Democratic Republic of the Congo — The Kinshasa-based National Centre for Epidemiological Intelligence seems a world away from the mega city's notoriously chaotic streets.
Although unassuming from the outside, this building is the epicenter of the vast digital disease surveillance system in the Democratic Republic of the Congo (DRC).
The box-shaped, grey-blue structure contains four rooms, including the Early Alert Room. Inside are seven large screens mounted on walls displaying rows of complex data, detailed charts and numerous maps of the country's 26 provinces.
A team of 14 epidemiologists, computer scientists and IT professionals work diligently behind large desktop computers. The team works in shifts, providing 24-hour monitoring of disease surveillance data.
"We want to anticipate, rather than react," says Felix Mulangu, who leads the Early Alert Room team. "We want to catch new cases early to avoid diseases from spreading. We also share the information gathered with relevant health authorities to ensure a rapid response and avoid largescale epidemics that are difficult to manage."
The Early Alert Room receives data related to 21 infectious diseases, including cholera, malaria, Ebola, measles, mpox and yellow fever, as well as endemic diseases such as HIV and tuberculosis.
This system has been vital in monitoring and containing the most recent mpox outbreak - tracing new cases, monitoring the virus' evolution as well as informing health authorities so they can rapidly react and share the latest data with health counterparts across Africa and beyond.
Experts at the Kinshasa-based Early Alert Room. The facility is the epicenter of DRC's vast digital disease surveillance system. Robust disease surveillance is vital to protecting people against infectious disease around the world. In DRC, it is crucial - but particularly challenging. Over the last decade DRC has had numerous cholera, Ebola and measles outbreaks, in addition to COVID-19, mpox and an "undiagnosed disease" outbreak in Kwango province, which was recently confirmed as acute respiratory infections complicated by malaria and malnutrition.
Decades of conflict and displacement, weak health systems and environmental conditions, which are ideal for vector-borne diseases to thrive, can lead to more frequent outbreaks. Low levels of connectivity lead to delays in reporting, slowing down response times and providing opportunities for diseases to spread.
These challenges are further complicated by massive logistical hurdles.
DRC is the second-largest country in Africa, with a land mass similar to Western Europe, but with far fewer reliable road systems and transportation networks as well as incredibly challenging terrain.
To ramp up the country's response to outbreaks and stop them before they spread, the Global Fund, along with other partners, is investing in the Ministry of Health's efforts to digitize the national disease reporting and early alert systems.
Community Health Worker Bomela Malco (top) and supervising nurse Basoki Ipeke, (right) in Kimpoko, DRC. The system begins in communities with frontline health workers like Basoki Ipeke, Supervising Nurse in Kimpoko, a town 50 kilometers north of Kinshasa on the shore of the Congo River.
About 18 months ago, Ipeke was trained to use a digital application that compiles data on new cases of infectious disease collected by community health workers and clinics from across the Kimpoko health district.
Ipeke uses a mobile phone or tablet to collect, encode and transmit the data to provincial authorities, who combine it with data from other health districts before it is sent to national health authorities in the Early Alert Room.
This process is repeated in hundreds of health districts across the country.
"Since mpox began, we've had three suspected cases," says Ipeke. "As soon as community outreach workers see the symptoms, they come and alert me."
Ipeke then ensures the patient gets to a hospital, and he reports the new case through the digital system using his phone or tablet.
Community Health Worker Bomela Malco with one of the families he works with in Kimpoko, DRC. Before disease surveillance was digitized, Ipeke compiled the data on paper and brought it to authorities to review, compile and repeat.
"Before this system, we often experienced 2- to 3-weeklong delays in data feedback," says Nick Bibwangu, the consultant in charge of digitizing epidemiological surveillance at the Ministry of Health's Epidemiological Surveillance Department.
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With the digital system, data is transmitted with the click of a button.
"Epidemics don't wait. By digitizing, we are really on the frontline, ensuring early detection," says Bibwangu.
With support from the Global Fund, approximately half the of DRC's 518 health districts will share disease surveillance data digitally.
The team is working to digitize the entire country and enhance the system so data can be transmitted from community health workers or nurses directly to the experts in the Early Alert Room in just seconds.
But significant challenges remain: poor internet coverage, difficulties in getting mobile devices to health workers in remote and conflict-affected areas, and trouble convincing health workers to use new technologies and training them to do so correctly.
But the benefits are clear.
"By setting up this system, by detecting new disease cases early, by being on the frontline of an outbreak - we are meeting our objective of saving lives," says Bibwangu.
Written by Melanie Sharpe. Photos by Vincent Becker. With many thanks to the Democratic Republic of the Congo's Ministry of Health.
