In the fight against the mpox epidemic in the Democratic Republic of Congo, the World Bank has rolled out a number of major initiatives to support the government and the affected communities. This interview with Dr. Michel Muvudi, Senior Health Specialist with the World Bank, highlights the work being done to address this epidemic and highlights the recommendations in place for the population.
What steps have been taken by the World Bank to support the Democratic Republic of Congo (DRC) in the fight against the mpox epidemic? What are some of the impacts that have been observed?
The health systems in the DRC draw on the long- and short-term support of the World Bank. We have provided long-term investment financing, including for health care and diagnostic equipment and infrastructure. Indeed, the World Bank has invested over $2 billion in the health sector over the past 10 years. The World Bank is supporting the government's response plan by mobilizing financing for the Regional Disease Surveillance Systems Enhancement (REDISSE) and Multisectoral Nutrition and Health Project (PMNS) projects.
As of April 2023, the country needed 100 percent of the drugs required, as before our intervention, no patients were receiving treatment free of cost. We have now been able to cover more than 90 percent of the healthcare requirements in the country's most affected provinces, such as Sud-Kivu, Equateur, Sankuru, Tshopo, Bas-Uele, Kasaï, and Tshuapa.
Furthermore, to limit the spread of the virus, we distributed nutrition kits to over 500 individuals to prevent them from having to move around to stock up on food. We also trained 36,000 community health workers working in the areas of local communication and community-based surveillance. If we include those trained in disease surveillance and response under REDISSE IV, then more than 100,000 people have already been trained.
In the final analysis, vaccinations are a critical component. Working in conjunction with our partners such as the EU and USAID, the country has received over 250,000 vaccine doses and additional supplies are being delivered. The World Bank will handle the logistics of rolling out these vaccines in the provinces down to the last mile. It should be noted that, depending on the government's stated priorities and urgent unmet needs, World Bank support is both scalable and very flexible and can adapt to the trajectory of the epidemic, and also to the country's priority needs.
What are the most pressing needs in the fight against mpox in the DRC, and how does the World Bank plan to respond to these needs?
Vaccines are urgently needed. Based on the priority groups identified by the government, including health workers on the front line, sex workers, etc., the needs are enormous, and the available vaccines can only cover 10 percent of these priority groups.
The same situation prevails in terms of the need for communication and community-based surveillance. Because the response plan is multi-donor in nature, World Bank interventions are mainly focused on playing an advocacy role for mobilizing increased resources from the other donor partners. However, the World Bank also provides the technical support of its experts, who have capitalized on the many lessons learned during the COVID-19 pandemic, notably regarding the importance of community engagement.
It should also be noted that the government has announced a contribution of $10 million in domestic funding to the response plan and that $2.5 million of that total has already been disbursed.
Could you explain how the World Bank organizes its financial and technical support and what are the envisaged next steps?
In terms of financial support, our contribution since the beginning of the epidemic is currently estimated at more than $2 million and this financing will certainly increase in accordance with the needs. In terms of technical support, apart from the active participation of World Bank experts in a number of coordination bodies, we also make available to the government the knowledge garnered from the management of the COVID-19 pandemic, in particular, and the lessons learned at the international level from the experiences of other countries.
What are the specific strategies deployed to ensure effective coverage and to reach vulnerable communities in the DRC?
It is important to emphasize that, as a donor, the World Bank provides support to the government. The World Bank does not act in isolation but works within the system that has been put in place by the country. Community platforms developed by the country with the support of the World Bank enable the implementation of a model of community-based surveillance to identify all the population groups within the health zones. Furthermore, with the help of its health teams, the World Bank can concentrate its efforts on affected persons who don't have access to the necessary services. By providing medical services free of charge and thus eliminating the financial barrier to health care, the Bank seeks to ensure that vulnerable sectors of the population are included and covered, factors that are considered essential for controlling the spread of the infection.
What is the long-term outlook for the management of future epidemics in the DRC and how does the World Bank plan to align with these strategies?
The long-term outlook for the management of future epidemics in the DRC is contingent on the effective implementation of the National Action Plan for Health Security (NAPHS). The World Bank provides technical and financial support for this plan, through, for example, the integration of a multisectoral approach into the Health System Strengthening (HSS) program.
The World Bank's strategies are aligned with these national mechanisms and are then adjusted as needed, brought into line with global guidelines, and tailored to the specific experience of the DRC. The World Bank's health portfolio is therefore focused on actions that promote a resilient health system that can contribute to the overall reduction of mortality rates, while ensuring that the health sector can become a real pole of human development and contribute to the country's economic growth.
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What recommendations would you make to help the people of the DRC protect themselves from the epidemic?
I would encourage the population to comply with the recommendations announced by the Ministry of Public Health, while adhering also to the guidelines of the World Health Organization, summarized as follows:
Be aware that the disease is out there and that we all need to cooperate if we are to conquer it: wash hands frequently using soap and water. If that is not possible, use an alcohol-based hand sanitizer; avoid all close contact with an infected person or one showing mpox symptoms (rash, fever, chills, cough, etc.); avoid all contact with towels, bedding, dishes, and other objects used by a person infected with mpox; avoid all sexual contact with a partner showing signs of a rash or other symptoms, as the current mpox virus can also be sexually transmitted; avoid eating animals found dead; get vaccinated if you are in the eligible target group identified by the Ministry of Health; go immediately to the nearest health center if you detect any signs of the disease, such as fever, muscle aches, cough, rash.
