In the Democratic

Republic of Congo

CONTRIBUTIONS TO ITS
ECONOMIC DEVELOPMENT
Who is WHO?
• World Health Organization or WHO
began when our Constitution came
into force on 7 April 1948 – a date
we now celebrate every year as
World Health Day.
• a 
specialized agency of the United N
ations
 responsible for international 
public health. The WHO
Constitution, which establishes the
agency's governing structure and
principles, states its main
objective as ensuring "the
attainment by all peoples of the
highest possible level of health
What we do

• Our primary role is to direct

and coordinate
international health within
the United Nations system.
• Our main areas of work are
health systems; health
through the life-course;
noncommunicable and
communicable diseases;
preparedness, surveillance
and response; and
corporate services.
DEMOCRATIC
REPUBLIC OF CONGO
• Congo is a country located in 
Central Africa. It was formerly
called Zaire (1971–1997). It is, by
area, the largest country in 
sub-Saharan Africa, the second-
largest in all of Africa (after Algeria
), and the 11th-largest in the world
. With a population of over 84
million, the Democratic Republic of
the Congo is the most populous 
officially Francophone country, the
fourth-most-populous country in
Africa, and the 
16th-most-populous country in the
world
.
Statistics

• Total population (2016)

• 78,736,000
• Gross national income per capita (PPP
international $, 2013)
• 680
• Life expectancy at birth m/f (years, 2016)
• 59/62
• Probability of dying under five (per 1 000 live
births, 2018)
• 88
• Probability of dying between 15- and 60-years m/f
(per 1 000 population, 2016)
• 281/232
• Total expenditure on health per capita (Intl $,
2014)
• 32
• Total expenditure on health as % of GDP (2014)
• 4.3
• Latest data available from the 
Global Health Observatory
WHO action
• In the Democratic Republic of the
Congo, WHO works with the
government and partners to make
sure more and more people can
reach doctors and health centers.
WHO helps to prevent and manage
diseases such as malaria, polio and
other communicable diseases. WHO
ensures the many partners working
in health are addressing the most
urgent health needs of the people.
WHO is helping the Democratic
Republic of the Congo to transition
from a crisis country to one where
the people can support themselves.
WHO support countries as they
coordinate the efforts of
governments and partners –
including bi- and multilaterals,
funds and foundations, civil
society organizations and the
private sector.

Working together, we attain health

objectives by supporting national
health policies and strategies.

Now, let’s delve more on how

WHO works with Congo in battling
the Ebola virus.
Ebola Virus
• Ebola virus disease (EVD), formerly known as
Ebola hemorrhagic fever, is a rare but severe,
often fatal illness in humans.
• The virus is transmitted to people from wild
animals and spreads in the human population
through human-to-human transmission.
• The average EVD case fatality rate is around
50%. Case fatality rates have varied from 25%
to 90% in past outbreaks.
• Community engagement is key to successfully
controlling outbreaks.
• There are five identified subtypes of Ebola
virus. The subtypes have been named after the
location where they have been first detected.
Three of the five subtypes have been associated
with large Ebola hemorrhagic fever (EHF)
outbreaks in Africa. Ebola–Zaire, Ebola–Sudan
and Ebola–Bundibugyo. EHF is a febrile
hemorrhagic illness which causes death in 25–
90% of all cases.
Countermeasure
s and Prevention
• Good outbreak control relies on applying a package of
interventions, namely case management, infection
prevention and control practices, surveillance and
contact tracing, a good laboratory service, safe and
dignified burials and social mobilization.
• Vaccines to protect against Ebola are under
development and have been used to help control the
spread of Ebola outbreaks in Guinea and in the
Democratic Republic of the Congo (DRC).

• Early supportive care with rehydration, symptomatic

treatment improves survival. There is no licensed
treatment proven to neutralize the virus but a range of
blood, immunological and drug therapies are under
development.

• Pregnant and breastfeeding women with Ebola should

be offered early supportive care. Likewise vaccine
prevention and experimental treatment should be
offered under the same conditions as for non-pregnant
population.
WHO response
• WHO aims to prevent Ebola outbreaks by
maintaining surveillance for Ebola virus
disease and supporting at-risk countries to
develop preparedness plans.

• When an outbreak is detected WHO responds

by supporting community engagement, disease
detection, contact tracing, vaccination, case
management, laboratory services, infection
control, logistics, and training and assistance
with safe and dignified burial practices.

• WHO and partners are supporting the Ministry

of Health in all aspects of the response,
including epidemiological investigation,
surveillance, logistics and supplies,
communications and community engagement.
Latest Response
of WHO
• The public health response pillar (Pillar 1) of the
fourth Strategic Response Plan (SRP-4) for the
Ebola virus disease outbreak in the provinces of
North Kivu and Ituri seeks to take into account
the new strategy to scale-up the response in
order to interrupt the epidemic. It focuses on
the following:
• Detection and rapid isolation of cases;
• Intensification of rapid multidisciplinary public
health actions around any confirmed case;
• Strengthening community engagement;
• Strengthening the health system and effective
coordination of the activities of local and
international partners;
• Synergies between public health activities and
those of the security, humanitarian, financial
and operational readinss sectors, and
operational readiness of neighboring countries,
to create an enabling environment for the
response.
WHO’s
Assistance
• On 10 May 2017, a multidisciplinary team
led by the Ministry of Health (MoH) and
supported by WHO and partners was
deployed to the field to reach the affected
area on 13 May 2017 to conduct an in
depth field investigation.
• Personal Protective Equipment (PPE) for
health care workers has been shipped on
12 May 2017 to Kisangani. Additional kits
are currently being prepared and will be
shipped as soon as available.
• WHO provided assistance and technical
support. Deployment to DRC of an
additional WHO multidisciplinary team to
support the response of national
authorities.
• The Global Outbreak Alert and Response
Network (GOARN) has been activated to
provide additional support if required.
WHO to DRC
• Intensify surveillance activities and investigation of
recently reported cases including potential nosocomial
infections.  
• Expand use of vaccine in high risk populations, as
vaccination is the best public health tool to prevent
and control the spread of EVD. 
• Continue to strengthen the EVD infrastructure (i.e.
primary health care, risk communications and
community engagement systems such as community
action cells, surveillance systems including at points
of entry, and alert management levels).
• Reinforce messaging with communities regarding the
potential for resurgence and the need for sustained
community engagement in reporting of alerts. 
• Remain vigilant against EVD while strengthening the
focus on routine immunization programs as well as
other vaccine preventable diseases (i.e. measles and
polio).
• Over 80,000 people have been vaccinated
and over 400 have received treatment.
Thousands of suspect cases have been
monitored, tested and transferred to other
centers once they were confirmed to not have
Ebola. More than 40,000 contacts have been
identified and reached daily for three weeks
each to ensure they did not fall sick as well.
WHO alone has shipped over 300 metric
tons of supplies, including vaccination
supplies and 470,000 sets of personal
protective equipment for partners
running treatment centers.
• Alongside the response in the country,
hundreds of health workers, border officers
and other responders in neighboring countries
have been trained and prepared for a
responding to a potential case.
How WHO impacts the
economy of DRC
directly and indirectly
• WHO is partnering with different agencies and
groups had a Strategic Preparedness and Response
Project aims to boost the capacity of the
government of the DRC to prepare for and combat
the Ebola Virus Disease (EVD), while focusing on
critical provinces to contain the epidemic.

• This immediate response includes financing, policy

advice and technical assistance to help countries
cope with the health and economic impacts of the
epidemic.

• WHO has undertaken a concerted effort to quantify

and analyze exactly what is happening in the
country – a painstaking task which is an essential
part of any coherent response to a crisis.

• Thus, with WHO’s effort, active promotions and

engagements to DRC it boosts their health systems
and inwardly boosts their finance and economy
aspects.
CONCLUSIONS AND
LESSONS LEARNT
• The Democratic Republic of the Congo Government formulated
a comprehensive health system strengthening strategy (HSSS)
in 2005 as a wide-ranging reform package under its strategy for
growth and poverty reduction. The HSSS was a key element in
reclaiming political leadership and governance of the health
sector. External technical and financial partners aligned
themselves with the HSSS strategy in 2006. This triggered a
dynamic of change on the ground that enjoys growing support,
including in the political arena outside the health sector. The
reforms guided by the HSSS helped improve efficiency and
effectiveness in the health sector, generating better health with
the available financial resources. The reforms, which are still
being implemented, target health financing; partner and sector
coordination; service delivery at district level; public financing
and government ownership of the sector strategy; the
pharmaceutical sector; and the organic framework of the
Ministry. Key in sustaining the reforms has been the
establishment of a set of transitional structures: a management
support unit to replace the multiple and fragmented
coordination structures; a common procedure manual agreed
upon by government, domestic and international partners; and
a fiduciary agency with a country-wide network to manage
health sector donor funds. This is estimated to have saved US$
56 million between 2009and 2014
CONCLUSIONS AND
LESSONS LEARNT
• Reforms of the processes and systems for sector planning reduced
the myriad of annual plans to a single multi-donor annual
operational plan for each level and structure of the health system.
It increased transparency in the management and allocation of
resources and reduced duplication. Greater transparency and
planning security enabled some provinces to increase their
available operational budget by 30%. The reform of health
services at district level is part of a wider effort to revitalize
primary health care in the country. In this way, the health district
is the implementation unit of the sector strategy, the district
hospital is the central structure for the organization of care, and a
network of integrated health centres serve as firstcontact and
entry points into the care system. These reforms are also allowing
the defragmentation of services provided at the health district
level, and are having an impact on all other levels of the health
system. The public finance reform allowed the Government to
make substantial savings on wages by eliminating double
payments and payments to fictitious employees. The resources
made available were invested in health infrastructure and
equipment. Government investment in the public procurement
and supply system for generic and essential medicines (SNAME) –
and its increased use by international development partners – has
reduced the number of parallel supply channels and improved the
availability of medicines in peripheral health facilities. The
proportion of health districts supplied by the regional distribution
centres of SNAME increased rapidly from 28% in 2005 to 75% in
2013, while its business volume grew from US$ 11 million in 2012
to an estimated US$ 25 million in 2014.
CONCLUSIONS AND
LESSONS LEARNT
• Numerous challenges remain to improve efficiency and the
effective use of resources. Some commitments by health partners
to aid alignment remain declarations of intent. Several technical
and financial partners are still reluctant to align with the health
financing reform, either because their governments have not yet 6
CONCLUSIONS AND LESSONS LEARNT 29 DEMOCRATIC REPUBLIC
OF THE CONGO. IMPROVING AID COORDINATION IN THE HEALTH
SECTOR approved the guidelines, or because they expect further
progress on the current reforms. Efforts to align the Country
Coordination Mechanism of the Global Fund with the unified sector
coordination committee are at a standstill. This situation continues
to duplicate resource allocation in the sector. Appropriation of the
strategy by government structures beyond the health sector, in
particular by the Ministry of Finance, has accelerated in recent
years. The next step is to use the medium-term expenditure
frameworks to orient the health sector budget towards supporting
the HSSS. There is major potential for improving efficiency and the
effectiveness use of domestic resources and international
assistance for health. The Government must increasingly fund the
health sector strategy from domestic resources, which would
accelerate the alignment of technical and financial partners with
the health reforms. All stakeholders – including the Global Fund –
must agree on a road map to unify coordination mechanisms at
national level. The stakeholders at central level – national and
international – should draw lessons from the way the
comprehensive policy dialogue at district level has improved
operations. This would make the national policy dialogue between
government structures, civil society organizations and international
partners more relevant, and their agreed actions more effective.
CONCLUSIONS AND
LESSONS LEARNT
• Recapitulating efforts over the last 10 to 15 years shows that
the inefficiencies created by the collapse of the health system in
the DRC were interlinked and complex. It also shows how
diverse the responses had to be. It is easy to become swamped
by the details of specific measures, and tempting to imagine a
single, magic solution might exist. Fortunately, the complexity
of the situation and its solutions was accepted, as was the need
to maintain a sense of direction and a comprehensive approach
throughout. With hindsight, two factors seem to have been
critical in maintaining coherent responses and achieving results
that, though modest, were difficult to imagine in the plight of
the country in 2005. First, the health authorities, within and
beyond the MOH, had a comprehensive vision and strategy for
the sector – not just in technical terms, but also in terms of how
to collaborate with international development partners. It is with
reference to this strategy that specific measures, institutions
and mechanisms could be tested, improved, redesigned and
adapted as circumstances changed and new constraints were
confronted. Second, stable leadership and growing domestic
consensus on the direction the reform should take have been
crucial. This continuity built the level of trust required for
partners of the DRC to agree to align with the national health
sector. Without ownership of its own strategy and continuity in
its implementation, the Government would not have been able
to lead an effective policy dialogue on alignment of international
development assistance. Other countries that have undergone a
collapse of state may be able to identify with and emulate the
health financing experiences of the DRC.
GROUP MEMBERS

• Cudiamat, Chrysel Joy

• Dela Cruz, Cyrus Jancel G.
• Estrada, Eurich G.
• Lachica, Mary Joyce
• Palpal, Ivy Clayn l.
• Segundo, Almera