IMPACT Initiatives

Since the outbreak was first detected in DRC, its spread has largely followed highly connected areas around the initial cluster in Ituri. REACH teams have updated their analysis and maps to reflect the rapid increase in confirmed cases and newly affected health zones.

Key takeaways:

🔴 While response efforts focus on affected areas, preparedness must be strengthened in neighbouring health zones with strong population movement links, through RCCE, community-based surveillance, and pre-positioned response capacity.

🔴 Preparedness should also factor in health system vulnerabilities, as areas with limited access to healthcare and higher levels of unmet health needs may face delays in detection and response. Further insights on facility readiness and response capacity will be shared through an upcoming REACH assessment.

🔴 Although efforts are rightly concentrated in Ituri and North Kivu, historical mobility patterns highlight several health zones in Haut-Uele as important areas for preparedness planning. Strengthening surveillance, contingency planning, and community engagement there will be essential to improve readiness.

🔗 Resources available via the links in the first comment.

🚨 REACH Alert: South Sudan & DRC

Recent public health rapid assessments have highlighted severe conditions in localized areas of South Sudan and the Democratic Republic of Congo—both already fragile contexts—underscoring the urgent need for large-scale expansion of health, nutrition, and sanitation services to prevent further loss of life.

• In Nyal Payam (Unity State, South Sudan) in February 2026, REACH teams conducted a small-scale public health rapid assessment in recently flood-affected communities. They assessed a crude mortality rate of 1.21 [95% CI: 0.694– 1.729] deaths per 10,000 people per day, indicating emergency-level conditions driven by preventable, non-traumatic causes, with diarrhea and dehydration accounting for a substantial proportion of deaths.

• In Aungba (Ituri Province, DRC), crude mortality rates were estimated at 0.77 [95% CI: 0.694– 1.729] deaths per 10,000 people per day, and an age-specific death rate for under-5-year-old children of 3.67 [95% CI: 1.96 – 5.37], very likely exceeding emergency thresholds. Large gaps in health and nutrition service provision likely contributed to the severity of the situation. This comes in a context of low vaccination coverage and prolonged disruption of nutrition services, and heightening vulnerability during the ongoing Ebola outbreak.

The results of these assessments are not standalone and represent the wider severity of public health conditions for many populations across South Sudan and DRC. The recent IPC AMN highlighted critical levels of acute malnutrition highlighted in the greater Unity state, and a novel Ebola outbreak originating in Ituri Province continues to expand.

In both contexts, immediate upscale of health, nutrition and sanitation services, integrated action is essential to prevent further loss of life and protect the most vulnerable.

Find more resources in the first comment below:

Who is best placed to define someone’s needs?

In a system facing growing humanitarian needs and shrinking resources, communities must be at the heart of how needs are understood, and acted upon.

This starts with the tools we use to collect data.

As part of a broader effort to reflect on its existing approaches, IMPACT Initiatives has spent the past few years exploring how to better assess the self-perceived needs of affected populations through the piloting of the World Health Organization (WHO)’s HESPER Scale (Humanitarian Emergency Settings Perceived Needs Scale) across more than eight crisis contexts since 2023. Focusing on 26 thematics, the HESPER scale enables households to report severe problems affecting various aspects of their lives.

In several contexts, communities’ defined priorities findings from this new tool have informed discussions with key stakeholders, helping challenge assumptions, reshape strategic conversations.

However, it is only one step forward on a much broader path that requires continuous consultation with affected communities, meaningful involvement of local partners in decision-making processes, and recognition of the solidarity systems that already support, or can help address, the challenges identified by communities.

🌐 To explore further on self-perceived needs and community challenges:

▪ Article "Rethinking Tools to Put Communities First": https://buff.ly/6KWRs3U

▪ “What is your most serious problem?” Lessons learned and reflections on the use of the HESPER Scale: https://buff.ly/8TabaOa

▪ “Who defines our needs” Aligning measured and perceived humanitarian needs: https://buff.ly/rVsozqC

▪ Read about the perception and measurement of humanitarian needs in Mali: https://buff.ly/E574aiQ

This project was supported by Sida - Styrelsen för Internationellt Utvecklingssamarbete.