Millions in Goma face an increased risk of infectious diseases as fighting disrupts vital health services. Picture: REUTERS/Arlette Bashizi

Fighting between Rwanda-backed rebels and the Congolese army has placed millions of people at high risk of death from the spread of disease, Africa’s chief health advisory body said.

The war - concentrated in Congo’s eastern city of Goma where 3 million people live - exponentially raises the risk of illnesses such as mpox, measles and cholera, according to the Africa Centres for Disease Control and Prevention. It’s also host to almost 1 million displaced citizens, the CDC said.

“Guns cannot kill all of us, but outbreaks can,” Africa CDC Director-General Jean Kaseya said in a briefing Thursday. “It’s not acceptable for us in Africa to still have this kind of open war.”

The fighting is complicating contact tracing, infection prevention and food access, all of which increase the risk of disease.

The World Food Programme has halted the distribution of basic nutrition in Goma because its staff safety isn’t guaranteed and the violence has cut off access to major roads and the airport.

“Food and water supplies are running very low,” Cynthia Jones, the WFP’s emergency coordinator in eastern Congo, said in an earlier briefing. “The next 24 hours are critical.”

The war is also straining the health system. “Hospital and medical services are overwhelmed by the number of injured individuals,” Jones said.

The conflict in eastern Congo has simmered since the mid-1990s in the aftermath of the Rwandan genocide. The current violence involves dozens of armed groups, fights over political and economic power, long-running ethnic tensions and troops from countries including Uganda, Burundi, South Africa, Tanzania and Malawi.

Outbreak Concerns

Among the groups that operate in eastern DRC are Hutu militias that have links to the perpetrators of the Rwandan genocide in which 800 000 mostly ethnic Tutsis died. They created an armed group known as the Democratic Forces for the Liberation of Rwanda, or FDLR, which is now allied with Congo’s army against the M23.

Kaseya’s tone was notably grave as he also talked about outbreaks in neighbouring African countries including mpox in Burundi, Marburg in Tanzania and Ebola in Uganda, where the virus killed a 32-year-old nurse on Jan. 29.

With the fatality rate for the haemorrhagic fever higher than mpox or even Marburg, there is an urgent need to act very quickly, Kaseya said. Of the 45 contacts being monitored, 34 are other health workers and 11 are family member. Vaccination of the contacts is being started urgently.

There have also been 12 suspected cases of Ebola in Congo, Kaseya said, with seven people having died. Authorities have taken samples from five of the deceased and sent them to the capital, Kinshasa, for testing.

“It’s time for us to take a strong decision as Africans and it’s time for us also to call upon our international partners to help Africans make this decision,” to stop fighting, he said.

As a health leader in Africa, Kaseya’s main concern is “an unexpected outbreak starting again from this region,” as it did with the new mpox variant last year. Africa CDC said while its mandate is to provide support in Goma, it simply can’t while the insecurity there persists.