MSF DRC: Children at risk as measles spreads amid insecurity and access challenges

Early 2025 – between the months of February and June, MSF teams launched emergency responses to outbreaks in the provinces of Ituri, Tshopo, Nord-Ubangi, Maniema, Sankuru, and Grand Katanga. The activities included the treatment of patients and the vaccination of children, efforts that helped to interrupt transmission and prevent complications such as pneumonia, brain inflammation, and blindness. They also reduced deaths from the disease.

A few months later, faced with the emergence of new outbreaks in North and South Kivu, South Ubangi, Haut-Lomami, and Tanganyika, MSF teams rapidly scaled up ongoing activities to additional provinces.

Bokolo Bayibongo, the chief of Bolingo village in the territory of Budjala, South Ubangi, witnessed the worst in his community, where an MSF team recently intervened.

He says, “ Measeles has claimed the lives of many children. Here, many suffered, and the situation was extremely serious.”

MSF vaccination campaigns also included assessing children’s nutritional status, vitamin A supplementation, deworming, and preventative multi-enhanced antigen campaigns. Between January and December 2025, the teams treated approximately 20,870 patients and vaccinated 1,146,810 children. In total, 22 measles response interventions were carried out during this period. The efforts are continuing at the beginning of 2026.

Why Measles Persists in the DRC

Measles can be almost entirely prevented with a vaccine given in two doses. However, ensuring maximum vaccination coverage at the community level is critical for efficacy and for preventing outbreaks. This requires adequate investments in routine immunization, surveillance, well-organized vaccination campaigns to reach children who missed their routine vaccines —resources the country currently lacks.

The DRC has limited health system capacity due to chronic underfunding by the government, which in turn weakens monitoring systems, contributes to low immunization coverage, and creates access barriers, leaving the country without the necessary means to prevent epidemics. Facilities, on the other hand, often lack electricity for vaccine storage, trained staff, syringes, cold boxes, and basic medical supplies.

“The response means having trained staff on hand, yet many are in short supply; maintaining surveillance and vaccination campaigns, which is difficult across DRC’s vast geography; and having the

basic resources to deliver vaccines safely and effectively—all of which are often lacking,” says Dr. Jean Gilbert, MSF’s medical coordinator in the DRC.

On the other hand, geography, weak road and transport infrastructure, and ongoing crises complicate the roll-out of vaccination campaigns. Many communities are reachable only by canoe or on foot through dense forests. Long distances, transportation costs, and occasional consultation fees also discourages vaccination for the parents. Added to this are religious beliefs and cultures against vaccination, misinformation and inadequate available information on vaccination and efficacy also can contribute to vaccine hesitancy and skepticism.

For parents like Mathieu, whom his 3-year-old son was treated for measles in Budjala in South Ubangi, support from humanitarian and medical teams can make all the difference. "The care is free; they even reimbursed the transport for the driver who brought us here. It is thanks to their [MSF’s] presence on the ground and their intervention that we have observed some positive changes” he explains.

All of this is taking place as cuts in humanitarian and development funding and global health financing is limiting the availability of essential vaccines and supplies. In 2025, only 20 per cent of the humanitarian response plan had been funded, with the health and water and sanitation sectors among the most affected.

"While MSF is still able to respond quickly, this is largely due to its independent funding model, based mainly on regular private donations. This is no longer the case for the humanitarian ecosystem as a whole, which has been hit hard by drastic budget cuts. The resources available to prevent and respond to measles are already sorely inadequate, the reduction in humanitarian funding is weakening the entire response chain, leaving thousands of children in the DRC unprotected against a disease that is preventable," warns Dr. Jean Gilbert Ndong, MSF medical coordinator in DRC.

Eastern DRC: Conflict and Displacement Exacerbate Outbreaks

The situation is particularly severe in eastern DRC, where decades of armed conflict—most recently intensified between the Congolese army and the AFC/M23 alliance and their respective allies—have worsened insecurity, population displacement, and access to health services.

Displacement disrupts the children’s vaccination schedules, as they are unable to return to health centers to receive follow-up doses. Crowded, poor conditions can increase the risk of poor health outcomes and outbreaks. Faced with poverty and accumulated vulnerability, they often lack the means to get their children's medical care. In Katoyi, in the Masisi territory, North Kivu, MSF recently completed a measles response. A mother of two, Rebecca Shukuru brought her children to be vaccinated during an MSF campaign in the Kirotshe health zone after seeing the devastating impact measles had on her community.

“When I saw the effects of measles on my neighbours' children, I was afraid for my family, because it is not only contagious but also deadly,” explains Rebecca. “Thanks to community relays, I was able to have my children vaccinated, and they also received antimalarials and vitamin A, which was very helpful.”

“Movement of people caused by ongoing fighting creates a breeding ground for continued transmission and rapid spread of the disease between regions,” says Dr. Ndong. “People living in collective shelters, often with limited access to clean water and sanitation, are particularly at risk.”

Insecurity—including unsafe roads, sporadic clashes, and active fighting in frontline areas—often makes it extremely challenging to deliver vaccines where they are most needed and to carry out immunization campaigns on time. Delays caused by security constraints allow the virus more time to spread, making outbreaks harder to contain and increasing the risk for children before teams can respond.

Logistical constraints and funding shortfalls are also playing a role in the delivery of vaccines and medical supplies in eastern DRC. Restrictions on humanitarian operations at Bukavu and Goma airports mean shipments from Kinshasa to some areas in east DRC must take longer, more expensive routes, delaying deliveries and stretching already limited resources.

“Even when supplies are available, getting them to where they are needed has become far more complex and costly,” explains Dr. Ndong. “Longer transport routes to some areas—where it used to take a few days now take more than a month during the rainy season—higher costs, with cargo prices fourfold higher than before, resulting in delays directly and affecting our ability to respond quickly to outbreaks.”

Health authorities and organizations, including MSF, are working to replenish supplies, but doing so now requires far greater logistical and financial resources—at a time when humanitarian funding is sharply reduced and government spending on healthcare remains insufficient.

“Continued collaboration and support are vital to safeguarding children from measles. We encourage the authorities, partners, and communities to work together to strengthen vaccination efforts, reinforce health systems, and ensure that essential care reaches every child in need,” concludes Dr. Ndong.