Malaria in the Democratic Republic of Congo: how support programs consolidate elimination gains and protect at-risk populations from recrudescence

Abstract

Malaria remains a significant public health challenge in the Democratic Republic of Congo (DR Congo), particularly among pregnant women and children under 5, who bear the highest burden of disease and mortality. Despite efforts to scale up control programs, the country faces numerous challenges, including limited healthcare access, inadequate funding, insecticide resistance, and gaps in surveillance. Vector control efforts are constrained by minimal government involvement and heavy reliance on international donors. Recent innovations, such as genomic surveillance, rapid diagnostic tests (RDTs), and mobile health (mHealth) solutions, offer new avenues for improving diagnosis, treatment, and data collection. Integrated approaches, such as incorporating malaria prevention into routine maternal and child healthcare, expanding access to vaccines like RTS,S and R21, and improving the distribution of long-lasting insecticidal nets (LLINs), are vital for sustaining control efforts. Community engagement and behavior change strategies are crucial to increasing uptake of preventive measures. Furthermore, climate change necessitates adaptable interventions to address shifting transmission patterns. Strengthening surveillance, training community health workers, and fostering public-private-philanthropic partnerships will enhance capacity for malaria control. Sustainable financing, policy reinforcement, and innovative tools are essential to prevent resurgence and protect vulnerable populations, ensuring progress toward malaria elimination in DR Congo. This review uniquely aims to address and consolidate evidence on pregnant women and young children in the DR Congo context, highlighting innovations and donor-dependence risks."