DRC: Cholera spreads in Kwango province as access to safe water remains limited

Geneva, 13 October 2026 - While the Democratic Republic of Congo (DRC) faces an outbreak of Ebola virus disease in the east of the country, cholera continues to spread in other regions, where limited access to safe water and sanitation infrastructure is driving transmission.

Since June this year, a cholera outbreak has affected the Popokabaka health zone in DRC’s Kwango province. As of 22 July, 345 suspected cases and 21 deaths had been reported across 26 of the health zone’s 35 health areas, representing a case fatality rate of 6.1 per cent. Médecins Sans Frontières (MSF) is supporting the Ministry of Health’s response through patient care, epidemiological surveillance, and water, sanitation and hygiene activities.

The outbreak in Popokabaka was officially declared on 25 June, after the National Institute of Biomedical Research confirmed the presence of Vibrio cholerae. The three health areas in the provincial capital – Secteur Popo, Cité Popo 1 and Cité Popo 2 – accounted for 200 cases, or 58 per cent of all reported cases.

Given the risk of further spread, MSF deployed an emergency team to support the response at Popokabaka General Referral Hospital, where a cholera treatment centre has been established, as well as four treatment units and 31 oral rehydration points in affected communities. Since the beginning of the intervention, 450 patients have received care, including 175 at Popokabaka General Referral Hospital.

Treatment alone is not enough

Rapid treatment is essential to reduce deaths, but it is not enough to stop a cholera outbreak. In Popokabaka, limited access to safe water and inadequate sanitation continue to drive transmission. A significant proportion of the population relies on rivers for its daily water needs.

According to an MSF assessment, 61 per cent of the population has access to less than 15 litres of safe water per person per day — the minimum requirement in humanitarian emergencies, according to the World Health Organization. Only 38 per cent have access to functional latrines, while open defecation remains widespread.

“We can treat a patient with cholera, rehydrate them and save their life. But if, once they return home, they still do not have access to safe water or latrines, there is a very real risk that the disease will continue to spread,” says Dr Materne Cirimuanua, medical lead for the Popokabaka response.

The outbreak is unfolding in a fragile humanitarian context, marked by violence linked to the Mobondo crisis in western DRC, where intercommunal conflict has forced many people to flee their homes. This has been compounded by overlapping population movements, including the arrival of more than 2,000 Congolese people expelled from Angola.

As the rainy season approaches, heavy rainfall could further increase the risk of water-source contamination where sanitation infrastructure is inadequate and water sources are insufficiently protected.

To address this risk and improve access to safe water, MSF has established 36 chlorination points. However, these measures are not enough to meet the population’s needs. Additional efforts and better coordination ​ between the different organisations involved are needed to provide sustainable water, sanitation and hygiene solutions.

“The rainy season can make the situation even more difficult when water sources are not adequately protected and sanitation infrastructure is limited,” says Materne. “Action is needed now to reduce the risks, strengthen access to safe water and bring healthcare closer to the communities that need it.”

A response that must reach communities

Access to healthcare is another major challenge. The Popokabaka health zone has 35 health areas but only one general referral hospital. Some communities can only be reached by canoe, motorcycle or on foot, delaying access to care.

MSF’s emergency team is bringing care closer to worst-affected communities while supporting epidemiological surveillance to identify new hotspots. Community health workers and health promoters are also raising awareness of cholera prevention measures and good hygiene practices.

“In Popokabaka, MSF calls on the health authorities and other stakeholders involved in the response to strengthen their efforts to sustainably improve access to safe water and sanitation, thereby reducing the risk of new cholera outbreaks,” says Materne.