Triple Burden in the Democratic Republic of Congo: Climate Change, Armed Conflict, and the Silent Spread of Arboviruses. A Narrative Review

Abstract

Background: The Democratic Republic of Congo (DRC) faces a “triple burden” of public health threats which includes climate change, protracted armed conflict, and the under-recognized spread of arboviral diseases. Arboviruses, such as dengue, chikungunya, Zika, and yellow fever, are transmitted by Aedes aegypti and Aedes albopictus mosquitoes. Certain factors, like environmental changes, population displacement, and inadequate vector control, have created conditions that favor sustained transmission.

Methods: The narrative review was conducted to compile evidence on factors influencing arbovirus spread in the DRC and to identify the priority causes of prevention. A comprehensive literature search was done in PubMed and Google Scholar for studies, NGO reports, and government documents published between 2019 and 2025 in French or English, focusing on human populations in the DRC or similar contexts.

Results: Key findings demonstrate that yellow fever remains endemic, with recurrent outbreaks and a case fatality rate of up to 21.3% in past years. Seroprevalence studies show significant dengue exposure (up to 41% in Kinshasa), multiple chikungunya epidemics which affected millions, and intermittent Zika virus exposure. On the other hand, adverse climate change alters vector ecology and increases transmission potential through drought, floods, rising temperatures, and deforestation. Armed conflict proved to play a major role in the large-scale displacement of people into overcrowded, unsanitary environments. This, as a result, disrupts the surveillance and control programmes and increases vulnerability to arboviruses.

Conclusion: The convergence of climate change, armed conflict, and arbovirus transmission poses a growing public health threat in the DRC. Strengthening integrated and reinforced surveillance, augmenting diagnostic capacity, applying sustainable vector control, and advocating climate and security considerations in health policy are essential and mandatory. Without coordinated and multidisciplinary action, the silent and hazardous spread of arboviruses will remain consistent to weaken and compromise health system resilience.

Summary:

• The Democratic Republic of Congo (DRC) confronts a triple health crisis facilitated by adverse climate change, ongoing armed conflict, and emerging arboviral infections.

• Climate change in the DRC is speeding up vector proliferation and extending transmission seasons, which in turn expands arbovirus-endemic zones.

• Ongoing armed conflict causes disruption in healthcare delivery and displacement of populations, increasing extreme vulnerability to infectious disease outbreaks.

• Arboviruses such as dengue, Zika, yellow fever, and chikungunya are often underdiagnosed due to limited laboratory capacity and overlap of symptomatic manifestations with malaria.

• In addition, climate-driven ecological and epidemiological shifts establish ideal conditions for silent arbovirus spread and contribute to risk for the human population.

• These problems can be eradicated by coordinated surveillance, aggressive vector control, and humanitarian-health integration, which are essential to break the cycle of vulnerability and unsafe situations.