A reflection from Dr. Marx Lwabanya a staff at NDH, DRC
Introduction
For decades, the United States Agency for International Development (USAID) has been a cornerstone of health sector development in the Democratic Republic of Congo (DRC). Through initiatives targeting malaria, tuberculosis, maternal health, and health system strengthening, USAID has helped millions access life-saving care. However, recent funding suspensions have triggered a cascade of disruptions—particularly in the eastern provinces, where fragile health systems are now buckling under the weight of civil unrest and resource scarcity.
USAID’s Historical Role in DRC’s Health Sector
USAID has invested billions in the DRC since the early 2000s, with over $935 million disbursed in 2023 alone(1). Key programs include:
Integrated Health Program (IHP): Operating in 9 provinces and 179 health zones, IHP has improved access to quality care for over 47 million people(2,3). It supports maternal and child health, nutrition, immunization, and disease prevention.
End Malaria Project: In 2023, USAID provided $15.88 million to distribute insecticide-treated bed nets to over 28 million people(1).
Nutrition and Child Health: Between 2021 and 2022, USAID reached 26.7 million children with nutrition programming and vaccinations(3).
Emergency Response: USAID has been instrumental in responding to outbreaks of Ebola, mpox, and cholera, and in providing humanitarian aid during displacement crises.
These programs have not only saved lives but also built local capacity, improved data systems, and fostered community engagement through initiatives like Champion Communities and health development committees (CODESAs)(4).
Consequences of Funding Cuts in Nundu Health Zone
The USAID funds cuts affect different stakeholders in Africa, and the Democratic Republic of Congo, especially the eastern part, that is facing political instability. It is a moment when humanitarian aid is needed more than ever before because the suffering is at its peak, when the cuts of USAID funds hit like lightning, causing a double burden to the people.
The impact goes beyond a single person suffering, affecting even organizations that were implementing projects with funding from the USAID, the case of the International Medical Corps (IMC) in the Nundu Health Zone in South Kivu. This disengagement of IMC from Nundu, has had immediate and far-reaching effects in the areas of their interventions including and not limited to the Reduced Community Outreach: Preventive health education, especially around family planning, has sharply declined. The Nundu health zone and hospital is struggling to manage patients in this fragile context when the pharmacy is empty for drugs that came from a program supported initially by the USAID. The main consequence on the ground is now:
Stockouts of Essential Medicines: Supplies of antimalarials, anti-tuberculosis drugs, and lab reagents for TB are frequently unavailable, delaying treatment and increasing disease burden.
Provider Capacity Erosion: Without technical and financial support, health workers lack training, supervision, and motivation.
Rising Mortality Rates: Infant deaths, low birthweight deliveries, and maternal fatalities are on the rise.
At Nundu General Hospital, the situation is especially dire. Patients diagnosed with tuberculosis are placed on waiting lists for over a month due to drug shortages, increasing both mortality and community transmission.
The lack of antimalarial drugs is even more concerning, as malaria remains the leading cause of morbidity and mortality in the region. Shortage of malaria drugs is a serious concern requiring a particular attention.
Civil Unrest and Humanitarian Crisis in South Kivu
The health crisis is compounded by escalating violence in South Kivu. Armed clashes have displaced over 850,000 people, half of them children(5). Hospitals are overwhelmed, health workers are fleeing, and access to clean water and sanitation is severely limited(6). In this volatile context, the absence of USAID-supported health interventions is not just a setback—it’s a humanitarian emergency.
Perspective on the ground
The USAID funds cuts information was perceived differently on the ground; some analysts think it is a good thing for African leaders to learn better how to use their responsibility to better serve their people and not relying on external aid. Of course, some countries are well positioned to start thinking their way forward after the USAID funding cuts. Unfortunately, this is an overwhelming situation to manage for countries like the Democratic Republic of Congo struggling to end war and conflict, and now called to fill the gap of USAID, which is an unrealistic goal unless new alternatives for funding options emerge.
Conclusion
The people of Nundu and surrounding areas are facing a perfect storm of disease, displacement, and dwindling resources. The shortage of antimalarial drugs at Nundu General Hospital demands urgent support to keep serving the community effectively, relying on it for appropriate care, especially as civil unrest continues to destabilize South Kivu.
In the face of adversity, the resilience of Congolese communities endures. But resilience alone cannot fill empty shelves or treat malaria without medicine. The time to act is now.