The Democratic Republic of the Congo is the hardest hit country in the African region by mpox outbreak, accounting for about 80% of laboratory-confirmed cases and deaths reported across the continent this year. While mpox is primarily transmitted through close physical contact, it can affect anyone. Vulnerable populations are at a heightened risk of infection and severe illness.

World Health Organization (WHO) is working closely with national health authorities to implement targeted interventions to protect vulnerable populations. This includes training health workers, supporting disease surveillance and contract tracing, delivering tailored risk communication and community engagement, providing medical supplies and case management as well as enhancing vaccine delivery systems and infrastructure. 

Among the most vulnerable people in the Democratic Republic of the Congo are the country’s 7 million internally displaced persons (IDPs), as well as over half a million refugees and asylum seekers, many of whom live in camps with limited access to water, sanitation and health services. 

“The detection of mpox cases in these settlements is cause for concern, as high population density can accelerate the spread of the virus. This means we are ramping up public health measures such as increasing access to health services, and sanitation facilities in these areas to prevent mpox transmission,” says Dr Bachir Mbodj, WHO’s mpox Incident Manager in the Democratic Republic of the Congo. 

As the Democratic Republic of the Congo faces multiple overlapping crises, including conflict and malnutrition, integrating public health measures into broader humanitarian efforts remains a priority. As part of a wider humanitarian response, WHO is working with partners such as Médecins Sans Frontières (MSF), Alima, International Organization for Migration (IOM), and UN Refugee Agency (UNHCR) to ensure that essential healthcare services continue within refugee and IDP camps. 

“By combining WHO’s technical expertise and IOM’s proficiency in border control, we are able to limit the cross-border spread of mpox and protect communities in both the Democratic Republic of the Congo and neighbouring countries,” said Dr Popol Bureme, IOM’s National Migration Health Officer in the Democratic Republic of the Congo.

At least 60 IOM staff have been trained in disease surveillance and mpox case management, with treatment and isolation facilities established at entry points to the Democratic Republic of the Congo. At the same time, and in addition to supporting many dozens more, WHO has deployed 18 doctors to North Kivu to support vaccinations and other medical interventions.

In North Kivu, which is home to 2.5 million IDPs, WHO has established three permanent health centres, capable of treating up to 2000 people per week, near the IDP camps including 23 temporary health facilities and four isolation facilities within the camps. Similar initiatives have also been launched in South Kivu and more than 1800 people have been vaccinated in IDP camps across the country. 

WHO is also providing technical and financial support to the Democratic Republic of the Congo’s National Fight Against HIV/AIDS Programme, leveraging its reach within communities to support sex workers who are also vulnerable to mpox infection. Sex workers make up about 3% of the female population aged between 15 and 49. Support to this group includes screening, providing treatment and follow-up care.

In North and South Kivu, the National HIV/AIDS Control Programme has trained leaders from sex worker associations and other at-risk groups, such as men who have sex with men, to become mpox peer educators. An additional 120 people are set to receive training in the capital, Kinshasa. For every trained peer educator, an estimated 80 people will be reached and receive crucial information on prevention and the benefits of mpox vaccination. To date, around 16% of those vaccinated against mpox in the Democratic Republic of the Congo are sex workers.

“Involving these leaders in our efforts helps raise awareness because they are trusted by the communities they represent and have already proven themselves to be powerful communicators on HIV/AIDS and STIs,” says Dr Clotilde Melisa Inaka Boolu, the programme’s mpox focal point. “The messaging now includes information about mpox, which will protect not just the sex workers, but also their clients and communities.”