Fighting escalated sharply in late January, as Rwanda-backed M23 rebels seized control of parts of North Kivu, including areas near the regional capital Goma, and advanced towards South Kivu.

Before the latest violence, mpox cases had been stabilizing, said WHO Director-General Tedros Adhanom Ghebreyesus, in a speech to the agency’s executive board.

Health system overwhelmed

Healthcare facilities are struggling to cope with a surge in casualties, alongside patients suffering from multiple endemic diseases, including mpox, cholera, malaria and measles.

WHO reported that shells hit a hospital in Goma, resulting in civilian casualties, including infants and pregnant women. Stocks of essential medicines in Minova (South Kivu) are rapidly depleting since M23 rebels took control of the city.

The agency said health partners are doing “everything possible” to provide lifesaving services “despite the risks posed by heavy artillery and the proximity of frontline fighting.”

Concerns over attacks on civilians, sexual violence, and other human rights violations have also reached alarming levels.

IDPs at risk, again

Ongoing clashes also threatens hundreds of thousands of internally displaced people (IDPs) sheltering in Goma, along with the aid workers supporting them.

“Thousands of displaced people sheltering close to Goma have had to flee for safety as heavy bombing and shelling struck close to the camps due to the proximity of military installations,” the UN World Food Programme (WFP) reported.

Many displaced families are now staying with host communities, while others are setting up temporary shelters in schools and public buildings. Host communities themselves could face “significant humanitarian needs”.

Infrastructure hit

The violence has severely damaged essential infrastructure, including water, electricity, and communication networks.

In Goma, water and electricity remain cut off and people are forced to rely on unsafe water, increasing risk of disease outbreaks. Telecommunications (phones) and Internet access is also disrupted.

Public and private property – including WFP and non-governmental organization-run warehouses – have been looted.

“Coupled with severed access to the city, food and other essential supplies are almost depleted,” WFP said, adding that scarcity has driven prices up, making it even harder for vulnerable communities to afford basic necessities.

Hard-won development gains at risk

In addition to threatening the safety and wellbeing of millions, the fighting has put years of hard-won development gains at risk.

Achim Steiner, Administrator of the UN Development Programme (UNDP) underscored that it is not just a humanitarian emergency but a development crisis jeopardizing progress toward the Sustainable Development Goals (SDGs).

“Every day the conflict continues, access to education and healthcare is disrupted, businesses collapse, and vital infrastructure is damaged – deepening hardship for communities and eroding the foundation for long-term recovery, resilience and sustainable development,” he said in a statement on Sunday.

“I call on all actors to prioritize dialogue, uphold international humanitarian law, and pursue a peaceful resolution to this crisis,” he added.