Submission ID 131794
| Issue/Objective | Despite substantial investments in surveillance, laboratory systems, early warning mechanisms, and emergency responses, recurring epidemics continue to highlight a structural weakness in many health systems: these systems are often better equipped to respond to visible outbreaks than to address the underlying conditions that give rise to health risks. In the Democratic Republic of the Congo (DRC), our field experience has shown that disease control remains primarily reactive, top-down, and insufficiently informed by communities. This undermines both the system's resilience and health equity, particularly when prevention-related aspects and the voices of the communities most affected by risks are not genuinely integrated into decision-making. |
|---|---|
| Methodology/Approach | Through our research project," we conducted studies in six provinces of the DRC that highlighted the contribution of each health sector to the fight against emerging and re-emerging diseases at the "Human-Animal-Plant-Environment" interface. An analytical framework was developed and used for this purpose. Functions related to risk analysis, prevention, surveillance, preparedness, response, communication, research, and training were assessed in each health sector. Data on community participation, intersectoral coordination, and the contextual feasibility of decisions were collected through participatory approaches. Cross-analysis of these data revealed weaknesses in the system's ability to control diseases at the interface. |
| Results | Four recurring gaps emerged. First, risk analysis, prevention, training, and research were less structured and less visible than surveillance and response. Second, communities were rarely considered contributors to the analysis, despite their solid indigenous knowledge of risks, resilience, and what is actually feasible. Third, multisectoral approaches remained incomplete, with a marked dominance of human health in a context where most of the determinants center on animal-related, environmental, and socioeconomic aspects. Fourth, decision-making prioritized technical relevance at the expense of contextual feasibility, resulting in measures that were difficult to implement or sustain locally. |
| Discussion/Conclusion | Our data show that there is a need to build more resilient, community-informed, and equitable health systems by shifting the response to epidemics from a reactive approach to earlier risk management governance and by placing at the center the voices that are too often marginalized in health decision-making. |
| Presenters and Affiliations | Justin MASUMU National Institute for Biomedical Research Soledad Colombe ITM/Antwerp Stéphanie Maltais Université de Montreal Jean Jacques Muyembe-Tamfum National Institute for Biomedical Research |
