting of results for public health interventions. ¹⁴⁶

Moreover, in 2024, the INRB provided training for in-house staff on risk management (p. 16), as well as training in reinforcing the capacity related to genetic sequencing of HIV for laboratory staff (p. 31). ¹⁴⁷

1.3.3 Personnel vetting: regulating access to sensitive locations

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is no evidence that the regulations or licensing conditions in the Democratic Republic of Congo (DRC) specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are subject to drug testing, background checks, and psychological or mental fitness checks.

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) does not mention such requirements either. ¹⁵⁰ There is no evidence of such requirements on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ¹⁵¹ ¹⁵² ¹⁵³ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ¹⁵⁴ ¹⁵⁵

1.3.4 Transportation security

1.3.4a National transport regulations for Category A and B infectious substances

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has publicly available information on national regulations on the safe and secure transport of infectious substances (specifically including Categories A and B).

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the use of triple packaging when transporting samples and personal protective equipment to laboratories is systematic (p. 28). ¹⁵⁶ However, the document notes that the country does not have legislation establishing a Hygiene Code or regulations governing the collection, packaging, and transport of samples. ¹⁵⁷ A recommended priority measure is the establishment and regulation of the transport of dangerous goods, particularly infectious substances, with an emphasis on personnel safety. ¹⁵⁸

The JEE further highlights that the country has ad hoc means of sample transport, sometimes relying on mechanisms established under the polio programme. It also notes the existence of a generic manual for sample collection, storage, and transport, which has been developed and widely disseminated, as well as training modules for providers on sample transport (p. 36). ¹⁵⁹ However, an area identified for improvement is the development of an integrated operational plan for a harmonised and secure sample transfer and transport system at all levels, including emergency procedures. ¹⁶⁰

In December 2020, the Ministry of Public Health, Hygiene and Social Security enacted the National Development Strategic Plan of Health Laboratory Services 2021-2025 (PSNDSLS), with the general objective to contribute to increasing the coverage of laboratory services as well as their use to achieve quality health care for the population with equity and financial protection (p. 36). ¹⁶¹ The plan highlights the absence of an optimal strategy for an integrated and secure sample transport system, noting that the mechanisms for collecting, storing, and transporting samples remain poorly structured, with frequent shortages of sample collection facilities in health zones and provincial laboratories. ¹⁶² It further observes that biosafety and biosecurity during sample collection, storage, and transport are not consistently guaranteed, and that staff responsible for shipping tasks are often not adequately trained. ¹⁶³

In February 2025, the NGO VillageReach launched the program "Integrated Laboratory Transport Systems to Stop Outbreaks" to strenghten laboratory specimen referral and transport systems for infectious diseases, namely polio, measles, yellow fever, Ebola, smallpox, and cholera. ¹⁶⁴ It seeks to enable the countries, including the DRC, to digitize and integrate electronic reporting systems, in order to improve the availability of data on sample movements and laboratory results. ¹⁶⁵ In the DRC, the program seeks to improve transportation networks and routes to national and regional laboratories for patient samples from 11 provinces, train 3,500 community leaders for crisis periods during outbreaks, and train local health worekrs and private transporters in biosafety and biosecurity, sample collection, packaging, transportation, and reporting. ¹⁶⁶

There is no evidence of such regulations on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ¹⁶⁷ ¹⁶⁸ ¹⁶⁹ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ¹⁷⁰ ¹⁷¹

1.3.5 Cross-border transfer and end-user screening

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has legislation or regulations in place to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country does not have legislation establishing a Hygiene Code or regulations governing the collection, packaging, and transport of samples. ¹⁷² There is no reference to legislation or regulations to oversee the cross-border transfer and end-user screening of especially dangerous pathogens, toxins, and pathogens with pandemic potential. ¹⁷³ Moreover, there is a lack of a national multisectoral risk-based international transport management strategy specifying the roles and responsibilities of the various sectors involved, and no standard operating procedures to facilitate the implementation of the international transport management strategy (p. 65). ¹⁷⁴

In December 2020, the Ministry of Public Health, Hygiene and Social Security enacted the National Development Strategic Plan of Health Laboratory Services 2021-2025 (PSNDSLS), with the general objective to contribute to increasing the coverage of laboratory services as well as their use to achieve quality health care for the population with equity and financial protection (p. 36). ¹⁷⁵ The plan highlights the absence of an optimal strategy for an integrated and secure sample transport system, noting that the mechanisms for collecting, storing, and transporting samples remain poorly structured, with frequent shortages of sample collection facilities in health zones and provincial laboratories. ¹⁷⁶ It further observes that biosafety and biosecurity during sample collection, storage, and transport are not consistently guaranteed, and that staff responsible for shipping tasks are often not adequately trained. ¹⁷⁷ However, there is no mention of cross-border transfer or end-user screening. ¹⁷⁸

The National Border Hygiene Program (PNHF), under the purview of the Ministry of Public Health, Hygiene and Social Security, is responsible for ensuring health controls at various border posts, public and private warehouses and concessions. ¹⁷⁹ The PNHF is responsible for disease surveillance through health reporting and surveillance of diseases with epidemic potential. ¹⁸⁰ However, there is no evidence of such legislation or requirements on PNHF's website. ¹⁸¹

There is no evidence of such regulations on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ¹⁸² ¹⁸³ ¹⁸⁴ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ¹⁸⁵ ¹⁸⁶

1.4 Biosafety

1.4.1 Whole-of-government biosafety systems

1.4.1a Biosafety laws/regulations

Score: 0

The Democratic Republic of Congo (DRC) does not have in place national biosafety legislation or regulations.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has developed biosafety and biosecurity guidelines for its human and animal health facilities and has disseminated them in several provinces. However, a comprehensive biosafety and biosecurity manual has not yet been finalised (p. 28). ¹⁸⁷ The report also notes that although some laboratories conduct annual certification of microbiological hoods, the absence of a regulatory and legal framework for biosafety and biosecurity has resulted in a poorly developed and inconsistently implemented quality management system for laboratory services (p. 28). ¹⁸⁸

According to the Biological Weapons Convention National Implementation Measures Database, the DRC has measures for the control of activities that may involve biological agents and toxins, which are incorporated in Law No. 11/009 of 9 July 2011, which outlines fundamental principles relating to environmental protection. ¹⁹¹ Pursuant to Articles 37 and 38, any industrial, commercial and agricultural facility whose operation presents either dangers to health, public health, or the environment are subject to prior declaration or authorization duly documented by a national or provincial operating permit. ¹⁹² In addition, Article 58 states that any person or company that produce or holds biomedical or pharmaceutical waste must manage it in accordance with safety provisions, while Article 59 mandates the State to take necessary measures to minimize the production of hazardous waste on national territory, ensuring that any person responsible for hazardous waste management has appropriate facilities or sites and technical resources. ¹⁹³ Nevertheless, it is not specific for biosafety, and it mostly focuses on environmental protection. ¹⁹⁴

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has an established agency (or agencies) responsible for the enforcement of biosecurity legislation and regulations.

According to the Biological Weapons Convention National Implementation Measures Database, the National Biomedical Research Institute (INRB), in collaboration with the Mérieux Foundation, has organised training activities on biosecurity and biosafety. These include training on sampling techniques, storage and transportation of respiratory samples, and training for laboratory personnel in biosafety and biosecurity protocols. ¹⁹⁶ However, there is no reference to a designated agency responsible for enforcing these protocols. ¹⁹⁷

There is no evidence these biosafety and biosecurity protocols are publicly available on the INRB's website. ¹⁹⁸ The INRB, established by Decree No. 13/006 of 22 January 2013, is mandated to contribute to improving the health of the Congolese population through the implementation and promotion, across the entire territory, of biomedical investigations necessary for research, diagnosis, surveillance, prevention, and treatment of epidemic and/or endemic human diseases (Article 3). ¹⁹⁹ Pursuant to Article 5, the INRB is responsible for coordinating and monitoring all biomedical research activities within the Ministry of Public Health. ²⁰⁰ The decree does not contains provisions granting the INRB a mandate to enforce biosecurity legislation or regulations. ²⁰¹

1.4.2 Biosafety training and practices

1.4.2a Biosafety training using a standardised, required approach

Score: 33.33

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has not developed any training or plan for biosafety and biosecurity, although some ministry officials have been trained on biosafety and biosecurity concepts by a partner, and training modules are available (p. 30). ²⁰² Additionally, there is a lack of quantified training needs on biosecurity and biosafety based on staff training plans established by reference laboratories, and there is a need to rewrite and mobilize funds to distribute a new manual on biosafety and biosecurity. ²⁰³ Nevertheless, the country offers ad hoc training by the African Society for Laboratory Medicine (ASLM) and the Food and Agriculture Organization (FAO) for ministry officials on biosafety and biosecurity, as well as biosafety and biosecurity modules for training laboratory staff and provincial laboratory managers on the concepts by the INRB. ²⁰⁴

1.5 Dual-use research and culture of responsible science

1.5.1 Oversight of dual-use research

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo (DRC) has conducted an assessment to determine whether ongoing research is occurring on especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

The National Biomedical Research Institute (INRB) conducts research through its Virology Laboratory in Ebola, polio, influenza, monkeypox, measles, and rotavirus. ²⁰⁷ Nevertheless, there is no evidence of an overall assessment to determine whether there is ongoing research across the country. ²⁰⁸

There is no evidence of such regulations on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ²⁰⁹ ²¹⁰ ²¹¹ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ²¹² ²¹³

There is no mention on the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) either. ²¹⁴

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has legislation or regulations requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the Directorate of Health Laboratories (DLS) is supported in its role of coordinating the national laboratory network by the National Institute of Biomedical Research (INRB), which serves as the national public health laboratory and the central technical body of the laboratory system (p. 35). ²¹⁵ The report further notes the absence of a clearly defined structure outlining the roles and responsibilities of key actors in charge of research (p. 50). ²¹⁶ There is no reference on Decree No. 13/006, which created the INRB, to a remit related to oversight of research. ²¹⁷

The National Development Strategic Plan of Health Laboratory Services 2021-2025 (PSNDSLS) (2020), enacted by the Ministry of Public Health, Hygiene and Social Security, states that research activities involving laboratories across the country are not organized, and there is no mention of a requirement of oversight of such research. ²¹⁸

There is no evidence of such regulations on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ²¹⁹ ²²⁰ ²²¹ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ²²² ²²³

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has an agency responsible for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the Directorate of Health Laboratories (DLS) is supported in its role of coordinating the national laboratory network by the National Institute of Biomedical Research (INRB), which serves as the national public health laboratory and the central technical body of the laboratory system (p. 35). ²²⁴ The report further notes the absence of a clearly defined structure outlining the roles and responsibilities of key actors in charge of research (p. 50). ²²⁵ There is no reference on Decree No. 13/006, which created the INRB, to a remit related to oversight of research. ²²⁶

There is no evidence of such regulations on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ²²⁸ ²²⁹ ²³⁰ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ²³¹ ²³²

1.5.2 Screening requirements for providers of genetic material

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo (DRC) has legislation or regulations requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before it is sold.

There is no evidence of such regulations on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ²³³ ²³⁴ ²³⁵ There is no evidence on the Biological Weapons Convention National Implementation Measures Database or the DRC legal database. ²³⁶ ²³⁷

There is no mention on the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) either. ²³⁸

1.6 Immunization

1.6.1 Vaccination rates

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 0

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 100

Official foot-and-mouth (FMD) vaccination figures for livestock in the Democratic Republic of Congo are publicly available through the OIE database.

The latest available data refers to the second semester of 2024, including data for domestic animals, such as cattle, buffaloes, goats, sheep, swine, camelidae, and mixed herd of sheep and goats. ²³⁹

1.6.1c Equitablenature of national immunization strategy/plan

Score: 0

The Democratic Republic of Congo (DRC) has a national immunization strategy. However, the document is not publicly available.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has a solid legal and regulatory framework for vaccination, in which the Expanded Program on Immunization (EPI) is funded by the government, international partners, and private donors (p. 31). ²⁴⁰ The EPI is responsible for the procurement, storage, and distribution of vaccines. ²⁴¹ It further adds that the DRC has taken steps to improve its vaccination system, including through investments to increase vaccination coverage (p. 31). ²⁴²

The country also has a National Immunization Strategy 2022-2026 that seeks to increase vaccination coverage to 95% for the diseases avoidable through vaccination (p. 31). ²⁴³ In addition, although routine vaccination is well established in the DRC, routine vaccination coverage remains between 50% and 69% of the pediatric population aged 12 months having received at least one dose of measles-containing vaccine, according to coverage surveys or administrative data. A plan including supplementary vaccination activities has been implemented with the aim of achieving 90% coverage within the next five years. ²⁴⁴

However, the document is not publicly available. ²⁴⁵

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) national immunization strategy includes measures to address vaccine hesitancy and build public trust in vaccines.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has a solid legal and regulatory framework for vaccination, in which the Expanded Program on Immunization (EPI) is funded by the government, international partners, and private donors (p. 31). ²⁴⁶ The EPI is responsible for the procurement, storage, and distribution of vaccines. ²⁴⁷ It further adds that the DRC has taken steps to improve its vaccination system, including through investments to increase vaccination coverage (p. 31). ²⁴⁸ The country also has a National Immunization Strategy 2022-2026 that seeks to increase vaccination coverage to 95% for the diseases avoidable through vaccination (p. 31). ²⁴⁹

However, the plan is not publicly available. ²⁵⁰

1.6.1e National advisory group for immunization strategy/plan

Score: 100

The Democratic Republic of Congo (DRC) has established a national advisory group (NITAG) that provides technical guidance and advice on the immunization strategy.

The DRC has established a NITAG on 17 October 2016, through Ministerial Decree No. 1250/CAB/MIN/SP/014/CD/2016. ²⁵¹ Its mission is to provide on request or on its own initiative, opinions, recommendations or independent reports on vaccination or vaccines in order to support policy in this area. ²⁵² ²⁵³ The DRC NITAG is comprised of 15 national experts in the fields of biostatistics, health economics, entomology, epidemiology, laboraty and clinical trials, immunologist, infectious diseases, neurology, paediatric, sociology/anthropology, healthcare logistics, research and clinical trials, policies and health systems, and vaccination. ²⁵⁴

In addition, the DRC self-reported having a NITAG to the World Health Organization (WHO). ²⁵⁵

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has an immunization programme for influenza.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has a solid legal and regulatory framework for vaccination, in which the Expanded Program on Immunization (EPI) is funded by the government, international partners, and private donors (p. 31). ²⁵⁶ The EPI is responsible for the procurement, storage, and distribution of vaccines. ²⁵⁷ It further adds that the DRC has taken steps to improve its vaccination system, including through investments to increase vaccination coverage (p. 31). ²⁵⁸ The country also has a National Immunization Strategy 2022-2026 that seeks to increase vaccination coverage to 95% for the diseases avoidable through vaccination (p. 31). ²⁵⁹ However, there is no reference to influenza. ²⁶⁰

In addition, there is no evidence that the DRC has an immunization programme for influenza on the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB) or the DRC legal database. ²⁶¹ ²⁶² ²⁶³ DRC's immunization programme is not publicly available. ²⁶⁴ ²⁶⁵ ²⁶⁶

1.7 Climate change adaptation and vector transmission

1.7.1 Health system resilience

1.7.1a Strategy/plan for resilience of health system

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a strategy or plan to develop a health system that is resilient to the challenges that climate change and changing seasonal weather patters pose, that includes the threat of infectious diseases.

The National Climate Change Adaptation Plan 2022-2026 (PANA) (2022) acknowledges the risk of increased incidence of diseases such as cholera, malaria, typhoid, and measles as a result of rising temperatures (p. 56). ²⁶⁷ It also outlines an initiative to improve access of poor and vulnerable populations affected by climate change to health services”, with an allocated budget of USD 500,000,000 (p. 64). ²⁶⁸ However, the plan provides no details regarding implementation or whether it encompasses the development of a health system resilient to the challenges posed by climate change and shifting seasonal weather patterns. ²⁶⁹

The National Strategic Plan 2023-2027 (2023) of the National Institute of Public Health (INSP) does not present such measures. ²⁷⁰

There is no evidence of such plan or strategy on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of the Environment and Sustainable Development. ²⁷¹ ²⁷² ²⁷³ There is no evidence on the DRC legal database either. ²⁷⁴ There is no mention on the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) either. ²⁷⁵

Early Detection

2.1 Laboratory systems strength and quality

2.1.1 Lab capacity for detecting priority diseases

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo's (DRC) national laboratory system has the capacity to conduct diagnostics tests for at least 5 of the 10 WHO-defined core tests. It includes PCR testing, virus culture, and rapid diagnostic testing.

According to the Annual Report (2023) of the INRB, the Multi-Pathogen Laboratory can conduct PCR-based diagnostic testing for Ebola – in 2023, it tested a selection of 800 samples using RT-PCR technique. ²⁷⁷ In the 2024 Annual Report, the INRB stated that it can conduct rapid diagnostic testing for cholera (p. 15). ²⁷⁸ The INRB can also process virus culture. ²⁷⁹

2.1.1b Plan to conduct testing during a public health emergency

Score: 50

The Democratic Republic of Congo (DRC) has a national plan for conducting testing during a public health emergency. Although it has considerations for scaling capacity and defining goals for testing, there is no consideration for testing for novel pathogens.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024), enacted by the Ministry of Public Health, Hygiene and Social Security, contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ²⁸⁰ It includes provisions for scaling capacity and defining goals for testing, but there is no mention of testing for novel pathogens. ²⁸¹ The PNM includes measures to distribute thousands of rapid diagnostic tests, and detect cases and address them within 48 hours, constitute rapid intervention teams to assist with investigation of cases, and others, with clear goals of detection of cases. ²⁸²

In addition, the Center for Disease Control and Prevention (CDC) reports that it has contributed to a the development of a national laboratory strategic plan in the DRC to strengthen diagnostics, optimize the laboratory network, and improve quality. ²⁸³

2.1.2 Laboratory quality systems

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a national laboratory that serves as a reference facility which is accredited.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the two main reference laboratories are the National Biomedical Research Institute (INRB) and the Central Veterinary Laboratory (Labovet) (p. 28). ²⁸⁴ However, there is no evidence they are accredited. ²⁸⁵ In contrast, the report also points out that several laboratories are engaged in the ISO 15189 and ISO 17025 accreditation process (p. 36). ²⁸⁶ For food safety, the Congolese Control Bureau (OCC) relies on a national network of 25 physicochemical and microbiological control laboratories throughout the country, some of which have already been accredited in food microbiology with the Tunisian Accreditation Council (TUNAC), drinking water with the Southern African Development Community Accreditation Services (SADCAS), and mass calibration with TUNAC (p. 25). ²⁸⁷

In April 2021, the INRB announced that it was preparing for the accreditation process for its Parasitology Laboratory with the support from the Global Health Systems Solutions (GHSS). ²⁸⁸ However, there is no evidence it has been acquired. ²⁸⁹ ²⁹⁰ In its Annual Report (2024), the INRB stated that the Pathogen Genomics Laboratory of the INRB was selected among 11 African laboratories supported by the Africa Center for Disease Control and Prevention (CDC) and the African Society for Laboratory Medicine (ASLM) for its accreditation process. ²⁹¹ Nevertheless, the INRB is accredited by the World Health Organization (WHO) for the biological diagnosis of poliovirus. ²⁹²

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

The Democratic Republic of Congo (DRC) has a national laboratory that serves as a reference facility which is subject to external quality assurance review.

According to Annual Report (2024) of the National Biomedical Research Institute (INRB), since 2022, the Pathogen Genomics Laboratory, within the INRB, has actively participated in several external quality assessment exercises organized by various international institutions, including Genomics Quality Assessment (GenQA), the Austrian Association for Quality Assurance and Standardization of Medical and Diagnostic Tests (ÖQUASTA), the Royal College of Pathologists of Australia, and the UK Health Security Agency (p. 17). ²⁹³

Nevertheless, the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) undescored that the DRC should enroll central and intermediate-level laboratories in regular external quality assessment in the fields of bacteriology, virology, biochemistry, hematology, parasitology, and molecular biology, and provide post-external quality assessment training as a corrective measure when results are not satisfactory (p. 37). ²⁹⁴

Likewise, the National Development Strategic Plan of Health Laboratory Services 2021-2025 (PSNDSLS) (2020), enacted by the Ministry of Public Health, Hygiene and Social Security, states that quality management systems for laboratory services is not implemented in the country, and that there is a lack of knowledge and non-application of the ISO 15189 standards relating to the competence and quality requirements specific to medical biology analysis laboratories, as well as absence of national and international accreditation mechanisms for laboratories (p. 26). ²⁹⁵

2.2 Laboratory supply chains

2.2.1 Specimen referral and transport system

2.2.1a Nationwide specimen transport system

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a nationwide specimen transport system.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country has ad hoc means of transporting samples, sometimes relying on systems established under the polio programme, particularly for transfers from intermediate zones (p. 36). ²⁹⁶ However, there is no legislation governing the transportation of samples (p. 29). ²⁹⁷ The JEE recommends several priority measures, including the establishment and regulation of the transport of dangerous goods, particularly infectious substances, with provisions for personnel safety (p. 30); the development of an integrated operational plan for a harmonised and secure sample transfer and transport system at all levels, including emergency procedures (p. 36); and the revision of the generic manual for sample collection, storage, and transport, with its dissemination extended to intermediate levels (p. 36). ²⁹⁸

Likewise, the National Development Strategic Plan of Health Laboratory Services 2021-2025 (PSNDSLS) (2020), enacted by the Ministry of Public Health, Hygiene and Social Security, identifies that the system for collecting, storing, and transporting samples is poorly structured, often lacking sample collection devices in health zones and provincial laboratories, in which only some specialized laboratories have established samples transport circuits (p. 29). ²⁹⁹

In February 2025, the NGO VillageReach launched the program "Integrated Laboratory Transport Systems to Stop Outbreaks" to strenghten laboratory specimen referral and transport systems for infectious diseases, namely polio, measles, yellow fever, Ebola, smallpox, and cholera. ³⁰⁰ It seeks to enable the countries, including the DRC, to digitize and integrate electronic reporting systems, in order to improve the availability of data on sample movements and laboratory results. ³⁰¹ In the DRC, the program seeks to improve transportation networks and routes to national and regional laboratories for patient samples from 11 provinces, train 3,500 community leaders for crisis periods during outbreaks, and train local health worekrs and private transporters in biosafety and biosecurity, sample collection, packaging, transportation, and reporting. ³⁰²

2.2.2 Laboratory cooperation and coordination

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a plan in place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024), enacted by the Ministry of Public Health, Hygiene and Social Security, contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ³⁰³ It includes provisions to distribute thousands of rapid diagnostic tests, and detect cases and address them within 48 hours, constitute rapid intervention teams to assist with investigation of cases, and others, with clear goals of detection of cases, but there is no mention of rapid authorization or licensing laboratories to supplement the capacity of the national public health laboratory system. ³⁰⁴

There is no evidence of such plan or strategy on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of the Environment and Sustainable Development. ³⁰⁶ ³⁰⁷ ³⁰⁸ There is no evidence on the DRC legal database either. ³⁰⁹ There is no mention on the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) either. ³¹⁰

2.3 Real-time surveillance and reporting

2.3.1 Indicator and event-based surveillance and reporting systems

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

The Democratic Republic of Congo (DRC) is conducting event- and indicator-based surveillance and analysis for notifiable and novel infectious diseases. However, there is no evidence it occurs on a daily basis, and that is is implemented nationwide.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), event-based surveillance has been implemented in eight of the country’s 26 provinces through an electronic surveillance system. The provinces where this system is operational are Kinshasa, Tshopo, Kwilu, Nord Kivu, Kongo Central, Kwango, Kasaï Central, and Haut Katanga (p. 39). ³¹¹ The country also conducts training for health workers in event-based surveillance (p. 40). ³¹² However, the JEE identifies weaknesses, including the limited implementation of community-based event surveillance nationwide (p. 40), and recommends expanding both event-based and community-based surveillance across all sectors and administrative levels to strengthen the detection of public health events (p. viii). ³¹³

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024), enacted by the Ministry of Public Health, Hygiene and Social Security, provides that alert mode should be triggered when an event is likely to threaten human, animal, or environmental health. The decision to activate alert mode is based on the analysis of routine surveillance data from indicator-based surveillance and event-based surveillance, along with ongoing media monitoring while in standby mode. ³¹⁴ However, the plan does not specify the frequency with which routine surveillance is conducted. ³¹⁵

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

The Democratic Republic of Congo (DRC) has a mechanism for reporting notifiable diseases to the World Health Organization (WHO) within the set timeline.

The National Border Hygiene Program (PNHF), under the purview of the Ministry of Public Health, Hygiene and Social Security, is the IHR focal point in the DRC. ³¹⁶

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country has an officially designated National IHR Focal Point, appointed by government decree within the PNHF, which is under the authority of the Ministry of Public Health, Hygiene and Social Security, but several other ministries have also designated focal points for the implementation of the International Health Regulations (2005) (p. 16). ³¹⁷

2.3.2 Interoperable, interconnected, electronic real-time reporting systems

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

The Democratic Republic of Congo (DRC) operates an electronic reporting surveillance system at both the national and the sub-national level.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country has an electronic real-time surveillance and notification system for animal diseases and zoonoses, namely the Event Mobile Application (EMA-i) developed by the Food and Agriculture Organization (FAO), and there is a database of electronic surveillance (p. 23). ³¹⁸ In April 2024, FAO, through its Emergency Centre for Transboundary Animal Diseases (ECTAD), organised a workshop to evaluate the implementation of EMA-i and conducted training sessions on the updated version of the platform, EMA-i+. ³¹⁹

The JEE further adds that data collected in the National Health Information System (SNIS), using the DHIS2, servers to monitor health service utilization, and the data is analyzed by the Epidemiological Intelligence Center based on geographic location, gender, catchment area, urbanization/rurality, and public/private sector, and that event-based surveillance has been implemented in eight of the country’s 26 provinces through an electronic surveillance system. The provinces where this system is operational are Kinshasa, Tshopo, Kwilu, Nord Kivu, Kongo Central, Kwango, Kasaï Central, and Haut Katanga (p. 39). ³²⁰ However, the DHIS2 is not publicly accessible, as it requires login and password. ³²¹

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 100

The electronic reporting system of the Democratic Republic of Congo (DRC) collects real-time laboratory data, and it is disaggregated and analysed by gender and geographic location.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country has an electronic real-time surveillance and notification system for animal diseases and zoonoses, namely the Event Mobile Application (EMA-i) developed by the Food and Agriculture Organization (FAO), and there is a database of electronic surveillance (p. 23). ³²² In April 2024, FAO, through its Emergency Centre for Transboundary Animal Diseases (ECTAD), organised a workshop to evaluate the implementation of EMA-i and conducted training sessions on the updated version of the platform, EMA-i+. ³²³

The JEE further adds that data collected in the National Health Information System (SNIS), using the DHIS2, serves to monitor health service utilization, and the data is analyzed by the Epidemiological Intelligence Center based on geographic location, gender, catchment area, urbanization/rurality, and public/private sector, and that event-based surveillance has been implemented in eight of the country’s 26 provinces through an electronic surveillance system. The provinces where this system is operational are Kinshasa, Tshopo, Kwilu, Nord Kivu, Kongo Central, Kwango, Kasaï Central, and Haut Katanga (p. 39). ³²⁴ In addition, organization and analysis of surveillance data is conduct in terms of time, place and individual characteristics (p. 41). ³²⁵ However, the DHIS2 is not publicly accessible, as it requires login and password. ³²⁶

On animal health, the surveillance of zoonotic diseases is conducted by the National Epidemiological Surveillance Service (SENES), under the purview of the Ministry of Fisheries and Livestock. ³²⁷ SENES uses a real-time electronic surveillance system, namely EMA-i, as well as DHIS2, QGIS, and Kobocollect, in which the information is made available in electronic and printed form in weekly and monthly epidemiological bulletins. ³²⁸

2.3.3 Wastewater surveillance

2.3.3a National wastewater surveillance programme or initiative

Score: 50

There is evidence of some wastewater and environmental surveillance (WES) activity within the country. In 2024, an outbreak of Mpox in sub-Saharan Africa, particularly in the Democratic Republic of Congo (DRC) led to thousands of suspected cases and hundreds of deaths and a declaration of a Public Health Emergency in April 2024. In response, the EU-funded ODIN-MPox project was established to use advanced genomic surveillance and wastewater-based epidemiology to track the presence of the virus in the environment, guiding targeted public health actions to control the outbreak and prevent future epidemics.³²⁹ There is limited evidence on whether this is ongoing or at the national level.

There is evidence that environmental surveillance samples for poliovirus detection were collected between 2017 and 2021 across multiple sites, however it is not clear whether this is still ongoing. ³³⁰ Moreover, in 2022, Imperial's Vaccine Epidemiology Research Group (VERG) funded by the Bill and Melinda Gates Foundation, developed a method for the direct detection of poliovirus in stool samples and environmental surveillance samples. Imperial's team provided online training for the use of Nanopore sequencing in August 2021, after which 2500 stool samples from children with paralysis of limbs were collected and analysed. Additional wastewater samples were collected and analysed for the environmental surveillance of poliovirus. However, it is not clear whether these training and capacity building efforts have been translated into ongoing ES programmes.³³¹

Support for integration of poliovirus environmental surveillance with other wastewater pathogens saw the region collaborate with partners in the Mpox wastewater surveillance project in Democratic Republic of Congo. The European Union Health Emergency Preparedness and Response Authority (HERA) wastewater project in AFRO, which supports countries and development partners in having clear guidance on minimum capacity needed and investment requirements to establish and sustain a credible wastewater and environmental surveillance programme. This resulted in four pilot countries (Democratic Republic of Congo, Senegal, Uganda, and Zambia) being supported in selecting priority pathogens based on local context and public health significance, feasibility, acceptability, and how best to integrate with existing surveillance and response systems, as well as multi-target wastewater and environmental surveillance. Scoping visits were conducted in the four pilot countries where the WHO prioritisation tool was applied to help countries select priority pathogens. Microplanning was conducted for its implementation, after which budgets were drawn up, and implementation is planned for 2026.³³² However, there is no evidence on whether this has been implemented yet, whether it is national/sub-national, or whether it is expected to be long-running.

Moreover, according to the 2025 Q4 Polio Environmental Surveillance Bulletin, published by the WHO and the GPEI, the Polio Eradication Programme (PEP), WHO Africa Regional Office (AFRO), have supported capacity-building in the DRC, which is a priority country, through a refresher training session for ES focal points from government and supporting partner agencies.³³³ The Bulletin also lists the country as having 22 ES sites as of Q4 in 2025, although it is unclear whether these are at the national level and are ongoing.

The government of Canada has a project – "Support to Polio Eradication in the Democratic Republic of Congo" – which aims to contribute to the eradication of polio in the Democratic Republic of Congo, by reinforcing the capacity of the epidemiological surveillance system in order to better detect polio cases and to respond quickly to these cases. The project works in seven out of the DRC's eleven provinces, where the surveillance capacity is the weakest in relation to the number of existing cases. The project started in 2019 and is expected to run until 2031, however, there is limited evidence as to the extent of government involvement by the DRC government.³³⁴

2.4 Surveillance data accessibility and transparency

2.4.1 Coverage and use of electronic health records

2.4.1a Common usage of electronic health records

Score: 50

Electronic health records are not commonly used in the Democratic Republic of Congo (DRC), but there is evidence they are used.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), data collected in the National Health Information System (SNIS), using the DHIS2, serves to monitor health service utilization, and the data is analyzed by the Epidemiological Intelligence Center based on geographic location, gender, catchment area, urbanization/rurality, and public/private sector, and that event-based surveillance has been implemented in eight of the country’s 26 provinces through an electronic surveillance system. The provinces where this system is operational are Kinshasa, Tshopo, Kwilu, Nord Kivu, Kongo Central, Kwango, Kasaï Central, and Haut Katanga (p. 39). ³³⁵

However, paper-based records are still dominant, and there are still infrastructure gaps, such as lack of internet access and limited skilled staff that limits the widespread use of electronic health records. ³³⁶

In addition, routine data on key indicators within the health zones are collected at healthcare facilities within each zone, and community health workers within a facility’s catchment area collect data on paper forms that are submitted to the facility, where they are collated with the facility’s other paper-based reports. At the end of a reporting period, facilities send their data on paper to the coordinating health zone office as part of a more elaborate report including data on program outcomes, stock management and disease surveillance. The reports are subsequently entered into the National Health Information System (SNIS), the DRC’s national DHIS2 platform for health information management, in the health zones. ³³⁷

2.4.1b Public health system access to individual electronic health records

Score: 0

In the Democratic Republic of Congo (DRC), the national public health system does not have access to electronic health records of individuals in the country.

In the DRC, routine data on key indicators within the health zones are collected at healthcare facilities within each zone, and community health workers within a facility’s catchment area collect data on paper forms that are submitted to the facility, where they are collated with the facility’s other paper-based reports. At the end of a reporting period, facilities send their data on paper to the coordinating health zone office as part of a more elaborate report including data on program outcomes, stock management and disease surveillance. The reports are subsequently entered into the National Health Information System (SNIS), the DRC’s national DHIS2 platform for health information management, in the health zones, with aggregated data. ³³⁸ There is no reference that the national public health system has access to individual-level electronic health records. ³³⁹ In addition, the DHIS2 is not publicly accessible, as it requires login and password. ³⁴⁰

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) does not mention if the national public health system has access to electronic health records of individuals in the country. ³⁴¹

2.4.1c Existence of data standards for health record data comparability

Score: 0

There are no data standards in the Democratic Republic of Congo (DRC) to ensure data is comparable.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the interoperability and interconnectivity of surveillance systems is flawed. ³⁴² However, interoperability is in course (p. 39). ³⁴³ The DHIS2 is not publicly accessible, as it requires login and password. ³⁴⁴

Nevertheless, data for tuberculosis and HIV is collected at local level on standardized paper-based reporting forms, validated at centers, then forwarded to the Health Zones for entry into DHIS2. ³⁴⁵ Data is then exported to Microsoft Excel where managers at the Health Zone level use it to support routine analysis and decision making. ³⁴⁶ However, there is no reference to data standards to ensure data is comparable. ³⁴⁷

2.4.2 Data integration between human, animal and environmental health sectors

2.4.2a Data sharing mechanisms

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has established mechanisms at the relevant ministries responsible for animal, human, and wildlife surveillance to share data.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC lacks a centralized mechanism to integrate clinical case reporting data with data from clinical or reference microbiological analysis laboratories, and there is weak capacity to organize advanced data analysis (p. 41). ³⁴⁸ Moreover, coordination between the bodies responsible for animal, human, and wildlife surveillance is informal and limited to a few diseases, and information sharing is not systematic (p. 22), and the report recommends the establishment of formal information-sharing mechanisms between the human, animal, and environmental health sectors. ³⁴⁹

On animal health, the surveillance of zoonotic diseases is conducted by the National Epidemiological Surveillance Service (SENES). ³⁵⁰ SENES uses a real-time electronic surveillance system, namely EMA-i, as well as DHIS2, QGIS, and Kobocollect, in which the information is made available in electronic and printed form in weekly and monthly epidemiological bulletins. ³⁵¹ However, there is no evidence of mechanisms that enable the Ministry of Public Health, Hygiene and Social Security, or the National Biomedical Research Institute (INRB) to share or access the data. ³⁵²

There is no evidence of such mechanism on the official websites of the Ministry of Public Health, Hygiene and Social Security, the INRB, or the Ministry of the Environment and Sustainable Development. ³⁵³ ³⁵⁴ ³⁵⁵

2.4.3 Transparency of surveillance data

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 100

The Democratic Republic of Congo (DRC) makes de-identified health surveillance data on infectious diseases publicly available via reports on government websites.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC publishes human and animal health data in epidemiological bulletins, but those are not regularly shared across sectors and internationally (p. 41). ³⁵⁶ The country also produces a monthly epidemiological bulletin on animal health, in addition to a quarterly "One World, One Health" bulletin on public health events (p. 60). ³⁵⁷

The National Program to Fight Against Malaria (PNLPRDC) publishes biannual epidemiological bulletins, which includes de-identified data on malaria, disaggregated by region. ³⁵⁸ ³⁵⁹ It includes the proportion of suspected cases tested, number of positive cases, and others. ³⁶⁰ The latest available report refers to the second semester of 2024. ³⁶¹

The Ministry of Public Health, Hygiene and Social Security, in partnership with the WHO, publish epidemiological bulletins about monkeypox, which includes the number of suspected cases, deaths, number of tests, number of confirmed cases, proportion of positive results, and others. ³⁶² The bulletin is published weekly. ³⁶³

2.4.4 Ethical considerations during surveillance

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

The Democratic Republic of Congo (DRC) has legislation that safeguards the confidentiality of identifiable health information for individuals, such as that generated through health surveillance activities.

The Democratic Republic of Congo ratified the African Union Convention on Cybersecurity and the Protection of Personal Data on 4 April 2023 through Ordinance-Law No. 23/008 of 10 March 2023. ³⁶⁵ ³⁶⁶ According to the Convention, personal health data is classified as sensitive data. ³⁶⁷ Pursuant to Article 195 of Ordinance-Law No. 23/008, the processing of personal health data is prohibited, except in cases where such processing is necessary for the protection of public health and safety, including measures to address serious cross-border health threats, among other authorised purposes. ³⁶⁸

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

Pursuant to Article 132 of Law No. 20/017 of 25 November 2020, on telecommunications and information and communication technologies, the collection, recording, processing, storage, and transmission of personal data require the authorisation of the data subject or the competent public authority. Furthermore, the law prohibits the collection and processing of personal data revealing racial, ethnic, or regional origin, lineage, political opinions, religious or philosophical beliefs, trade union membership, sexual life, genetic data, or, more broadly, data concerning the health status of the individual concerned. ³⁶⁹ In addition, Article 135 states mandates network operators and service providers to take the necessary administrative and technical measures to ensure the security of electronic communications, including the establishment of standardized systems enabling them to continuously identify, assess, address, and manage risks related to the security of information systems within the framework of the services offered directly or indirectly, informing users of specific risks of security breaches, including distributed denial of service attacks, abnormal rerouting, traffic spikes, unusual traffic and ports, passive and active eavesdropping, intrusions, and any other risks. ³⁷⁰

The Democratic Republic of Congo ratified the African Union Convention on Cybersecurity and the Protection of Personal Data on 4 April 2023 through Ordinance-Law No. 23/008 of 10 March 2023. ³⁷¹ ³⁷² According to the Convention, personal health data is classified as sensitive data. ³⁷³ Pursuant to Article 195 of Ordinance-Law No. 23/008, the processing of personal health data is prohibited, except in cases where such processing is necessary for the protection of public health and safety, including measures to address serious cross-border health threats, among other authorised purposes. ³⁷⁴

Pursuant to Article 10 of the African Union Convention on Cybersecurity and the Protection of Personal Data, the "processing of personal data involving genetic information and health research" must be-identified. ³⁷⁵ The document outlines some general practices and guidelines for personal data to be accessed, in order to safeguard their confidentiality, such as the requirement to provide the purpose of the use of data, the details on how the data will be processed, and others. Article 10 also covers data involving offenses and convictions, biometric data, and others. ³⁷⁶ Additionally, in accordance with Article 25, Section (1), "each State Party must adopt legislative and/or regulatory measures it deems effective to classify as substantive criminal offences any acts that affect the confidentiality, integrity, availability, and survival of information and communication technology systems, the data they process, and the underlying network infrastructures. It must also adopt effective measures for the investigation and prosecution of offenders. State Parties should take into consideration the choice of language used in international best practices". ³⁷⁷

Furthermore, as per Article 29, Section (2), State Parties must take legislative action to criminalize violations of data privacy, including: (i) fraudulently intercepting or attempting to intercept, through technical means, computer data during its non-public transmission to, from, or within a computer system; (ii) fraudulently obtaining, for oneself or for another, any benefit through the insertion, alteration, deletion, or suppression of computer data, or by any other means that interferes with the functioning of a computer system; (iii) participating in an association formed or an agreement established with the intent to prepare or commit one or more of the offences set forth in this Convention; and other related acts. ³⁷⁸

2.4.5 International data sharing

2.4.5a Cooperative commitments or agreements within regions

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has made public commitments to share surveillance data during a public health emergency with other countries.

There is no evidence of such commitments on the National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024). ³⁷⁹ There is no evidence of such committments on the official websites of the Ministry of Public Health, Hygiene and Social Security, the INRB, or the Ministry of the Environment and Sustainable Development either. ³⁸⁰ ³⁸¹ ³⁸²

In February 2023, health authorities in the DRC conducted a regional training course on strengthening laboratory diagnostic capacities for emerging and re-emerging diseases in Africa, with the support from the World Health Organization (WHO), the Japan International Cooperation Agency (JICA), the Africa Center for Disease Control and Prevention (CDC), and the United States of America CDC. ³⁸³ The training session included representatives from the DRC, Cameroon, the Central African Republic (CAR), Gabon, Burundi, the Republic of Congo, Chad, the Republic of Guinea, Burkina Faso and Niger; at the occasion, the director of the National Biomedical Research Institute (INRB) stated that this would "help create a network of laboratory service providers who share information in real time". ³⁸⁴ However, it was not disease-specific, but overall cooperation. ³⁸⁵

The country's adherence to the International Health Regulations (IHR 2005) serves as a primary legal and operational commitment. As a signatory, DRCA is obligated to notify the World Health Organization (WHO) of public health events that may constitute a public health emergency of international concern. This legally binding framework necessitates the sharing of surveillance data with the WHO but does not specify provisions to share with other countries. ³⁸⁶

2.5 Case-based investigation

2.5.1 Case investigation and contact tracing

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

The Democratic Republic of Congo (DRC) has a national system in place to provide support at the sub-national level (e.g. training, metrics standardization and/or financial resources) to conduct contact tracing in the event of a public health emergency.

The DRC’s Preparedness and Response Plan to Covid-19, which was launched in March 2020 and finalized on 1 April 2020, set up a national Task Force led by the Prime Minister with the Minister of Health responsible for, among other tasks, mobilizing resources and managing funds both at national and regional levels. According to the national plan, this includes increasing training and contact tracing in “hot spots” throughout the country. ³⁸⁷ ³⁸⁸. Previously, the DRC has been praised for increasing contact tracing at regional levels which it had put in place during the ongoing Ebola outbreak 2018-2020. ³⁸⁹ ³⁹⁰

In addition, according to World Health Organization (WHO) and United Nations’ reports, although there is such a system in place, it has been hampered by a lack of funding, local strikes and regional conflicts. ³⁹¹ ³⁹² In October 2025, the WHO reported having provided training for over 250 frontline workers, including community health workers and local surveillance teams to enhance skills in detection, tracing, and isolation. ³⁹³

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 0

There is no evicence that the Democratic Republic of Congo (DRC) provides wraparound services to enable infected people and their contacts to self-isolate or quarantine as recommended, particularly economic support and medical attention.

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) states that the DRC does not have a solid legal framework regulating quarantine of individuals who present a risk for public health (p. 53). ³⁹⁴

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) has measures to provide food for over 80% of affected low-income families affected by public health emergencies, but there is no specific mention of those who are required to self-isolate or quarantine. ³⁹⁵ There is no mention of economic support or medical attention. ³⁹⁶

There is no evidence of such services on the official websites of the Ministry of Public Health, Hygiene and Social Security, the INRB, the National Social Security Fund, or the National Border Hygiene Program. ³⁹⁷ ³⁹⁸ ³⁹⁹ ⁴⁰⁰

2.5.2 Point of entry management

2.5.2a Strategy for tracing and quarantining international travelers

Score: 100

There is evidence of a joint cooperative agreement between the public health system and border control authorities in the Democratic Republic of Congo (DRC) to identify suspected cases in international travelers and trace and quarantine their contacts in the event of public health emergencies.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC does not have a memorandum of understanding (MOU) for collaboration and coordination between public health and security authorities (p. 52). ⁴⁰¹ There is an operational framework at border level, as well as some general guidelines for coordinating joint actions in the event of an emergency, particularly regarding public health at official sites, such as points of entry, with involvement of security authorities in the management of health emergencies, including through the exchange of information (p. 53). ⁴⁰²

However, there is both a lack of formalization and standardized operation procedures of this collaboration, with insufficient joint training between public health and security authorities (p. 53). ⁴⁰³ In addition, restrictive measures, such as quarantine of individuals who pose a public health risk, are still not regulated (p. 52). ⁴⁰⁴

The National Border Hygiene Program (PNHF), created through Ministerial Order No. 1250/CAB/MIN/S/BYY/MC/007/2006 of 28 March 2006, collaborates with border authorities to ensure health security, in which the PNHF ensures epidemiological surveillance of zoonoses and emerging diseases, carry out vector control in cross-border zones, including disinfection, disinfestation, rodent control, and decontamination. ⁴⁰⁵ ⁴⁰⁶ The PNHF is to ensure alert and control activities at the DRC's borders, including notification, isolation and care of any suspected cases of diseases with epidemic potential; there is no explicit reference that these contacts should be quarantined. ⁴⁰⁷

2.6 Epidemiology workforce

2.6.1 Existence of applied epidemiology training program such FETP and FETPV

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

The Democratic Republic of Congo (DRC) has an applied epidemiology training program.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC offers epidemiology training in public health schools, in which the FETP (Frontline, Intermediate FETP, Advanced FLTP, and AVoCH SURGE) program is available for professionals in human, animal, and environmental health (p. 43). ⁴⁰⁸ According to the Training Programs in Epidemiology and Public Health Interventions Network (TEPHINET), the FETP program in the University of Kinshaha has been implemented in the DRC since 2010. ⁴⁰⁹

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

The Democratic Republic of Congo (DRC) has field epidemiology training programs that include animal health professionals.

Moreover, the DRC also benefits from the Training Program for Veterinary Professionals in Field Epidemiology (ISAVET). ⁴¹¹

2.6.2 Epidemiology workforce capacity

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has at least 1 trained epidemiologist per 200,000 people.

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) recommended the DRC to increase the critical mass of field epidemiologists (p. 44). ⁴¹² There is no reference to the number of trained field epidemiologist in the country on the official websites of the Ministry of Public Health, Hygiene and Social Security, or the Ministry of Higher and University Education. ⁴¹³ ⁴¹⁴

Rapid Response

3.1 Emergency preparedness and response planning

3.1.1 National public health emergency preparedness and response plan

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 100

The Democratic Republic of Congo (DRC) has an overarching national public health emergency response plan in place which addresses planning for multiple communicable diseases with epidemic or pandemic potential. The plan is also funded.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ⁴¹⁵ The PNM presents a response phase, in which the Public Health Emergency Operations Center (COUSP) coordinates all response actions to incidents or events, scaling staff and resources, in which during emergencies it is guided by an Incident Management System (SGI), and activation levels are used to escalate resources up to international support when national capacity is exceeded; the actions includedevleopment of an incident action plan, strengthening epidemiological surveillance through investigation and contact tracing activities in affected areas, rapid implementation of case management, implementation of risk communication, strengthening infection prevention and control, strengthening mental health and psychosocial support, implementing a vaccination campaign for at-risk populations, if necessary, strengthening collaboration between COUSPs, reinforcing civil protection, and making specific kits available (pp. 63-64). ⁴¹⁶ The plan also details disease-specific response plans for Ebola, cholera, COVID-19, rabies, measles, and mpox. ⁴¹⁷

The PNM also provides for specific initiatives to reinforce laboratory and operational readiness, such as the organization of laboratory training sessions for staff involved in public health emergencies in health zones across 17 identified hotspot provinces, and the quarterly provision of sampling and transport kits to national and subnational laboratories, including both veterinary and human health facilities. ⁴¹⁸ Additionally, PNM requires the organization of simulation exercises at both the national level and within provincial health directorates (DPS) to ensure preparedness for large-scale public health events. ⁴¹⁹

The PNM has a budget of USD 236 million for its entire duration, which is disaggregated by specific initiative. ⁴²⁰ The financial resources come from the Government and technical and financial partners through the Directorate General of the National Institute of Public Health (INSP), in which the Government of the DRC mobilizes and manages all resources allocated to public health emergencies (p. 144). ⁴²¹

3.1.1b National public health emergency response plan published in past 3 years

Score: 100

The overarching national public health emergency response plan of the Democratic Republic of Congo (DRC) has been updated in the last 3 years.

3.1.1c One health principles by covering multiple threat types

Score: 100

The overarching national public health emergency response plan in the Democratic Republic of Congo (DRC) follows one health principles by covering multiple threat types, such as antimicrobial resistance, zoonotic diseases spillover, biological accidents or deliberate acts.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ⁴²⁴ It includes a list of priority threats by province using a Threat Hazard Identification Risk Assessment (THIRA), which includes radiological accidents, specific diseases, and others (p. 148). ⁴²⁵ The PNM integrates surveillance and interventions at related to human, animal, and environmental. ⁴²⁶ In addition, besides priority diseases, it also identifies several threats, such as bioterrorism, radiocative irradiation and contamination, and others. ⁴²⁷

Nevertheless, the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) also recommends that the DRC undertakes a multisectoral legal action aimed at optimizing the Public Health Emergency Operations Center (COUSP), in line with the "One World, One Health" approach, which should capitalize on existing achievements and available infrastructure within the Epidemiological Surveillance Directorate (p. 48). ⁴²⁸

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 100

The overarching national public health emergency response plan in the Democratic Republic of Congo (DRC) includes mechanisms for identifying and considering the needs of vulnerable population, particularly people with lower socioeconomic status, women, children, people with reduced mobility, and the elderly.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) includes considerations of the impact of health equity. ⁴²⁹ It includes a list of priority threats by province using a Threat Hazard Identification Risk Assessment (THIRA), which includes the socioeconomic impact of each type of threat. ⁴³⁰ In addition, there are measures to provide food for low-income families affected by public health emergencies, as well as identify vulnerable populations (people with reduced mobility, pregnant women, children under 5, the elderly, etc.) within 2 weeks of the incident, and others. ⁴³¹

3.1.2 Private sector involvement in response planning

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 100

The Democratic Republic of Congo (DRC) has a specific mechanism for engaging with the private sector to assist with outbreak emergency preparedness and response.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) states that a financial contingency for preparedness and response include funds from the Government and bilateral and multilateral cooperation organizations, civil society, and the private sector, in which efforts to coordinate and harmonize partner interventions are carried out through the Inter-Donor Health Group (GIBS), which continues to gradually integrate the Sectoral Coordination Committee (p. 144). ⁴³² The private sector is responsible for financing and making available human, material, and financial resources when needed for public health emergency preparedness and response, and civil society is responsible for supporting community participation in public health emergency preparedness and response (p. 70). ⁴³³

In addition, GIBS convenes once a month, and there are established communication channels with other stakeholders such as Inter-Donor Groups, international NGOs, partners in the for-profit and non-profit private sectors, and the various humanitarian clusters (p. 7). ⁴³⁴

During the COVID-19 outbreak, the DRC had a multisectoral response committee that was headed by the prime minister and with a secretariat at the Ministry of Health. ⁴³⁵ In the DRC, private entities supported the surveillance activities of the COVID-19 response; a Belgian company (Bluesquare) that provides services for digitizing health systems partnered with the Ministry of Health to implement an e-surveillance system using the existing national surveillance system. ⁴³⁶

3.1.3 Non-pharmaceutical interventions planning

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 50

The Democratic Republic of Congo (DRC) has a policy, plan, or guidelines in place to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic.

On 18 March 2020, the DRC announced a series of NPIs which included the prohibition of gatherings of more than 20 people in public places, the suspension of international flights and of worship and sports activities, the closure of schools and universities, restaurants and bars as well as restrictions on the movement of people. The government said these measures were necessary to prevent the spread of COVID-19 after its first case was detected on 10 March 2020. ⁴³⁷

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ⁴³⁸ Even though there are disease-specific measures, such as safe burials, there is no specific mention of implementing NPIs during an epidemic or pandemic. ⁴³⁹ There is no mention of self-isolation or quarantine. ⁴⁴⁰

In addition, as per the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC does not have a solid legal framework regulating quarantine of individuals who present a risk for public health (p. 53). ⁴⁴¹

3.2 Exercising response plans

3.2.1 Activating response plans

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

The Democratic Republic of Congo (DRC) has activated their national emergency response plan for an infectious disease outbreak in the past year. It completed a biological threat-focused exercise in the past year, but it was not nationwide.

In December 2024, the International Organizations for Migration (IOM) and the WHO supported public health emergency case management simulation exercises organized by the National Border Hygiene Program (PNHF) and the Animal and Fisheries Quarantine Program (SQAH) at the Port Martine of Matadi and the Lufu Border Post (Kongo-Central Province) with the aim of strengthening coordination and communication capacities in the implementation of public health emergency responses at the borders, highlighting the roles of national health institutions and other services operating at the borders. ⁴⁴⁴ These exercises were conducted by a team of national facilitators with financial and technical support from IOM and the WHO. ⁴⁴⁵ However, the exercise was not conducted at the national-level. ⁴⁴⁶

In January 2025, a similar exercise was conducted in collaboration between the IOM and PHNF and SQAH at 18 entry points, simulating a Mpox alert. ⁴⁴⁷ The exercise included 317 participants, including providers from the Congolese Control Office (OCC), the General Directorate of Customs and Excise (DGDA), the National Intelligence Agency (ANR), the General Directorate of Migration (DGM), SQAH, PNHF, and the Central Office of Health Zone (BCZS), as well as other users on case definitions, observation procedures, and information for identifying travelers showing symptoms of Mpox, in order to proceed with isolation measures. ⁴⁴⁸

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is no publicly available evidence that the Democratic Republic of Congo (DRC) has identified a list of gaps and best practices in response and developed a plan to improve response capabilities in the last year.

In March 2024, the Public Health Emergency Operations Center (COUSP) enacted the second version of the Integrated National Preparedness and Response Plan for the Epidemic of Mpox Virus Disease in the Democratic Republic of Congo. ⁴⁴⁹ In August 2024, the Ministry of Public Health, Hygiene and Social Security met with African Union's public health agency, the Africa CDC, to adapt its plan to combat mpox. ⁴⁵⁰ According to the United Nations Children's Fund (Unicef) and the Nutrition Cluster, the DRC published a third version of the plan in August 2024, but the is no evidence the plan is publicly available. ⁴⁵¹ ⁴⁵² ⁴⁵³ ⁴⁵⁴

3.2.2 Private sector engagement in exercises

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has undergone a national-level biological threat-focused exercise that has included private sector representatives.

In December 2024, the International Organizations for Migration (IOM) and the WHO supported public health emergency case management simulation exercises organized by the National Border Hygiene Program (PNHF) and the Animal and Fisheries Quarantine Program (SQAH) at the Port Martine of Matadi and the Lufu Border Post (Kongo-Central Province) with the aim of strengthening coordination and communication capacities in the implementation of public health emergency responses at the borders, highlighting the roles of national health institutions and other services operating at the borders. ⁴⁵⁵ These exercises were conducted by a team of national facilitators with financial and technical support from IOM and the WHO. ⁴⁵⁶ However, the exercise was not conducted at the national-level. ⁴⁵⁷

There is no evidence of such exercises on the official websites of the Ministry of Public Health, Hygiene and Social Security, the PNHF, the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ⁴⁵⁸ ⁴⁵⁹ ⁴⁶⁰ ⁴⁶¹ There is no evidence on the Biological Weapons Convention National Implementation Measures Database either. ⁴⁶²

3.3 Emergency response operation

3.3.1 Emergency response operation

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

The Democratic Republic of Congo (DRC) has in place an Emergency Operations Center (EOC).

In August 2023, the DRC created the Public Health Emergency Operations Center (COUSP), within the National Institute of Public Health (INSP) of the Ministry of Public Health, Hygiene and Social Security (p. 8). ⁴⁶³ The COUSP is an EOC specialized in command, control, and coordination requirements to respond to emergencies that pose threats and have adverse consequences for public health, which also serves as a platform for the coordination of responses, interventions, and information related to public health emergency management (p. 8). ⁴⁶⁴

In April 2024, the INSP published the Plan of COUSP with the support of the World Health Organization (WHO), which seeks to provide detailed guidance on the organization and operation of the COUSP for the effective management of public health emergencies and other disasters. ⁴⁶⁵

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 100

The Emergency Operations Center (EOC) of the Democratic Republic of Congo (DRC) is required to conduct a drill for a public health emergency scenario at least once per year.

According to the concept document of the Public Health Emergency Operations Center (COUSP) (2024), the staff of COUSP is required to participate in simulation exercises at least once per year, such as tabletop simulation exercises, drills, functional simulation, or full-scale simulation (pp. 18; 64). ⁴⁶⁶

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) highlights that a strong feature of the DRC is the organization within COUSP of simulation exercises, including for testing preparation and response plans (pp. 48-49). ⁴⁶⁷

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is no evidence to show that the Emergency Operations Center (EOC) has conducted within the last year a coordinated emergency response or emergency response exercise activated within 120 minutes of the identification of the public health emergency/scenario.

There is no evidence of such on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Border Hygiene Program (PNHF), the National Institute of Public Health (INSP), or the Ministry of National Defense and Veterans Affairs. ⁴⁶⁸ ⁴⁶⁹ ⁴⁷⁰ ⁴⁷¹

In September 2025, the Ministry of Public Health, Hygiene and Social Security activated the Public Health Emergency Operations Center (COUSP) after the detection of the reappearence of Ebola in Boulapé, in the Kasai province. ⁴⁷² COUSP rapidly mobilized response teams, strenghtened epidemiological surveillance, and organized triage and isolation facilities, as well as set up secure burial procedures to protect the community. ⁴⁷³ Nevertheless, there is no evidence it was activated within 120 minutes of the identification. ⁴⁷⁴

3.4 Linking public health and security authorities

3.4.1 Public health and security authorities linked for a biological event

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has carried out multisectoral exercises or enacted standard operating procedures, guidelines, memoranda of understanding (MOUs) or other agreements to respond to a potential deliberate biological attack.

There is no evidence of such exercises or procedures on the official websites of the Ministry of Public Health, Hygiene and Social Security, the PNHF, the National Institute of Public Health (INSP), or the Ministry of National Defense and Veterans Affairs. ⁴⁷⁵ ⁴⁷⁶ ⁴⁷⁷ ⁴⁷⁸ The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) does not mention deliberate biological attacks. ⁴⁷⁹

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) qualifies bioterrorism attacks as public health emergencies, and identifies terrorism as a threat to the DRC. ⁴⁸⁰ Nevertheless, there is no evidence of specific standard operating procedures, guidelines, MOUs or other agreements to respond to a potential deliberate biological attack. ⁴⁸¹

3.5 Risk communication

3.5.1 Risk communication planning

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) has in place strategy documents that contain sections detailing a risk communication plan that is specifically intended for use during a public health emergency.

The National Health Promotion Communication Program (PNCPS) (2023) is focused on developing and implementing communication strategies to promote the health and well-being of populations, including by designing public health communication campaigns, raising awareness of health-promoting behaviors, ensure the dissemination of prevention messages through various channels, and strengthening the capacities of health communication stakeholders. ⁴⁸² ⁴⁸³ The PNCPS defines roles and strategies per phase of emergency, including prevention, response, and resilience, including strengthening the capacity of stakeholders in CREC during public health emergencies at all levels, as well as reinforcing networking with the media, and others. ⁴⁸⁴

In 2021, the Ministry of Public Health, Hygiene and Social Security, in collaboration with the National Border Hygiene Program (PNHF), organized training workshops on risk communication and community engagement for all phases of public health emergency management. ⁴⁸⁵

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the PNCPS is the anchor structure for risk coordination and community engagement (CREC) for public health events and emergencies, in which the multisectoral communication working group operates through a mechanism for exchange and collaboration among emergency communication stakeholders, although efforts are still needed to strengthen coordination (p. 60). ⁴⁸⁶ The working group has demonstrated its dynamism and produced numerous normative documents and strategic communication plans for specific diseases (COVID-19, MPOX), as well as a national multisectoral communication strategy on priority zoonoses (p. 60). ⁴⁸⁷ It further adds that there are partnerships with media networks and training of journalists in CREC, but at the sub-national level there is a lack of funding, infrastructure, and equipment (p. 61). ⁴⁸⁸

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 100

The Democratic Republic of Congo (DRC) risk communication plan outline how messages will reach populations and sectors with different communication needs.

The PNCPS segments audience into primary, secondary, and tertiary groups based on factors like age, profession, geographic location, vulnerability, and influence (p. 11). ⁴⁹¹ It underscores that communication materials are designed to be translated and localised for accessibility in all provinces, with engagement of religious groups and community leaders to reach populations that are hard to reach (pp. 52; 20). ⁴⁹²

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) risk communication plan designates a specific position within the government to serve as the primary spokesperson to the public during a public health emergency. It is the Ministry of Public Health, Hygiene, and Social Security.

The National Health Promotion Communication Program (PNCPS) (2023) states that the implementation of risk communication and community engagement activities in public health emergencies will be carried out under the responsibility of the Ministry of Public Health, Hygiene, and Social Security (MSPHP) (p. 46). ⁴⁹³

3.5.2 Public health systems communication

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is evidence that the public health system in the Democratic Republic of Congo (DRC) has shared messages via online media platforms to inform the public about ongoing public health concerns and dispel rumors, misinformation or disinformation.

On 5 September 2025, the Ministry of Public Health, Hygiene and Social Security published an official statement on its official website about the reapperance of Ebola virus disease in the the Boulapé, in the DRC and sharing the number of suspected cases, deaths, and initiatives undertaken to respond to the outbreak. ⁴⁹⁴ In the public announcement, the minister explicitly stated that it was going to launch a massive community awareness campaign with radio broadcasts in national languages, mobilization of religious and traditional leaders, involvement of local associations and local interventions with households to dispel rumors about the disease. ⁴⁹⁵ The message was also shared on the Ministry of Public Health, Hygiene and Social Security's X (formerly Twitter) account. ⁴⁹⁶

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is no evidence that senior leaders in the Democratic Republic of Congo (DRC) have shared misinformation or disinformation on infectious diseases in the past two years.

There is no evidence of such statements or remarks on the websites of the Congolese Press Agency (ACP), Radio Okapi, Actualite, RFI, or Le Potentiel. ⁴⁹⁷ ⁴⁹⁸ ⁴⁹⁹ ⁵⁰⁰ ⁵⁰¹

There is no evidence of such exercises on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Health Border Program (PHNF), the National Institute of Biomedical Research (INRB), or the Ministry of National Defense and Veterans Affairs. ⁵⁰² ⁵⁰³ ⁵⁰⁴ ⁵⁰⁵

3.6 Access to communications infrastructure

3.6.1 Internet users

3.6.1a Percentage of households with Internet

Score: 0.14

3.6.2 Mobile subscribers

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 28.77

3.6.3 Female access to a mobile phone

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 36.67

3.6.4 Female access to the Internet

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 54.17

3.7 Trade and travel restrictions

3.7.1 Trade restrictions

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 100

There is no evidence that the Democratic Republic of Congo (DRC) has implemented restrictions on the import of medical goods (e.g. medicines, oxygen, medical supplies, PPE).

In May 2025, the Ministry of Foreign Trade signed an order prohibiting the temporary importation of various hygienic products, including single-use baby diapers, ladies' sanitary pads, pocket tissues, boxed tissues, napkins, toilet paper towels, multi-use baby wipes in the western part of the DRC. ⁵⁰⁶ To this end, applicants must expressly specify in advance in their letters of request the place of destination and the batch number of the goods concerned, while indicating that the said request must be accompanied by the documentary bundle validated by the single window for foreign trade, failing which it would be rejected. ⁵⁰⁷

There is no evidence of further restrictions on the import of export of medical goods due to an infectious disease outbreak on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Health Border Program (PHNF), the National Institute of Biomedical Research (INRB), the Ministry of the National Economy, or the Ministry of Foreign Trade. ⁵⁰⁸ ⁵⁰⁹ ⁵¹⁰ ⁵¹¹ ⁵¹²

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 100

There is no evidence that the Democratic Republic of Congo (DRC) has implemented restrictions on export/import of non-medical goods (e.g. food, textiles, etc) due to an infectious disease outbreak. However, they were based on international recommendations or structured decisions based on scientific parameters.

According to the General Directorate of Customs and Excise, the DRC prohibits the importation of frozen tilapia and fry from Colombia, Ecuador, Egypt, Israel and Thailand, following the health alert regarding the deadly Tilapia Lake Virus (TiLV) affecting wild and farmed Tilapia in these countries, and poultry meat and its derivatives from Uganda following the health alert concerning the outbreak of avian influenza among wild and domestic poultry in the Lake Victoria region of Wakiso. ⁵¹³

There is no evidence of further restrictions on the import of export of non-medical goods due to an infectious disease outbreak on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Health Border Program (PHNF), the National Institute of Biomedical Research (INRB), the Ministry of the National Economy, or the Ministry of Foreign Trade. ⁵¹⁴ ⁵¹⁵ ⁵¹⁶ ⁵¹⁷ ⁵¹⁸

3.7.2 Travel restrictions

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 100

There is no evidence that the Democratic Republic of Congo (DRC) has implemented inbound or outbound travel restrictions due to an infectious disease outbreak.

There is no evidence of restrictions related to inbound or outbound travel restrictions on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Health Border Program (PHNF), the National Institute of Biomedical Research (INRB), the Ministry of the National Economy, or the Ministry of Foreign Trade, or the Ministry of Tourism. ⁵¹⁹ ⁵²⁰ ⁵²¹ ⁵²² ⁵²³ ⁵²⁴

Nevertheless, the country has implemented in-country movement restrictions in the Kasai Province as Ebola cases rose in September 2025. ⁵²⁵

3.7.2b Risk-based approach to international travel-related measures

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) use a risk-based approach to international travel-related measures.

There is no evidence of the use of risk-based approach to international travel-related measures on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Health Border Program (PHNF), the National Institute of Biomedical Research (INRB), the Ministry of the National Economy, or the Ministry of Foreign Trade, or the Ministry of Tourism. ⁵²⁶ ⁵²⁷ ⁵²⁸ ⁵²⁹ ⁵³⁰ ⁵³¹

In 2018, the International Organisation for Migration (IOM) worked with the PHNF and the World Health Organization (WHO) to deploy epidemiologists at points of entry, as well as other strategic sites with high population mobility, to prevent Ebola. ⁵³²

Health System

4.1 Health capacity in clinics, hospitals and community care centers

4.1.1 Available human resources for the broader healthcare system

4.1.1a Doctors per 100,000 people

Score: 2.59

4.1.1b Nurses and midwives per 100,000 people

Score: 15.08

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a health workforce strategy in place which has been updated in the past five years to identify fields where there is an insufficient workforce and strategies to address these shortcomings.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC developed a National Human Resources Development Plan for Health in 2019 and a National Strategic Plan for Strengthening Human Resources Capacity for the Ministry of Fisheries and Livestock in August 2021. However, it is noted that no multisectoral human resources strategy has been developed, encompassing all sectors, to adequately respond to epidemics and public health events (p. 42). ⁵³³ It further adds that although multidisciplinary and multisectoral human resources exist, including epidemiologists, public health specialists, medical biologists, veterinarians, etc., they remain insufficient in certain fields and sectors, and their distribution across the country, particularly in the provinces, is uneven (p. 43). ⁵³⁴

However, there is no evidence that the National Human Resources Development Plan for Health (2019) is publicly available or that it has been updated in the past five years on the official website of the Ministry of Health, Hygiene and Social Security, or the RDC Legal Database. ⁵³⁵ ⁵³⁶

Additionally, the National Strategic Development Plan 2024-2028 (PNSD) (2024), enacted by the Ministry of Planning, and Development Aid Coordination, includes measures related to workforce in the health sector. ⁵³⁷ The strategy undertakes a three-tiered approach by gradually adding a care package to each tier, which includes: (i) Reproductive, Maternal, Newborn, and Child Health and Nutrition (RMNCAH-Nut), infectious diseases (HIV, tuberculosis, malaria); (ii) prevention of non-communicable diseases; and (iii) trauma and injuries (pp. 70-71). ⁵³⁸ It includes an objective to support the development of health zones by strengthening the pillars of the health system by increasing the availability, motivation, and capacity building of health professionals and administrative staff in public health centers and hospitals (p. 71). ⁵³⁹ However, there are no further details on how to specifically address these shortcomings. ⁵⁴⁰

In February 2024, the DRC was in the process of finalizing its National Health Development Plan (PNDS) for 2024-2030. ⁵⁴¹ However, there is no evidence the plan has been enacted. ⁵⁴² ⁵⁴³ ⁵⁴⁴

4.1.1d Health system capacity for essential health services

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has sufficient capacity within its health system to deliver essential health services.

According to the The National Strategic Development Plan 2024-2028 (PNSD) (2024), enacted by the Ministry of Planning, and Development Aid Coordination, the health sector is characterized by poor geographic coverage, insufficient integration of health facilities that meet standards, and unsatisfactory quality of services and care provided due to operational inadequacies in health facilities, in a context in which public investment in the health sector has not kept pace with population growth, resulting that patient intake capacities are largely exceeded (p. 31). ⁵⁴⁵ Medical facilities show low resilience in the face of epidemics, emergencies, and disasters, particularly due to the poor implementation of preventive measures. ⁵⁴⁶ Moreover, there is inadequate health coverage (employer medical coverage, health insurance system), which poses a major obstacle to accessing health care, the costs of which are prohibitive for the majority of the population (p. 31). ⁵⁴⁷

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has essential health services available, such as vaccination, childbirth and urgent surgeries, but there is still a need to optimize the use of primary health services, particularly in emergency situations (p. 55). The JEE allocates a score of 1 in this measure. ⁵⁴⁸

4.1.1e Essential health services continuity plan for public health emergencies

Score: 100

The Democratic Republic of Congo (DRC) has a plan to ensure continuity of essential health services during a public health emergency.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ⁵⁴⁹ It includes a goal to ensure the continuity of primary healthcare services, which includes actions related to developing the tool for identifying needs, organizing workshops to analyze information collected during public health emergencies, mapping human resources and healthcare faciltiies, developing an input supply plan, establishing a referral system, and collaborating with other involved sectors (p. 116). ⁵⁵⁰

However, according to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has established specific contingency plans for certain diseases, including Ebola, COPD, measles, rabies, yellow fever, cholera, polio, and others, but those plans do not take into account continuity of care during emergencies (p. 54). ⁵⁵¹ Although national guidelines governing therapeutic and diagnostic measures at all levels of the health pyramid are in place, there is no mapping of the resources needed to manage cases related to priority emergencies. ⁵⁵² Nevertheless, hoc measures are taken during crises to ensure the continuation of essential services such as vaccination, maternity, emergency surgery, and pediatrics by adapting existing services to the crisis situation. ⁵⁵³

4.1.2 Facilities capacity

4.1.2a Hospital beds per 100,000 people

Score: 17.15

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 100

The Democratic Republic of Congo (DRC) has capacity to isolate patients with highly communicable diseases in a patient isolation room or unit located within the country.

In September 2025, the Ministry of Public Health, Hygiene and Social Security activated the Public Health Emergency Operations Center (COUSP) after the detection of the reappearence of Ebola in Boulapé, in the Kasai province. [1] COUSP rapidly mobilized response teams, strenghtened epidemiological surveillance, and organized triage and isolation facilities, as well as set up secure burial procedures to protect the community. [1]

In October 2024, the NGO ALIMA supported the opening of a Mpox treatment center in Goma, North Kivu, that allows for a rapid response and includes patient isolation (one patient per bed), including free meals and psychological support throughout their care. [2] In addition to the hospital, ALIMA has set up three temporary isolation centers, each able to accommodate up to 5 patients, with the capacity to expand to 10 beds, in the internally displaced person camps around Goma. [2]

In addition, in July 2020, the International Organization for Migration (IOM) supported the Ministry of Public Health, Hygiene and Social Security in constructing an isolation center for non-severe cases of COVID-19 in Kinshasha, with capacity to accomodate 300 patients. [3]

However, according to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), a priority measure recommended to the DRC is to update and disseminate to all healthcare facilities the standards relating to the implementation of hygiene services, including isolation areas and sterilization, in healthcare facilities (p. 59). [4}

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 100

The Democratic Republic of Congo (DRC) has demonstrated capacity to expand isolation capacity in response to an infectious disease outbreak in the past two years.

In July 2024, the Ministry of Public Health, Hygiene and Social Security and the International Organization for Migration (IOM) launched the construction work on health control infrastructure to improve disease surveillance at DRC points of entry, specifically at the N'Djili International Airport. ⁵⁵⁴ The building will include isolation rooms. ⁵⁵⁵

In October 2024, the NGO ALIMA supported the opening of a Mpox treatment center in Goma, North Kivu, that allows for a rapid response and includes patient isolation (one patient per bed), including free meals and psychological support throughout their care. ⁵⁵⁶ In addition to the hospital, ALIMA has set up three temporary isolation centers, each able to accommodate up to 5 patients, with the capacity to expand to 10 beds, in the internally displaced person camps around Goma. ⁵⁵⁷

4.2 Supply chain for health system and healthcare workers

4.2.1 Routine health care and laboratory system supply

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 100

The Democratic Republic of Congo (DRC) has a national procurement protocol in place which can be utilized by the Ministries of Health and Agriculture for the acquisition of laboratory supplies and medical supplies for routine needs.

The DRC has a National Essential Medicines Supply System (SNAME), coordinated by the National Essential Medicines Supply Program (PNAM), which is based on centralized purchasing through two procurement agencies, the Purchasing Coordination Office (BCAF) in Kinshasa and Regional Association for the Supply of Essential Medicines (ASRAMES) in Goma, and on the decentralization of the distribution of medicines and other health products to the provincial level through a network of 15 Regional Distribution Centers (CDRs) (p. 6). ⁵⁵⁸ Equipments (p. 43), reagents (p. 44), and other health supplies can be purchased through SNAME. ⁵⁵⁹

The BCAF and ASRAMES have a procurement procedures manual defining, in particular, the purchasing procedures and the types of contracts to be used (p. 34). ⁵⁶⁰ To ensure the quality of the medicines and other health products they purchase, BCAF and ASRAMES conduct supplier prequalification, allowing the selection of a list of approved products/suppliers. ⁵⁶¹ Both agencies have harmonized their purchasing procedures with those of the European Union – for the 19 procurement agencies used by the other partners, they all have a specific purchasing policy and procedure. ⁵⁶² However, these purchasing policies/procedures because they were not available at the partners' representations in the DRC. ⁵⁶³

4.2.2 Stockpiling for emergencies

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 33.33

There is no evidence that the Democratic Republic of Congo (DRC) has a stockpile of medical supplies for national use during a public health emergency defined by the overarching national public health emergency response plan.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) assigns to the National Medicine Supply Program (PNAM) the role of supporting the emergency supply chain and to set up storage spaces for inputs in regional depots (p. 67). ⁵⁶⁴ However, there is no mention of a stockpile of medical supplies or what it would contain. ⁵⁶⁵

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) recommended the country to establish a predefined emergency supply stockpile, which can be mobilized at any time and prepositioned according to country-level risk profiles, and develop and implement an emergency logistics plan (p. 51). ⁵⁶⁷ The document also identified the lack of a logistics depot at the central and provincial levels to respond rapidly to public health emergencies, while the lack of mechanisms that underlie the supply chain in emergency situations, leading to disruptions and shortfalls (p. 51). ⁵⁶⁸

It also adds that vaccine procurement and needs assessment are inadequate and lead to occasional stockouts at the central and district levels; they also do not lead to stockouts at the central level, but are responsible for occasional stockouts in the districts (p. 32). ⁵⁶⁹

In September 2024, the WHO delivered 14 metric tons of medical supplies and equipment to the DRC to support infection prevention and control and casa management for response efforts related to the Mpox outbreak, which includes personal protective equipment, tents, treatments and other medical supplies. ⁵⁷⁰

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a stockpile of laboratory supplies for national use during a public health emergency defined by the overarching national public health emergency response plan.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) assigns to the National Medicine Supply Program (PNAM) the role of supporting the emergency supply chain and to set up storage spaces for inputs in regional depots (p. 67). ⁵⁷¹ However, there is no mention of a stockpile of laboratory supplies or what it would contain. ⁵⁷²

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) recommended the country to establish a predefined emergency supply stockpile, which can be mobilized at any time and prepositioned according to country-level risk profiles, and develop and implement an emergency logistics plan (p. 51). ⁵⁷⁴ The document also identified the lack of a logistics depot at the central and provincial levels to respond rapidly to public health emergencies, while the lack of mechanisms that underlie the supply chain in emergency situations, leading to disruptions and shortfalls (p. 51). ⁵⁷⁵

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) assigns to the National Medicine Supply Program (PNAM) the role of supporting the emergency supply chain and to set up storage spaces for inputs in regional depots (p. 67). ⁵⁷⁶ However, there is no mention of mandated annual reviews. ⁵⁷⁷

According to the National Essential Medicines Supply System (SNAME) Strategic Plan 2017-2020 (2017), storage capacity is very low in SNAME, and there was no comprehensive inventory of storage capacities and conditions at the peripheral level (p. 20). ⁵⁷⁸ There is no evidence that its either conducts or required to conduct assessments of the national stockpile. ⁵⁷⁹

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) recommended the country to establish a predefined emergency supply stockpile, which can be mobilized at any time and prepositioned according to country-level risk profiles, and develop and implement an emergency logistics plan (p. 51). ⁵⁸⁰ The document also identified the lack of a logistics depot at the central and provincial levels to respond rapidly to public health emergencies, while the lack of mechanisms that underlie the supply chain in emergency situations, leading to disruptions and shortfalls (p. 51). ⁵⁸¹

There is no evidence of such requirement or conduct on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Border Hygiene Program (PNHF), or the National Institute of Public Health (INSP). ⁵⁸² ⁵⁸³ ⁵⁸⁴

4.2.3 Manufacturing and procurement for emergencies

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) has a plan to procure medical supplies for national use during a public health emergency, and there is mechanisms to expedite medical supplies through points of entry.

Pursuant to Article 133 of Decree No. 10/22 of 2 June 2010, which approved the Public Procurement Manual, the delegating authority may, in exceptional circumstances, use the direct contracting procedure in cases of extreme urgency, provided such action is duly validated by the Directorate-General for Public Procurement Control. This procedure is permitted when immediate intervention is required to ensure the continuity of public services, when it is not feasible to initiate a competitive selection process within a reasonable timeframe, or when only a single source is capable of providing the required service. ⁵⁸⁵

Additionally, the National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) assigns to the National Medicine Supply Program (PNAM) the role of supporting the emergency supply chain and to set up storage spaces for inputs in regional depots (p. 67). ⁵⁸⁶ In addition, the PNM provides that the Ministry of Finance is responsible for facilitating the emergency disbursement of funds allocated to public health emergencies and for coordinating with the Ministry of Planning to authorise exemptions for medical countermeasures. ⁵⁸⁷ The Ministry of Planning is, in turn, tasked with facilitating the importation of supplies and intervention materials required for the preparation for and response to public health emergencies, ensuring their exemption from applicable restrictions or duties (p. 69). ⁵⁸⁸

In 2020, the DRC enacted Decree No. 20/018 of 10 June 2020, which exempted medical equipment, medical materials, and pharmaceutical inputs and products from all duties, taxes and fees for the duration of the COVID-19 pandemic. ⁵⁸⁹

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) has a plan to procure laboratory supplies for national use during a public health emergency, and there is mechanisms to expedite medical supplies through points of entry.

Additionally, the National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) assigns to the National Medicine Supply Program (PNAM) the role of supporting the emergency supply chain and to set up storage spaces for inputs in regional depots (p. 67). ⁵⁹¹ In addition, the PNM provides that the Ministry of Finance is responsible for facilitating the emergency disbursement of funds allocated to public health emergencies and for coordinating with the Ministry of Planning to authorise exemptions for medical countermeasures. ⁵⁹² The Ministry of Planning is, in turn, tasked with facilitating the importation of supplies and intervention materials required for the preparation for and response to public health emergencies, ensuring their exemption from applicable restrictions or duties (p. 69). ⁵⁹³

4.2.3c Mechanism emergency logistics and supply chain management

Score: 100

The Democratic Republic of Congo (DRC) has a system for national and subnational levels for emergency logistics and supply chain management. The system covers specific considerations such as cold chain management for vaccines.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), vaccines are accessible and distributed nationwide, with vaccine distribution (maintaining the integrity of the cold chain) occurring in 40% to 59% of the country’s districts or reaching 40% to 59% of the target population (p. 32). ⁵⁹⁵ The JEE identifies as strengths the regularity of vaccine distribution at the provincial level, supported by a quarterly distribution plan, and the implementation of the Next Generation Supply Chain Approach (NGCA). ⁵⁹⁶

The NGCA is primarily based on a complete reconfiguration of the distribution system and the cold chain, allowing for more efficient storage and more reliable delivery of vaccines. ⁵⁹⁷ It includes the integration of drones into the supply chain, complementing traditional means of transport. ⁵⁹⁸

Moreover, the RDC innaugurated Central Africa's largest warehouse for vaccines and health products, with support from GAVI and the United Nations Children's Fund (Unicef). ⁵⁹⁹ According to Unicef, the facility facilitates vaccine storage and strenghten the cold chain to make vaccines available throughout the country, particularly in the most remote and hard-to-reach health zones. ⁶⁰⁰ The warehouse is integration into the health system supply chain system. ⁶⁰¹

4.3 Medical countermeasures and personnel deployment

4.3.1 System for dispensing MCMs during a public health emergency

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) has a plan in place for dispensing medical countermeasures (MCM) for national use during a public health emergency.

Additionally, the National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) provides that the Ministry of Finance is responsible for facilitating the emergency disbursement of funds allocated to public health emergencies and for coordinating with the Ministry of Planning to authorise exemptions for medical countermeasures. ⁶⁰² The Ministry of Planning is, in turn, tasked with facilitating the importation of supplies and intervention materials required for the preparation for and response to public health emergencies, ensuring their exemption from applicable restrictions or duties (p. 69). ⁶⁰³

In addition, there are provisions for dispensing MCM. The PNM plans for the procurement of specific antiviral molecules, citing 50 doses of each molecule (Ebanga and Regeneron) for Ebola (p. 36), as well as the acquisition and deployment of diagnostic material for rapid detection, including PCR reagent kits and GeneXpert cartridges (p. 36), and others. ⁶⁰⁴

4.3.2 System for receiving foreign health personnel during a public health emergency

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a public plan in place to facilitate workforce surge in an emergency.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), a national multisectoral strategic plan for increasing the workforce in case of an emergency is not available or is currently being developed (p. 45). ⁶⁰⁵ It also adds that, despite the availability of a personnel deployment policy, there is absence of a multisectoral strategic plan for the deployment of personnel for health emergencies. ⁶⁰⁶

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) does not present specific measures to facilitate workforce surge in a public health emergency; it has measures specifics to mobilize human resources during floods, which includes initiatives to establish a consultation framework for resource mobilization and make it operational (p. 113). ⁶⁰⁷ Nevertheless, there is no specific mention of similar measures for public health emergencies. ⁶⁰⁸

There is no evidence of such plan on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Border Hygiene Program (PNHF), the National Institute of Public Health (INSP), or the DRC legal database. ⁶⁰⁹ ⁶¹⁰ ⁶¹¹ ⁶¹²

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a public plan in place to receive health personnel from other countries to respond to a public health emergency.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), despite the availability of a personnel deployment policy, the country does not have a multisectoral strategic plan for deployment in the event of a health emergency. (p. 43). ⁶¹³ There is no specific mention of receiving health personnel from other countries to respond to a public health emergency. ⁶¹⁴

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) does not present specific measures to facilitate workforce surge in a public health emergency; it has measures specifics to mobilize human resources during floods, which includes initiatives to establish a consultation framework for resource mobilization and make it operational (p. 113). ⁶¹⁵ There is no specific mention of receiving health personnel from other countries to respond to a public health emergency. ⁶¹⁶

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has a public plan in place to redeploy existing health personnel within the country.

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2024) states that the Public Health Emergency Operations Center (COUSP) has backup staff, which can be mobilized in conjunction with organizations that have expertise in one or more public health emergency preparedness and response functions (p. 144). ⁶²¹ However, there are no further details. ⁶²²

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), a national multisectoral strategic plan for increasing the workforce in case of an emergency is not available or is currently being developed (p. 45). ⁶²³ Moreover, although the country has experience in mobilizing multisectoral staff reinforcements in the event of a public health emergency, there is not a national multisectoral strategic plan for staff reinforcement during those emergencies (p. 45). ⁶²⁴

4.4 Healthcare access

4.4.1 Access to healthcare

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 75

The Constitution of the Democratic Republic of Congo (DRC) explicitly guarantees citizens' rights to medical care. It is a guaranteed right, but it is not guaranteed free.

Pursuant to Article 47 of the Constitution of the DRC (2006), the right to health and food is guaranteed ⁶²⁹ Article 18 adds that all detainees must receive treatment that preserves their life, physical and mental health, and dignity. ⁶³⁰ Nevertheless, there is no reference as to whether they are guaranteed free. ⁶³¹

4.4.1b Access to skilled birth attendants (% of population)

Score: 77.94

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 98.43

4.4.1d Coverage of essential health services through universal health coverage

Score: 31.25

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 78.86

4.4.1f Rate of mortality amenable to health care

Score: 79.05

4.4.2 Paid medical leave

4.4.2a Guaranteed paid sick leave

Score: 66.67

Workers in the Democratic Republic of Congo (DRC) are guaranteed paid sick leave.

Pursuant to Article 105 of the Labour Code (Law No. 015/2002 of 16 October 2002), when a worker is unable to provide his services due to illness or accident, he retains the right, for the entire duration of the suspension of the contract, to two-thirds of the remuneration in cash and to the full family allowances. ⁶³² The right to contractual benefits in kind remains in force during incapacity for work, unless the worker requests their cash equivalent. ⁶³³ However, there is no reference to mental health problems. ⁶³⁴

4.4.3 Healthcare worker access to healthcare

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no evidence that the government of the Democratic Republic of Congo (DRC) has issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency.

There is no evidence of such committment on the Public Health Law (Law No. 18/035 of 13 December 2018) or the Labour Code (law No. 015/2002 of 16 October 2002). ⁶³⁵ ⁶³⁶ There is no evidence of such commitments on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Border Hygiene Program (PNHF), the National Institute of Public Health (INSP), or the DRC legal database either. ⁶³⁷ ⁶³⁸ ⁶³⁹ ⁶⁴⁰

The National Strategy of Infection Prevention and Control: Water, Hygiene and Sanitation 2023-2027 (2023) includes an action aimed at strengthening the health and safety of healthcare providers in the workplace, with a focus on enhancing their immunity, managing cases of occupational exposure, and implementing preventive measures to ensure their overall safety. ⁶⁴¹ However, the strategy does not specifically address prioritisation measures. ⁶⁴²

In addition, the DRC established monetary benefits in the form of salaries and allowances as a means of motivation for the work of healthcare workers in the continuity of health services during the COVID-19 pandemic. ⁶⁴³ In the DRC, the salaries of health workers involved in testing for COVID-19 was similar to all other staff involved in the response in any committee (epidemiological surveillance, case management, communication, etc.) but a temporary suspension of taxes was used as an incentive for health workers during the pandemic. ⁶⁴⁴ Nevertheless, there is no reference as to whether it was focused on healthcare workers who became sick as a result of responding to a public health emergency. ⁶⁴⁵

4.5 Communications with healthcare workers during a public health emergency

4.5.1 Communication with healthcare workers

4.5.1a Existence of system for communication during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) has a system in place for public health officials and healthcare workers to communicate during a public health emergency.

The Public Health Emergency Operations Center (COUSP), within the National Institute of Public Health (INSP) of the Ministry of Public Health, Hygiene and Social Security, has communication operating procedures aimed at governing internal communication between COUSP members and external communication with the public, the media, partners, and the government, during the three operating modes (Monitoring, Alert, and Response). (p. 55). ⁶⁴⁶

During response mode, information, including notifications of the ongoing public health threat, is shared daily with all stakeholders. Email communications are used to ensure that members of other ministries and partners are regularly informed of developments in the situation and of the response measures to be implemented. Situation Reports (SITREPs) are prepared by the planning section in collaboration with other relevant sections and are subsequently disseminated. The incident coordinator, or another person designated by them, is responsible for informing the public about the situation and any recommended preventive measures. Social media and other communication channels may also be utilised to disseminate public awareness and prevention messages (p. 58). ⁶⁴⁷

Moreover, there is the mHero platform, supported by the Digital Impact Alliance (DIAL), the National Agency for Clinical Engineering of Health Information and Computing (ANICiis), and mobile network operators, such as Airtel, Vodacom, and Orage, which connects the Ministry of Public Health, Hygiene and Social Security with frontline health workers. ⁶⁴⁸ The platform aims for two-way phone-based communicationa cross the health workforce. ⁶⁴⁹ ⁶⁵⁰

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 100

The Democratic Republic of Congo (DRC) has a system in place for public health officials and healthcare workers to communicate during a public health emergency which includes both public and private sector.

Moreover, there is the mHero platform, supported by the Digital Impact Alliance (DIAL), the National Agency for Clinical Engineering of Health Information and Computing (ANICiis), and mobile network operators, such as Airtel, Vodacom, and Orage, which connects the Ministry of Public Health, Hygiene and Social Security with frontline health workers, including those from the private sector . ⁶⁵⁴ The platform aims for two-way phone-based communicationa cross the health workforce. ⁶⁵⁵ ⁶⁵⁶

4.6 Infection control practices

4.6.1 Healthcare-associated infection (HCAI) monitoring

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is no evidence that the national public health system in the Democratic Republic of Congo (DRC) monitors and tracks the number of healthcare associated infections (HCAI) that take place in healthcare facilities.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), HCAI are not monitored in healthcare facilities through a well-established mechanism. However, some indicators related to HCAIs are incorporated into the District Health Information Software 2 (DHIS2) and the national infection prevention and control (IPC) assessment tool for healthcare facilities (p. 59). ⁶⁵⁷ The JEE underscores that there is a strategic focus on the surveillance of nosocomial infections in the National Strategy of Infection Prevention and Control: Water, Hygiene and Sanitation 2023–2027 (2023); a component on HCAI surveillance is also defined in the national IPC assessment tool, and key indicators for HCAIs have been defined and validated for reporting to the National Health Information System (DHIS2). ⁶⁵⁸ Nevertheless, the report identifies areas for improvement, particularly the absence of a dedicated surveillance plan for HCAIs, the lack of standardised definitions, and the absence of appropriate methodologies for monitoring nosocomial infections. ⁶⁵⁹

The National Strategy of Infection Prevention and Control: Water, Hygiene and Sanitation 2023-2027 includes a strategy to improve surveillance of HCAI (Strategy 3), which sets out measures to establish an effective surveillance system for HCAIs and antimicrobial resistance (AMR) in healthcare facilities, to strengthen and organise diagnostic systems for HCAIs and AMR to enable early identification of pathogens responsible for HCAIs, and to conduct antibiotic resistance testing on priority pathogens identified by the World Health Organization (WHO) (pp. 38-39). ⁶⁶⁰ It also includes provisions to organise studies and research on infection prevention and control to produce the necessary evidence to guide political, administrative, and technical decision-making based on scientific data. ⁶⁶¹

4.6.1b Infection prevention and control programme

Score: 100

The Democratic Republic of Congo (DCR) has an infection prevention and control (IPC) programme in place nationally.

In January 2023, the Directorate of Hygiene and Public Sanitation (DHSP) of the Ministry of Public Health, Hygiene and Social Security enacted the National Strategy of Infection Prevention and Control: Water, Hygiene and Sanitation 2023-2027. ⁶⁶² The strategy aims to contribute to reducing morbidity and mortality attributable to communicable infectious diseases through infection prevention and control (IPC) measures implemented nationwide, with an emphasis on the One Health approach (p. 33). ⁶⁶³ It sets out several strategic priorities, including strengthening institutional capacity and governance; training and education on infection prevention and control, including capacity-building initiatives; enhancing surveillance of healthcare-associated infections; improving material and safety conditions; promoting measures to ensure the safety of both patients and healthcare workers; improving water, hygiene, and sanitation (WASH) conditions; and implementing monitoring and evaluation of IPC activities at all levels. ⁶⁶⁴

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), IPC activities remain largely limited to emergency interventions, primarily during epidemics and population movements in humanitarian crises, although their sustained implementation is considered essential (p. 57). ⁶⁶⁵ The JEE notes that the country has conducted a situational analysis of minimum IPC requirements at the national level using the WHO assessment tool and confirms the adoption of the National Strategy of IPC: Water, Hygiene and Sanitation 2023-2027 (p. 58). ⁶⁶⁶ Furthermore, the DRC has a core group of IPC-trained personnel at the central level and in certain provinces affected by outbreaks of Ebola virus disease and COVID-19. It also conducts IPC assessments in healthcare facilities, accompanied by improvement plans, and has developed IPC guidelines and technical guides. ⁶⁶⁷

However, the JEE highlights the absence of a strategic risk assessment to designate points of entry as part of the national preparedness framework, the lack of designated and trained IPC officers in all secondary and tertiary healthcare facilities, and the irregular monitoring and documentation of hand hygiene practices. It also notes that IPC guidelines and technical guides are not widely disseminated nationwide, and infrastructure and equipment at designated points of entry are insufficient (p. 58). ⁶⁶⁸

4.6.1c National plan to ensure a safe environment in health facilities

Score: 100

The Democratic Republic of Congo (DRC) has a plan to ensure a safe environment in health facilities nationally.

In January 2023, the Directorate of Hygiene and Public Sanitation (DHSP) of the Ministry of Public Health, Hygiene and Social Security enacted the National Strategy of Infection Prevention and Control: Water, Hygiene and Sanitation 2023-2027. ⁶⁶⁹ Strategy 4 of the plan focuses on improving material and safety conditions and emphasises that, to ensure the effective implementation of Infection Prevention and Control (IPC) and Water, Hygiene and Sanitation (WASH) measures at all levels and across relevant sectors, the design of infrastructure, equipment, and materials must comply with IPC-WASH standards and guidelines (p. 39). ⁶⁷⁰ The strategy aims to safeguard the health of patients, healthcare professionals, and visitors by ensuring they are in clean, hygienic, and well-constructed environments that facilitate effective prevention and control of healthcare-associated infections (HAIs) and antimicrobial resistance (AMR). ⁶⁷¹

This involves ensuring adequate WASH infrastructure and services, as well as the availability of appropriate IPC materials and equipment. IPC-WASH specialists must be involved at every stage of healthcare infrastructure planning and implementation, including design, construction, renovation, improvement, demolition (to mitigate airborne fungal emissions), and commissioning. These experts are also required to contribute to the development of standards and provide recommendations for implementing appropriate IPC-WASH services, maintaining hygienic environments, and ensuring the availability of materials and equipment. ⁶⁷²

The strategy outlines several actions, including conducting multiple risk and vulnerability assessments, establishing and using disaster information management and sharing mechanisms, and implementing non-structural activities in collaboration with communities and natural resource management programmes. It also highlights the need to improve biomedical waste management in healthcare facilities for human, animal, and environmental health; to increase access to personal and collective protective equipment for staff and users by identifying context-appropriate solutions and creating procurement mechanisms; and to strengthen workplace health and safety for healthcare providers through immunity measures, protocols for exposure management, and preventive actions. ⁶⁷³

In addition, it calls for improving water supply and building adequate water, sanitation, and waste management infrastructure in healthcare facilities to ensure sufficient access to safe drinking water, integrating IPC-WASH experts into all stages of infrastructure planning, construction, implementation, and demolition to ensure compliance with standards, and organising vector control activities both in healthcare facilities and in communities. This last action involves training healthcare providers on vector control, defining procurement and supply mechanisms for vector control equipment, and formalising regulations to manage these activities at the community level. ⁶⁷⁴

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) pointed out that the country has developed standards for basic IPC-WASH services in healthcare facilities, but they are not widely disseminated across the country and there is water shortage in healthcare facilities, as well as lack of triage units (p. 58). ⁶⁷⁵

4.7 Capacity to test and approve new medical countermeasures

4.7.1 Regulatory process for clinical trials of unregistered interventions

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

The Democratic Republic of Congo (DRC) requires ethical review before beginning a clinical trial.

Pursuant to Article 53, Section (8), of the Public Health Law (Law No. 18/035 of 13 December 2018), the Congolese Pharmaceutical Regulatory Authority (ACOREP), under the Ministry of Public Health, Hygiene and Social Security, is responsible for authorising and monitoring clinical trials. ⁶⁷⁶ ⁶⁷⁷ Additionally, under Article 4, Section (d), of Decree No. 20/002 of 5 March 2020, ACOREP is mandated to ensure that clinical trials involving medicines, medical devices, and herbal medicinal products are conducted in accordance with prescribed standards and to make impartial information on regulated products publicly available. ⁶⁷⁸

Clinical trials are subject to review by Ethics Committees (ECs), which assess the scientific validity and ethical acceptability of any research proposal involving human subjects. ⁶⁷⁹ The study protocol must be submitted to the relevant EC for review simultaneously with an application to ACOREP for study authorisation and registration, allowing regulatory and ethical reviews to proceed in parallel. However, ACOREP approval is contingent upon EC approval. ⁶⁸⁰

ECs may be established under the authority of national or local health authorities, national or centralised medical research councils, or other nationally representative bodies, but they must operate independently of the research team and be approved by the Ministry of Public Health, Hygiene and Social Security. ⁶⁸¹ The DRC also has a National Committee of Health Ethics (CNES), established pursuant to Articles 1 and 2 of Ministerial Order No. 1250/CAB/MIN/S/ZKM/043/MC/2006 of 18 December 2006, which is responsible for reviewing research proposals involving human subjects in line with the ethical principles of respect for individuals, beneficence, and justice. ⁶⁸² ⁶⁸³

The Ministry of Public Health, Hygiene and Social Security has published guidelines for the ethical evaluation of clinical trials involving human beings. ⁶⁸⁴ Those guidelines must be followed by ECs. ⁶⁸⁵ ⁶⁸⁶

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has an expedited process for approving clinical trials for unregistered medical countermeasures (MCM) or mutual recognition of clinical trial results taking place elsewhere to treat ongoing pandemics or epidemics.

There is no evidence of such expedited process on the official website of the Congolese Pharmaceutical Regulatory Authority (ACOREP), of the Ministry of Public Health, Hygiene and Social Security. ⁶⁸⁷ ⁶⁸⁸ There is no evidence on the National Institute of Allergy and Infectious Diseases (NIH) page about the DRC. ⁶⁸⁹

As per the Guidelines for the ethical evaluation of clinical trials involving human beings of the Ministry of Public Health, Hygiene and Social Security, records and biological samples from individuals who have expressly refused the use in the past may only be used in public health emergencies with approval from the Ethics Committee. ⁶⁹⁰ However, there is no reference to expedited approval process during public health emergencies. ⁶⁹¹

4.7.2 Regulatory process for approving medical countermeasures

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

The Democratic Republic of Congo (DRC) has a government agency responsible for approving new medical countermeasures (MCM) for humans.

The Congolese Pharmaceutical Regulatory Authority (ACOREP) is responsible for approving new MCM for humans, as per Article 4 of Decree No. 20/002 of 5 March 2020. ⁶⁹² The article provides that ACOREP is responsible for authorising and controlling, in accordance with applicable legislation and regulations, and in collaboration with the Ministry of Foreign Commerce, the importation, exportation, manufacture, labelling, marking or identification, storage, promotion, sale, and distribution of medicines, food products, cosmetics, herbal medicinal products, medical devices, and any material or substance used in the manufacture of these products. ⁶⁹³ ACOREP is also tasked with reviewing applications and granting, where appropriate, marketing authorisations for medicines and other health products, as well as approving any related variations. ⁶⁹⁴

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has an expedited process for approving medical countermeasures (MCM) for human use or recognition of approval decisions taking place elsewhere during public health emergencies.

There is no evidence of such expedited process on the official website of the Congolese Pharmaceutical Regulatory Authority (ACOREP), of the Ministry of Public Health, Hygiene and Social Security. ⁶⁹⁵ ⁶⁹⁶ There is no evidence on the National Institute of Allergy and Infectious Diseases (NIH) page about the DRC. ⁶⁹⁷

Nevertheless, in June 2024, the DRC approved the emergency use for 2 Mpox vaccines in the country to help curb a surge in cases involving a new strain. ⁶⁹⁸ ⁶⁹⁹

Commitment to International Norms

5.1 IHR reporting compliance and disaster risk reduction

5.1.1 Official IHR reporting

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Congo (Democratic Republic) has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁷⁰⁰

5.1.2 Integration of health into disaster risk reduction

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 100

Epidemics are integrated into the national health risk reduction strategy in the Democratic Republic of Congo (DRC).

The National Multi-Risk Plan of Public Health Emergencies 2024-2027 (PNM) (2023) contains provisions to address epidemics, with specific measures dedicated to Ebola, COVID-19, cholera, poliomyelitis, rabies, measles, and mpox. ⁷⁰¹ In addition to these disease-specific measures, the plan outlines overarching strategies for epidemic prevention and health emergency preparedness, such as (i) strengthening the capacity of human resources for managing the consequences of epidemics and disasters, (ii) training personnel in case identification and the implementation of response exercises for diseases such as COVID-19, Ebola, cholera, poliomyelitis, rabies, measles, and mpox, and (iii) ensuring the investigation of all alerts within 24 hours. The plan also stipulates that 80% of affected and neighbouring households must undergo disinfection in the event of outbreaks and emphasises the creation of an early warning system to strengthen rapid response mechanisms. ⁷⁰²

The PNM also provides for specific initiatives to reinforce laboratory and operational readiness, such as the organization of laboratory training sessions for staff involved in public health emergencies in health zones across 17 identified hotspot provinces, and the quarterly provision of sampling and transport kits to national and subnational laboratories, including both veterinary and human health facilities. ⁷⁰³ Additionally, PNM requires the organization of simulation exercises at both the national level and within provincial health directorates (DPS) to ensure preparedness for large-scale public health events. ⁷⁰⁴

5.2 Cross-border agreements on public health and animal health emergency response

5.2.1 Cross-border agreements

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 0

The Democratic Republic of Congo (DRC) is part of a regional group with provisions on public health emergencies.

While the DRC is a member of regional support networks, this does not necessarily mean that there are specific agreements in place in the event of a public health emergency.

The DRC has been a member of the African Union since 23 May 1963. ⁷⁰⁵ On 15 July 2022, the African Union published its Revised Statute of the African CDC and its Framework of Operation; pursuant to Article 3, Member States will receive support to the implementation of early warning and response surveillance platforms, as well as preparedness and response systems, declare Public Health Emergency of Continental Security (PHECS), promote partnerships and collaborations among Member States to address emerging and endemic diseases, pandemics, and public health emergencies, implement capacity-building measures in public health, including through medium- and long-term leadership, field epidemiological, public health emergency and laboratory training programs, and others. ⁷⁰⁶

In addition, the DRC, along with eight other African countries, is part of the Central Africa Regional Collaborating Centre of the Africa Centers for Disease Control and Prevention (Africa CDC). ⁷⁰⁷ ⁷⁰⁸ Regional Collaborating Centers are technical support institutions for the Africa CDC that work with member states to develop capacity in surveillance, laboratory systems and networks, information systems, emergency preparedness and response, public health research, and fighting major public health outbreaks. ⁷⁰⁹ ⁷¹⁰

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 0

The Democratic Republic of Congo (DRC) has cross-border strategies, as part of a regional group, with regards to animal health emergencies. However, there is no evidence of gaps in implementation.

While the DRC has been a member of the African Union since 1968, this does not necessarily mean that there are specific agreements in place between countries in the event of a public health emergency. ⁷¹¹ In 2019, the African Union Inter-African Bureau for Animal Resources (AU-IBAR) enacted the Animal Health Strategy for Africa 2019-2035, which includes the goal of promoting the establishment of early warning, emergency response mechanisms and disaster fund for animal resources at national, regional and continental levels. ⁷¹² It includes goals to adapt emergency preparedness and response framework guidelines, train and simulate exercises at regional and national levels, establish regional response teams and mechanism, and establish a continental-level disaster fund. ⁷¹³

There is no further evidence of such agreements on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the Ministry of Agriculture and Food Security. ⁷¹⁴ ⁷¹⁵ ⁷¹⁶

5.3 International commitments

5.3.1 Participation in international agreements

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

The Democratic Republic of Congo (DRC) has signed and ratified the Biological Weapons Convention.

The country signed the Biological Weapons Convention on 10 April 1972, and ratified it on 15 September 1975. ⁷¹⁷

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 0

The Democratic Republic of Congo (DRC) has not submitted confidence building measures for the Biological Weapons Convention in the past three years. ⁷¹⁸

The DRC has never submitted confidence building measures for the BWC. ⁷¹⁹

5.3.1c Submission of UNSCR 1540 reports

Score: 100

The Democratic Republic of Congo (DRC) has provided the required United Nations Security Council Resoultion (UNSCR) 1540 report to the Security Council Committee established pursuant to resolution 1540 (1540 Committee).

THe country submitted the required document on 28 April 2008. ⁷²⁰

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 25

5.3.2 Voluntary memberships

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

The Democratic Republic of Congo (DRC) is not part of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction (GP), the Australia Group, or the Proliferation Security Initiative (PSI).

The DRC is not a member in the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction. ⁷²¹ The DRC is not a member in the Australia Group (AG) or the Proliferation Security Initiative (PSI) either. ⁷²² ⁷²³

5.4 JEE and PVS

5.4.1 Completion and publication of a JEE assessment and gap analysis

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

The Democratic Republic of Congo has completed a Joint External Evaluation (JEE) and published a full public report in the last five years.

The DRC conducted a WHO Joint External Evaluation (JEE) and published a full public report in 2023, which was later published in 2025. ⁷²⁴

5.4.2 Completion and publication of a PVS assessment and gap analysis

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

The Democratic Republic of Congo (DRC) has neither completed nor published a Performance of Veterinary Services (PVS) assessment in the last five years.

The DRC has never completed or published a PVS assessment. ⁷²⁵ According to the World Animal Health Organization (WOAH), the country had a National Bridging Workshop in 2024, but there is no evidence of a PVS assessment. ⁷²⁶

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

The Democratic Republic of Congo (DRC) has neither completed nor published a Performance of Veterinary Services (PVS) gas analysis in the last five years.

The DRC has never completed or published a PVS gap analysis. ⁷²⁷ According to the World Animal Health Organization (WOAH), the country had a National Bridging Workshop in 2024, but there is no evidence of a PVS assessment. ⁷²⁸

5.5 Financing

5.5.1 National financing for epidemic preparedness

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 0

There is no evidence that the Democratic Republic of Congo (DRC) has allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years.

In August 2024, the President of the DRC announced a disbursement of USD 10 million to strengthen the fight against the Mpox epidemic in the country. ⁷²⁹ However, some of the disbursement came from Africa CDC. ⁷³⁰

There is no further evidence of national funds being allocated on the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), or the DRC legal database. ⁷³¹ ⁷³² ⁷³³

5.5.2 Financing under JEE and PVS reports and gap analyses

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

The Joint External Evaluation (JEE) report for the Democratic Republic of Congo (DRC) does not describe specific funding from the national budget to address the identified gaps.

The World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023) undescores that the country has not yet switched to a "program budget" approach and presents its budget in an average mode, based on available funding (p. 13). ⁷³⁴ There are allocations for investment in health and health security, but there are no specific budget items in the state budget for the technical areas of the 2005 IHR. However, there are budget items in the budget that, once implemented, will contribute to improving the implementation of the IHR (2005). ⁷³⁵

It further adds that there is limited financial planning, with significant external funding allocated to certain relevant ministries and sectors to support IHR implementation at the national level (p. 14). ⁷³⁶ However, one are for strenghtening is planning for multi-year needs for public health emergencies and establishing multisectoral consultation frameworks for budget forecasts (p. 13). ⁷³⁷ Nevertheless, there is no description of specific funding to address the identified gaps. ⁷³⁸

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

The Democratic Republic of Congo (DRC) has neither completed nor published a Performance of Veterinary Services (PVS) gas analysis or PVS assessment.

The DRC has never completed or published a PVS gap analysis or PVS assessment. ⁷³⁹ According to the World Animal Health Organization (WOAH), the country had a National Bridging Workshop in 2024, but there is no evidence of a PVS assessment. ⁷⁴⁰

5.5.3 Financing for emergency response

5.5.3a Emergency public financing during a public health emergency

Score: 100

The Democratic Republic of Congo (DRC) has a publicly identified special emergency public financing mechanism and funds which the country can access in the face of a public health emergency.

According to World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the DRC has pre-identified financial resource mechanisms for public emergencies, which mechanism allows for the receipt, distribution, and use of funds to respond to public health emergencies (p. 14). ⁷⁴¹ However, the activation and disbursement procedures are cumbersome and inadequate. ⁷⁴² It suggests the country to identify, develop, and operationalize flexible fund disbursement mechanisms to respond to public health emergencies and evolving needs, and allow for reallocations as needs evolve. ⁷⁴³

5.5.4 Accountability for international commitments to address epidemic threats

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that senior leaders in the Democratic Republic of Congo (DRC) has made public commitments in the past three years to improve the country's domestic capacity to address pandemic or epidemic threats by expanding financing or requesting support to improve capacity.

In August 2024, the President of the DRC announced a disbursement of USD 10 million to strengthen the fight against the Mpox epidemic in the country. ⁷⁴⁴

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that the Democratic Republic of Congo (DRC) has requested financing or technical support from donors to improve the country's domestic capacity to address epidemic threats in the past three years.

In October 2024, the European Union provided an additional EUR 20 million (USD 23.44 million) to fund Mpox preparedness and response plan in the DRC. ⁷⁴⁵ Likewise, the Global Fund provided USD 10 million for DRC's Mpox Response. ⁷⁴⁶

In September 2024, the Pandemic Fund Board approved a USD 128.89 million to support 10 countries impacted by Mpox, including the DRC. ⁷⁴⁷ The support is focused on bolstering the country's and regional's capacity in critical areas, like disease surveillance, diagnostics, laboratory networks, and health workforce, while addressing the immediate challenges posed by mpox. ⁷⁴⁸

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 100

The Democratic Republic of Congo has fulfilled its full contribution to the World Health Organization (WHO) within the past two years.

According to the latest available statement of the World Health Organization (January 2025), the DRC has paid its assessed contributions for 2024 and 2025. ⁷⁴⁹ In 2024 and 2025, the assessed contributions amounted to USD 114,830, in which the country paid USD 57,420 in 2024 and USD 57,410 in 2025. ⁷⁵⁰

However, the DRC is has outstanding payments for previous years (2022-2023), amounting to USD 95,690. ⁷⁵¹

5.6 Commitment to sharing of genetic & biological data & specimens

5.6.1 Commitment to share data and specimens in emergency/non-emergency research

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is pubicly available evidence that the Democratic Republic of Congo (DRC) has a plan or policy for sharing genetic data, clinical specimens, and isolated specimens along with the associated epidemiological data with international organizations and other countries that go beyond influenza.

According to the World Health Organization’s (WHO) Joint External Evaluation (JEE) of IHR Core Capacities of the Democratic Republic of Congo (2023), the country shares epidemiological surveillance data with the World Health Organization (WHO), the World Organization for Animal Health (WOAH), and the Food and Agriculture Organization (FAO) (p. 41). ⁷⁵² Nevertheless, there is no reference to a plan or policy for sharing genetic data, clinical specimens, and isolated specimens. ⁷⁵³

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no evidence that the Democratic Republic of Congo (DRC) has not shared samples in accordance with the PIP framework in the past two years.

There is no evidence that the DRC failed to share samples in accordance with the PIP framework on the Advisory Group Annual Report fo the Director -General (2024). ⁷⁵⁷ There is no evidence that the country failed to share samples on the official website of the World Health Organization (WHO). ⁷⁵⁸ There is no evidence on the Pandemic Influenza Preparedness Framework: Annual Progress report, 1 January – 31 December 2024 (2025) either. ⁷⁵⁹

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no evidence that the Democratic Republic of Congo (DRC) has not shared pandemic pathogen samples during an outbreak in the past two years.

There is no evidence of a denial to share pandemic pathogen samples on the official websites of the Ministry of Public Health, Hygiene and Social Security, the National Institute of Biomedical Research (INRB), the National Border Hygiene Program (PHNF), or the Ministry of Foreign Affairs. ⁷⁶⁰ ⁷⁶¹

Risk Environment

6.1 Political and security risk

6.1.1 Government effectiveness

6.1.1a Policy formation

Score: 50

6.1.1b Quality of bureaucracy

Score: 0

6.1.1c Excessive bureaucracy/red tape

Score: 0

6.1.1d Vested interests/cronyism

Score: 0

6.1.1e Corruption

Score: 20

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 0

6.1.2 Orderly transfers of power

6.1.2a Orderly transfers of power

Score: 25

6.1.3 Risk of social unrest

6.1.3a Risk of social unrest

Score: 0

6.1.4 Illicit activities by non-state actors

6.1.4a Risk of terrorism

Score: 25

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 0

6.1.5 Armed conflict

6.1.5a Presence or risk of armed conflict

Score: 0

6.1.6 Government territorial control

6.1.6a Government territorial control

Score: 0

6.1.7 International tensions

6.1.7a International tensions

Score: 0

6.2 Socio-economic resilience

6.2.1 Literacy

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 69.53

6.2.2 Gender equality

6.2.2a UNDP Gender Inequality Index score

Score: 16.63

6.2.3 Social inclusion

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 0.64

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4 Public confidence in government

6.2.4a Public confidence in government

Score: 0

6.2.5 Local media and reporting

6.2.5a Robust, open, diverse local media and reporting

Score: 50

6.2.6 Inequality

6.2.6a Gini coefficient

Score: 55.3

6.3 Infrastructure adequacy

6.3.1 Adequacy of road network

6.3.1a Adequacy of road network

Score: 0

6.3.2 Adequacy of airports

6.3.2a Adequacy of airports

Score: 0

6.3.3 Adequacy of power network

6.3.3a Adequacy of power network

Score: 0

6.4 Environmental risks

6.4.1 Urbanisation

6.4.1a Urban population (% of total population)

Score: 56.8

6.4.2 Land use

6.4.2a Change in forest area (percentage points)

Score: 18.91

6.4.3 Natural disaster risk

6.4.3a Natural disaster risk

Score: 50

6.5 Public health vulnerabilities

6.5.1 Access to quality healthcare

6.5.1a Total life expectancy (years)

Score: 33.72

6.5.1b NCD mortality rate

Score: 47.52

6.5.1c Population aged 65+

Score: 90.25

6.5.1d Tobacco use (% of adults)

Score: 54.64

6.5.1e Level of adult obesity (%)

Score: 97.66

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 57.44

6.5.2 Access to potable water and sanitation

6.5.2a Access to potable water

Score: 0

6.5.2b Access to at least basic sanitation facilities

Score: 0

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 72.92

6.5.3 Public healthcare spending levels per capita

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 0.54

6.5.4 Trust in medical and health advice

6.5.4a Trust medical and health advice from the government

Score: 50

6.5.4b Trust medical and health advice from medical workers

Score: 50

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