The Trump administration’s executive order to freeze U.S. foreign aid for 90 days has halted the supply of lifesaving medical care to populations facing rising conflict in eastern Democratic Republic of the Congo (DRC) including survivors of conflict-related sexual violence, said Physicians for Human Rights (PHR).
The order was issued as the M23 militia moves deeper into eastern DRC after taking Goma, the largest city and the capital of North Kivu, in January, further destabilizing the region’s dire humanitarian crisis. More than 500,000 people in North and South Kivu have been displaced due to the escalation of violence by armed groups, while health facilities have been subjected to indiscriminate shooting and bombing. There is an acute risk of further violence as M23 advances south in DRC and the United Nations has expressed concern about the significant increase of sexual violence. A rapid assessment of health care facilities in and around Goma conducted by the WHO found 45 cases of rape and gender-based violence reported among the displaced and 21 survivors of multiple-perpetrator rape admitted to medical facilities in recent days. The actual number of cases is likely much higher in light of barriers to reporting.
“Health facilities in eastern DRC are struggling as they try to provide health care in unimaginable conditions,” said Payal Shah, JD, PHR director of research, legal, and advocacy. “The United States pulled funding right when besieged communities in DRC needed international support the most. Health workers are risking their lives to address the rise in injuries, deaths, displacements, and cases of sexual violence. Now, they must do so without the vital support of foreign aid from the United States, which accounted for nearly 70 percent of humanitarian funding to DRC last year.”
PHR partner medical facilities and humanitarian organizations in the region reported a massive influx of cases of survivors of sexual violence in 2024, including children, who require specialized support. These facilities were already overburdened by mass displacements and the outbreak of infectious diseases including mpox.
HEAL Africa, a center for medical, psychosocial, and legal support for survivors of sexual violence in North Kivu, has been forced to halt critical projects related to the care of adult and child survivors of sexual violence, including the treatment of fistulas, specialized psychosocial care, and protection for child survivors. In places like Bulengo, an internally displaced persons camp in North Kivu, services like child-friendly spaces for younger survivors of sexual violence are at risk of being abandoned due to forced closure, attacks on health care facilities, and staffing shortages due to the U.S. aid freeze.
The funding freeze has also significantly impacted access to essential health supplies and resources, including blood bank reserves and post-exposure prophylaxis (PEP) kits for HIV. These kits, which are expensive and can be difficult to procure, are a key tool in post-rape care as they typically include prophylaxis medication and a copy of a medicolegal forensic form used by providers to collect forensic evidence and support justice processes for survivors. Many facilities will run out of supplies within days if financial support does not resume.
“For survivors, the lack of health care is compounding the trauma of sexual violence and leading to grave risks of lifelong debilitating health conditions. Urgent and coordinated action is needed on the part of international actors and all parties to the ongoing conflict to respond to this conflict, including to prevent violence and ensure care for survivors of sexual violence,” said Shah. “The U.S. government must use its influence to ensure all parties abide by international humanitarian law and it must end the 90-day freeze on foreign funding support, which is indispensable to the development, security, and facilitation of humanitarian aid in DRC.”
“All parties to the ongoing conflict in DRC must support safe access to resources via dedicated humanitarian corridors to enable the continued supply of essential medical supplies and services. Each day that goes by without funding for lifesaving health interventions as well as legal and psychosocial support is causing devastating, preventable harm for countless individuals in eastern DRC,” said Shah.
