US funding pause impedes mpox response in DR Congo
February 14, 2025
The Democratic Republic of the Congo (DRC) is facing a worsening mpox crisis as armed conflict disrupts sample transport, lab testing, and healthcare services, according to Africa CDC. Ongoing violence in and around Goma has caused displaced populations, including mpox patients, to flee, compounding the outbreak. A US funding freeze has further crippled response efforts, forcing African leaders to seek alternative funding from China, Japan, and South Korea. Meanwhile, Uganda shows promising vaccine uptake, with 9,000 of 10,000 doses administered. Africa CDC urges caution as data remains incomplete due to testing disruptions, calling for urgent global cooperation to prevent wider spread.
The mpox outbreak in the Democratic Republic of the Congo (DRC) is intensifying as armed conflict severely hampers public health response efforts. According to Africa CDC officials, violence in and around the key city of Goma has disrupted the transport of samples for lab testing, overwhelmed healthcare facilities, and forced displaced populations—including isolated mpox patients—to flee for safety. This has caused significant delays in disease tracking and containment efforts.
Ngashi Ngongo, MD, PhD, MPH, head of Africa CDC’s mpox incident management team, emphasized that despite recent data suggesting a slight decline in cases over the past three weeks, the apparent drop is likely due to testing disruptions rather than actual progress in controlling the outbreak. Ngongo described the deteriorating situation in the DRC as a “nightmare,” highlighting the growing strain on public health systems.
The crisis has been further exacerbated by a Trump administration executive order freezing US foreign aid, including funding from USAID, a key partner in Africa’s mpox response. While there is a waiver process for life-saving humanitarian assistance, it remains unclear if the DRC’s situation qualifies. Africa CDC has urged African heads of state to engage with US ambassadors to clarify eligibility for such waivers.
With 84% of US global health assistance directed toward Africa, the funding freeze has forced African nations to explore alternative funding sources. Negotiations with China, Japan, and South Korea were already underway before the freeze, and African officials are now also considering repurposing unspent European Union COVID-19 funds.
Despite these challenges, there are some bright spots. Uganda has reported strong vaccine uptake, with 9,000 of 10,000 available mpox doses administered, primarily targeting sex workers. However, the DRC remains the epicenter of the outbreak, with clade 1a and 1b mpox variants spreading rapidly, particularly among children in endemic provinces and adults in urban centers like Kinshasa. Urgent international cooperation is needed to prevent the crisis from escalating further.