The Democratic Republic of the Congo is currently facing a large-scale Ebola outbreak. The Ministry of Health’s surveillance and response teams and their partners are mobilized to respond, with support from Bluesquare. This support builds on infrastructure developed over the long term, and on lessons from previous outbreaks. The work carried out during the Mpox outbreak is particularly useful today. To understand how this infrastructure was built and how it is evolving to support the response to the Ebola outbreak, we look back at this long-term effort.
In August 2024, the Democratic Republic of the Congo declared a nationwide Mpox outbreak. Unlike previous outbreaks, this one combined multiple challenges: zoonotic transmission from wildlife, accelerated human-to-human transmission, a lack of decentralized diagnostics, and data fragmentation between the Public Health Emergency Operations Center (COUSP) and other response actors (laboratories, routine surveillance, humanitarian actors). The DRC needed a data intelligence infrastructure able to support a complex, integrated, and sustainable response. Find out what actions were put in place.
Bluesquare joined as a technical partner alongside PATH, with funding from the Gates Foundation. The goal: to urgently build a integrated intelligence platform able to support the COUSP.
The approach was resolutely integrative. Rather than creating a Mpox-specific tool that would have added yet another silo, Bluesquare built a general-purpose infrastructure able to bring in data of different kinds.
DHIS2 handles the structured collection of suspected and confirmed cases, through a longitudinal flow: notification, investigation, laboratory, case management. OpenHEXA orchestrates the automated integration of INRB data (biological confirmation results, clades, genomic sequencing), decentralized laboratory data, case management registers, and contextual data such as climate or geographic data. A shared geographic registry (built via IASO), links the mapping of health facilities and health zones to epidemiological surveillance, enabling operational geolocation of cases and interventions.
This multi-standard architecture is at the heart of the One Health approach: linking the human dimension (confirmed cases, contacts), the laboratory (diagnosis, sequencing), space (zones, accessibility), and context (climate, demographics) within a single decision-making platform.
On this consolidated infrastructure, real-time dashboards continuously visualize the situation: geographic distribution of cases, transmission by age and exposure, changes in incidence over time by zone, and hotspot identification. Consolidated multi-source data is visualized and analyzed within a single tool, facilitating comparisons and multidimensional analysis of the crisis.
The project’s real strength does not lie in technology alone. Bluesquare worked in close collaboration with the Agence Nationale d’Ingénierie Clinique et du Numérique de la Santé (ANICNS) and the Division du Système National d’Information Sanitaire (DSNIS) to ensure the infrastructure fits within the national governance framework, meets security standards, and integrates with the Ministry of Health’s other health information systems.
In 2025, the Gates Foundation approved a second phase: the PaluTrack initiative, which extends and consolidates the infrastructure well beyond Mpox.
In the DRC, PaluTrack targets 3 main developments.
First, the advanced integration of early warning and molecular surveillance tools directly into OpenHEXA. This means a genomic sequencing result from the laboratory becomes immediately visible to the COUSP, enabling real-time monitoring of emerging clades and mutations.
Second, the development of a targeting algorithm designed to automatically identify hotspots of undifferentiated acute fever. Rather than waiting for a manual investigation, this algorithm cross-references clinically compatible case data, spatial data (geographic clustering), and exposure data to automatically recommend where response teams should focus their efforts.
Third, activation reports specific to the COUSP: rather than generic reports, the system generates action-oriented outputs. When activating a response to a newly emerging outbreak, it is essential to report on the emerging outbreak itself as well as on the resources available locally to respond to it, and on local population characteristics such as vaccination coverage or access to care. These activation reports can be generated automatically across different geographic zones, providing useful, actionable information for response teams.
The most structural innovation concerns the hosting and management of the platform. Bluesquare currently hosts the infrastructure. As part of PaluTrack, a migration to a local solution managed by the Congolese government is underway. This means that ANICNS and DSNIS will gradually take over the administration, maintenance, and evolution of the platform.
This transition is not simply a technical migration. It involves strengthening internal capacity: training national IT teams in OpenHEXA administration, certifying administrators, establishing support and maintenance procedures, and clarifying governance models. Bluesquare supports this process, but strategic and operational control passes to the Congolese government.
The stakes? Avoiding dependency. A surveillance infrastructure that is hosted locally and managed locally belongs to the country and can evolve according to its own priorities, independently of any external partner.
The platform relies entirely on open-source, highly interoperable technologies, which further strengthens digital sovereignty.
DHIS2 for structured data collection and longitudinal monitoring. OpenHEXA for data pipeline orchestration and automated integration. IASO for georegistry management and geospatial data. Power BI / Apache Superset for analytics dashboards. These tools interoperate through open standards (APIs, standardized data formats), meaning no component is locked in. At any time, the DRC can replace one tool or add another without rebuilding the entire system.
The DRC-Mpox project shows that surveillance of a complex crisis requires an infrastructure that is itself complex and integrated. But it also shows that this complexity can be managed if it rests on:
This infrastructure is constantly evolving, and is currently being enhanced and expanded to meet the specific needs of the Mpox outbreak.
For other complex outbreak contexts, the DRC model is replicable. Discover how this integrated infrastructure approach can support your own health emergency response through our One Health surveillance expertise.
