How conflict in Congo, Sudan and Yemen is fueling the spread of disease

Conflict in the Democratic Republic of the Congo (DRC), Sudan, and Yemen is intensifying the spread of infectious diseases, creating a dangerous synergy between warfare and public health crises. In eastern DRC, the emergence of the Bundibugyo strain of the Ebola virus has led to a rapidly escalating outbreak, exacerbated by ongoing violence and the displacement of hundreds of thousands of people. At the Kigonze camp, located on the outskirts of Bunia, 20,000 internally displaced persons (IDPs) live under dire conditions, facing severe shortages of clean water, sanitation facilities, and hygiene supplies. D’zirava Lety, one of the residents, described the bleakness of their situation: “There is no water. In the entire camp, there is only one tap. Another challenge is the lack of toilets. Children relieve themselves anywhere. With the disease that has arrived, we are being told to wash our hands, but there are no hygiene kits.” Camp officials confirmed that the Ebola virus was first detected in June among individuals who had died. Since then, the death toll has risen sharply, with up to six fatalities recorded daily. Étienne Ndrutsi, the camp chairman, noted the alarming rate of infection. According to experts, the Bundibugyo strain has circulated in the region since at least April, and the World Health Organization (WHO) declared a public health emergency shortly after the outbreak was identified in May. As of mid-July, the DRC reported 1,963 confirmed infections and 719 deaths, while neighboring Uganda saw 20 cases and two deaths. However, the WHO estimates that only half of all cases, and possibly as few as a quarter, are being detected, highlighting the extent of the hidden crisis. Ongoing armed conflict in eastern DRC is significantly impeding containment efforts. Displaced populations, including those in overcrowded camps or forced to migrate frequently, contribute to the rapid spread of the virus. Health workers and treatment centers operate under constant threat, as military forces and political factions interfere with medical operations. Juste Codjo, a security researcher, emphasized the need for stronger protections for healthcare infrastructure. He stated, “Health workers, treatment centers, laboratories, ambulances, medical supply routes must always be protected from military interference and political competition.” While international humanitarian law guarantees access to healthcare during armed conflicts, Codjo argued that these rights require active enforcement through dialogue with territorial controllers. This pattern of conflict-driven disease spread is not unique to the DRC. In Yemen, aid groups and government agencies have struggled for over a decade to combat recurrent cholera outbreaks, often hindered by restrictions on humanitarian access imposed by warring parties. Similarly, Sudan’s ongoing civil war has contributed to a deadly cholera epidemic, which has claimed more than 3,500 lives since 2024. These situations underscore how war disrupts essential services, weakens public health systems, and creates environments conducive to disease transmission. Historical precedents offer insights into mitigating such crises. During the civil war in El Salvador (1980–92), warring factions agreed to brief ceasefire periods to enable safe vaccination campaigns against childhood diseases. Such cooperation could provide a model for addressing current challenges in the DRC. Yet, despite growing calls for similar measures, efforts to secure temporary pauses in hostilities to address the Ebola outbreak have thus far failed to gain traction. The interplay between conflict and disease continues to shape the trajectory of public health emergencies. In eastern DRC, the combination of violence, displacement, and limited resources has created a perfect storm for the spread of Ebola. As the situation worsens, the urgent need for coordinated action, both locally and internationally, becomes increasingly apparent. Until these barriers are addressed, the risk of further escalation remains high.