Why we exist

Solidarite, Sante & Nutrition exists to Improve the food and nutrition security of vulnerable populations in Bunia Health Zone, in particular people living with chronic diseases (HIV, diabetes, hypertension, tuberculosis),  the elderly, children under five years of age, and pregnant and lactating women, in order to reduce associated morbidity, malnutrition and mortality, while building community resilience in the face of food insecurity and recurrent humanitarian crises in Ituri.

We want to: 

1.  Strengthen the availability of and access to nutritious food for vulnerable households, particularly those affected by chronic diseases, malnutrition and poverty, while improving food security at the household level.

2. Improve the nutritional status of children under five, pregnant and lactating women, and the elderly, through targeted prevention, screening, nutritional management and improved access to quality health services.

3. Improve people's knowledge of the risks of malnutrition and good nutrition, hygiene and health practices at the community level, with a focus on preventive nutrition, health education and community monitoring.

4. Strengthen the capacities of health personnel, community relays and local structures in the integrated management of nutrition and chronic diseases, in order to ensure quality and sustainable care services.

5. Promote multi-sector coordination (health, agriculture, education, social protection) for a sustainable and integrated food and nutrition security response in the Bunia health zone, while consolidating support initiatives for vulnerable households.

Chronic diseases such as tuberculosis (TB), HIV/AIDS, diabetes, and cardiovascular disease, as well as the frailty associated with aging, constitute a heavy health burden. These people have specific nutritional needs, greater vulnerability to malnutrition, and require integrated care. Nutrition security and health education play a key role in:

Strengthen immunity and improve response to treatments (TB, HIV).

Prevent complications related to blood sugar imbalance (Diabetes).

Reduce cardiovascular risks through a healthy diet (heart disease).

Maintain independence and reduce undernutrition in the elderly.

(1) HIV/AIDS — situation, figures, and trends

Worldwide

• In 2023, an estimated 39.9 million people were living with HIV worldwide: ≈ 1.3 million new infections per year recently. AIDS-related mortality remains high despite the spread of antiretroviral treatment. Progress towards the 95-95-95 targets is uneven across regions. UNAIDS+1

Africa Region

• Africa is the most affected region in absolute numbers (a significant proportion of people living with HIV reside there). Recent trends show progress in access to ARVs but also risks related to the reduction of international funding (potential impact on cases and deaths). UNAIDS

DRC (national level)

• Estimated prevalence among adults 15–49 years: ≈ 0.7% (recent estimate, 2023). The estimated number of HIV-related deaths among adults in 2023: ≈ 7,800. The country has ARV programmes at the national level, but coverage remains uneven across areas and access is disrupted in crisis provinces. CDC

Ituri (province)

• Recent and comparable public provincial data are limited. Local studies and humanitarian reports show an increase in vulnerabilities (displacement, sexual violence) which increases the risk of infection and complicates access to ARV services. Academic studies and local reports document pockets of higher prevalence in Ituri Province, but there is no single, public, and recent standardized provincial surveillance series available in major international databases. PLOS

Trends / Implications

• Progress on expanding access to ARVs but financial fragility and local crises (conflicts, displacement) can reverse the gains; prevention (mother-child, screening) and continuity of treatment remain priorities. UNAIDS+1

2) Tuberculosis (TB)

Worldwide

• In 2023, the number of people falling ill with TB is about 10.8 million (WHO figures) with about 1.25 million deaths in 2023. The reduction in incidence between 2015 and 2023 is slow (well below the WHO targets), and TB remains one of the leading infectious causes of mortality. World Health Organization+1

Africa Region

• The African Region bears a significant share of the global TB burden (several million new cases annually). HIV–TB co-infection remains a major challenge in many areas. The treatment of resistant forms (MDR/RR-TB) is insufficiently covered. World Health Organization+1

DRC (national level)

• TB incidence estimates: about ~300–320 cases per 100,000 population (order of magnitude according to WHO/assessments reports), placing the DRC among the countries with a high TB burden. The exact number varies by year and by estimation method (under-reporting possible). National programmes are improving screening and treatment, but coverage is not uniform. tbassessment.stoptb.org+1

Ituri (province)

• Specific provincial data not published in major international databases. There are indications that the eastern provinces, exposed to displacement and the fragility of services, have greater difficulty in finding and treating cases (under-reporting, difficulty in accessing care). Local operational reports (ministry/NGO) are required to obtain provincial incidence/mortality. World Health Organization+1

Trends / Implications

• TB remains largely preventable and treatable, but the detection, follow-up and management of resistant forms are weak points. HIV/TB comorbidity and malnutrition (see below) increase risk and mortality.

3) Diabetes and hypertension/cardiovascular disease (CVD)

Global (Diabetes & CVD)

• Diabetes: According to the IDF, >589 million adults (20–79 years) are living with diabetes worldwide (recent estimates) and the number is growing rapidly. Diabetes has caused millions of deaths annually (several million per year according to 2023–2024). Diabetes Atlas

• Cardiovascular disease: CVDs remain the leading cause of death worldwide (≈ 17–20 million annual deaths according to the recent reference year), mostly due to heart attacks and strokes. Low/middle-income countries bear >75% of CVD deaths. World Health Organization+1

Africa Region

• The burden of noncommunicable diseases (including CVD and diabetes) is increasing due to urbanization, dietary changes, smoking, physical inactivity and exposure to risk factors (pollution, uncontrolled hypertension). Health systems often remain insufficient for long-term detection and monitoring. WHO | Regional Office for Africa+1

DRC (national level)

• Diabetes: IDF estimates ~2.86–2.9 million adults (20–79 years) living with diabetes in 2024 in DRC (estimated prevalence approximately 7.7% in adults according to IDF for 20–79 years). Many cases remain undiagnosed. Diabetes Atlas+1

• CVD: Studies and estimates show that CVDs account for a significant proportion of deaths and that the preparedness of health structures for care is low (readiness often <50% in many provinces). Local surveys (Kinshasa, Matadi) found that ~20% of observed deaths could be attributed to cardiovascular disease in some urban contexts studied. World Health Organization+1

Ituri (province)

• Detailed provincial data are missing from international databases. However, the combination of poor access to care, poverty, malnutrition, conflict-related stress and low availability of chronic follow-up services likely means: late diagnosis, poor control of hypertension/diabetes, and increased risk of cardiovascular complications. Provincial assessments are needed to quantify prevalence/incidence/mortality. Mailman School of Public Health+1

Trends / Implications

• CVDs and diabetes are on the rise in Africa and DRC; they require integration (screening, monitoring, education) into primary services, appropriate nutritional care, and a fight against the main risk factors (hypertension, obesity, tobacco, unhealthy diet).

4) Malnutrition — children <5 years and pregnant women (and link to chronic diseases)

Worldwide

• Despite progress in several countries, millions of children suffer from stunting and wasting. The global targets (WHA/SDG) to reduce malnutrition are not being achieved everywhere. Children <5 and pregnant women remain priority groups as malnutrition increases neonatal/child mortality and complicates recovery in the chronically ill. UNICEF DATA+1

Africa Region

• High stunting rate in several African countries (high regional average compared to the world). The use of exclusive breastfeeding, dietary diversification and access to nutritional services vary widely. Global Nutrition Report

DRC (national level)

• Stunting in children <5: ~41–43% (according to JME / Global Nutrition Profile).

• Wasting (acute wasting): ~6–8% (WED / UNICEF / Global Nutrition estimates).

• The DRC has very high levels of food insecurity (millions in crisis) and a large number of children at risk of acute nutritional insufficiency; pregnant and lactating women are also at risk (micronutrient deficiencies, low maternal weight). Global Nutrition Report+1

Ituri (province)

• Warning signs: Humanitarian reports (UNICEF, WFP) indicate that Ituri is among the provinces particularly affected by food insecurity related to conflict and displacement, with territories with high levels of malnutrition (some local assessments indicate very high rates of chronic and acute malnutrition in areas assessed). For example, the DRC 2024 humanitarian report mentions Kasai, Ituri and Tanganyika as highly affected provinces (areas up to ~45% of populations are food insecure according to local assessments). These assessments highlight a high riskof an increase in severe cases of malnutrition among children <5 and pregnant women. UNICEF+2World Food Programme+2

Trends / Implications

• Malnutrition increases vulnerability to infections (TB, HIV complications), reduces resilience to chronic diseases, and compromises the effectiveness of treatments (poor nutrition → poorer immune response). Targeted nutritional interventions (supplements, management of severe acute malnutrition, social protection) are critical, especially in conflict zones such as Ituri.

5) Frailty related to aging (elderly people)

General comments (global / Africa / DRC)

• The international literature notes that older adults are more susceptible to complications of chronic diseases, malnutrition and loss of independence. In a context with limited resources (such as several parts of the DRC), support services (geriatric care, adapted nutrition, management of comorbidities) are insufficient. Provincial quantitative data on "frailty" (frailty syndrome) are scarce; We often base ourselves on local studies and extrapolations. World Health Organization+1

Ituri

• No robust public provincial statistics on frailty. Nevertheless, local risk factors (malnutrition, uncontrolled chronic diseases, limited access to care, isolation, conflict-related damage) suggest a high prevalence of frailty and undernutrition among the elderly, with the need for support services and integrated care (nutrition + comorbidities). Targeted surveys would be needed to establish accurate figures. UNICEF+1

2. INTEGRATED SYNTHESIS — IMPLICATIONS FOR INTEGRATED MANAGEMENT (KEY MESSAGE)

1. The burden is double: the DRC (and particularly fragile provinces such as Ituri) is experiencing both a high burden of infections (TB, HIV) and the rise of noncommunicable diseases (diabetes, CVD) — all compounded by persistent malnutrition. These factors interact (e.g. malnutrition ↔, poorer response to TB/HIV treatment; diabetes ↔, risk of more severe infections). World Health Organization+1

2. Limited provincial data: For Ituri, there is a lack of detailed and regular public statistical series on TB/HIV/DIABETES/CDV; humanitarian reports and ad hoc studies are relied upon to estimate the situation. It is essential to strengthen provincial surveillance (screening, registries, nutritional surveys). World Health Organization+1

3. Priorities for action:

   • Integrate screening (TB, HIV, HYPERTENSION, diabetes) into front-line services and nutritional programs.

   • Strengthen food security and supplementation programmes for children <5 and pregnant women, as well as targeted nutritional management for TB/HIV/diabetes patients.

   • Implement continuity of care threads for the elderly and chronic patients (follow-up, medication, nutritional support).

   • Improve data collection and provincial surveillance (Ituri), to monitor incidence/prevalence/mortality and measure the impact of interventions. World Food Programme+1

Main sources consulted (selection)

• WHO — Global Tuberculosis Report 2024 / 2023. World Health Organization+1

• UNAIDS — Global AIDS Update / Data (2023–2024). UNAIDS+1

• CDC — DRC HIV & TB overview (pages pays CDC). CDC

• IDF Diabetes Atlas — profil et estimations pour la RDC (2024). Diabetes Atlas+1

• WHO / WHO-AFRO — Non-communicable diseases (NCD) factsheets and country profiles. World Health Organization+1

• Global Nutrition Report / UNICEF / JME / WFP — DRC NUTRITION PROFILES, HUMANITARIAN REPORTS MENTIONING Ituri (food insecurity, assessments). Global Nutrition Report+2UNICEF+2

• Local/academic articles and reports on HIV/TB and the quality of care in the DRC (published examples).

Epidemiological data collected from international sources (UNAIDS, WHO, IDF, UNICEF, WFP, MTaPS, ReliefWeb, PubMed, and MSF) reveal a heavy health burden in Ituri province, Democratic Republic of Congo (DRC). On the nutritional front, recent assessments indicate an alarming situation with an estimated 18,600 children treated for severe acute malnutrition (SAM) in 2024, according to UNICEF, highlighting the impact of ongoing humanitarian and food crises. TB remains highly endemic: the MTaPS program recorded 10,807 cases in 2020, and more than 13,000 cases were reported in 2024, confirming high community transmission despite screening efforts. Regarding HIV/AIDS, studies conducted in Bunia show fragile therapeutic adherence and high rates of viral non-suppression, linked to population displacement and insecurity. For noncommunicable diseases (diabetes and cardiovascular diseases), national data indicate about 2.86 to 2.9 million adults with diabetes (7.7% prevalence), but provincial data remain limited, suggesting likely underdiagnosis in Ituri. Finally, the frailty associated with ageing remains poorly documented, although the vulnerability of the elderly is accentuated by malnutrition and comorbidities. The majority of these indicators come from ad hoc reports or humanitarian evaluations, highlighting the urgency of ongoing and integrated provincial health surveillance, including nutrition, infectious and chronic diseases.

4. LOCAL EVIDENCE — ITURI / BUNIA

Condition

Statistics / data for Ituri / Bunia

Sources

HIV/AIDS

• Bunia has the highest HIV prevalence rate in the DRC among cities, with ≈ 7.1% of people testing HIV-positive. Bunia NEWS+2Bunia News+2
• In 2021, 1014 deaths attributed to HIV/AIDS in Ituri. ACP
• Cohort of patients on ARVs: in 2020, 20,933 people on treatment; in 2021 this number increased to 18,118, a loss of follow-up of 13.44% (~2,815 people not found). ACP
• In IDP sites in Nizi, Djugu territory: 337 HIV cases recently reported, of which ~26.65% were treatment-resistant cases. Bunia NEWS

Tuberculosis

• In 2023: 11,861 cases of tuberculosis reported in Ituri, including 1,211 children, with 332 deaths. Bunia News+1
• In 2022: 11,796 cases, up ~3% compared to 2021 (11,392 cases) — +404 more cases. ACP+1
• In 2024: ≈ 13,389 cases, with 343 deaths, entire province. Djugu and Bunia among the most affected areas. Actualite.cd
• In the central prison of Bunia (overcrowding): 45 cases detected between February and August in this institution. Actu30

Malnutrition

• In 2023: 47% of children under 5 years of age in Ituri suffer from chronic malnutrition, 5% from acute malnutrition. Radio Okapi
• Province: it is reported that in 2024 the prevalence of chronic malnutrition among children <5 and pregnant/lactating women is 52% (Ituri / Bunia) according to the National Nutrition Program. ituri.cd

Chronic diseases (diabetes, hypertension)

No publicly identified strong/recent data for Bunia/Ituri specifically regarding the prevalence of diabetes or hypertension or their local mortality. No specific figures were found in the sources reviewed.

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Interpretation (severity and implications)

• HIV in Bunia/Ituri has a very high local prevalence rate (~7.1%) — much higher than the national average — indicating a problem of active transmission, incomplete treatment/follow-up coverage, and resistance to treatment, exacerbated by displacement, insecurity, and breaks in the chain of care.

• Tuberculosis is on the rise: an increase in the number of cases each year, a significant number of deaths, children particularly affected, and some areas such as Djugu / Bunia concentrating many cases. Treatment success is mentioned elsewhere (~84%) but missing cases/late diagnosis remain a concern. Actualite.cd+27sur7+2

• Malnutrition, especially chronic malnutrition, affects almost half of children <5 years of age in the province — a very high rate. This suggests that malnutrition is chronic, widespread, linked to insecurity, access to food, living conditions — which weakens immunity, stunts development, and increases potential infant mortality.

• The lack of data on chronic diseases in Bunia/Ituri makes estimates uncertain, but comorbidities (HIV, TB, malnutrition) suggest that undiagnosed or poorly controlled diabetes/hypertension is a significant hidden risk.