COVID-19 Business in DRC: Rethinking Epidemic Responses
Over the past decade, the Democratic Republic of Congo has experienced several outbreaks, including cholera and Ebola. Yet, as with COVID-19, whose first case in the country was announced on March 10, 2020, the Congolese health system is still unable to cope with these epidemics today without significant financial support from external partners.
This has not prevented the government from creating several ad hoc structures, often budgetary, that are supposed to contribute to the fight against the spread of COVID-19. These include the multisectoral committee, the technical secretariat, the advisory board, the presidential task force, and the national solidarity fund against the coronavirus. This new report demonstrates how the multiplication of structures in the response to epidemics does not solve the problems raised by the previous responses: poor management of human and financial resources, poor circulation of information, and rivalries between actors.
Photo Credit: Kinshasa, RDC, mai 2020. Des membres du mouvement citoyen pour la démocratie Filimbi (« sifflet » en swahili) mènent une campagne d’information sur le coronavirus dans un marché de la capitale Kinshasa, RD Congo - © Justin Makangara.
In fact, far from being efficient, all these structures have considerably increased the budget of the response without improving its financial management. For example, out of 363 million dollars allocated in April 2020 by the International Monetary Fund (IMF) to mitigate the effects of the pandemic, the government has only been able to publish, on the Ministry of Health's website, some 40 documents justifying the use of approximately 6 million dollars. Again, this is essentially spending that does not comply with public financial management rules but was ordered by different actors: the presidency, ministers, governors, provincial health departments, hospitals.
This report also documents and analyzes several other concrete cases of alleged financial management abuse. These concern, for example, the “business” surrounding bonuses. The Ministry of Health and the Technical Secretariat refused or were unable to communicate to CRG either the number of staff or the amount of bonuses allocated to each category of response agents. These abuses also extend to the various issues of over-billing and opacity in the management of traveler test revenues.
Despite this, the government was able to conclude a three-year program with the IMF. The international financial institution is committed to paying $1.5 billion in instalments to the government, which must initiate structural reforms. This would be an opportunity to, among other things, redefine the advisory and control bodies, rationalize the organization of the health system in order to have, in the medium and long term, a sustainable system of response to epidemics with a clear operational plan.
[ Download the full research report: COVID-19 business in DRC: Rethinking the Response to Epidemics / COVID-19 Business en RDC: Repenser la riposte aux épidémies (French-only) ]