As the world moves to fight Ebola, Africa must be made to pay a very high price - otherwise it is all useless

In Guinea, they murdered eight Ebola workers...such actions cannot just be explained away. Someone needs to give the people some tough love.

AFRICA cannot just get a pass on Ebola. Once the virus is overcome, the continent must be made to put its money where its mouth is on the disease.

But, first, the good news: Nigeria is expected to be declared Ebola-free on Monday, just three months after fears that the virus could spread like wildfire through Africa’s most populous nation.

The World Health Organisation (WHO) is preparing to announce that Nigeria has not had a confirmed case of Ebola for 42 days—or two incubation periods of 21 days—just as it did for Senegal on Friday.

But there were – rightly - warnings against any premature celebration, with complacency still a risk and luck considered to have played a part in containing the outbreak.

Meanwhile European foreign ministers will meet on Monday under pressure to scale up their response to the Ebola epidemic after warnings it could become the “disaster of our generation”.

Ahead of the talks, Aid agency Oxfam, which works in the two worst-hit countries—Liberia and Sierra Leone—issued a stark call for more troops, funding and medical staff to be sent to the West African epicentre of the outbreak.

“There is a very strong political focus on this as the most immediate crisis facing us,” a European diplomat said ahead of the meeting in Luxembourg.

“In the eye of a storm”

The worst-ever outbreak of the deadly virus has so far killed more than 4,500 people, mainly in Guinea, Liberia and Sierra Leone, but isolated cases have now begun to appear in Europe and the United States.

Oxfam chief executive Mark Goldring said the world was “in the eye of a storm” as the charity warned Ebola “could become the definitive humanitarian disaster of our generation”.

The World Bank has warned the battle is being lost against the disease, which spreads via contact with bodily fluids and for which there is no licensed treatment or vaccine.

A global UN appeal for nearly $1 billion to fight the spread of the disease has so far fallen short, although a spokesman told AFP more money was coming in daily.

Out of $988 million requested a month ago, the UN said Saturday $385.9 million had already been given by a slew of governments and agencies, with a further $225.8 million promised.

As the death toll in Sierra Leone rose to 1,200, the country said it was putting Defence Minister Alfred Paolo Conteh in charge of a new national Ebola response centre.

With panic spreading in Western countries fearing a spread of the tropical disease, US President Barack Obama named an “Ebola czar” to coordinate crisis response.

Obama also cautioned against “hysteria” after a string of Ebola false alarms among a US public spooked by the news that two American nurses had contracted Ebola after treating a Liberian patient who died on October 8.

Meanwhile, US media reported on overzealous action taken by some worried communities, including a group of Mississippi parents who pulled their children from school because the principal had travelled to Zambia—a southern African country far from the Ebola crisis in West Africa.

What has African done for itself?

It is commendable that Nigeria got on top of Ebola quickly, despite an under-funded and ill-equipped health system.

The reality is that the country was lucky, and won a geography lottery as far as Ebola goes. Nigeria does not share a border with Guinea, Sierra Leone, or Liberia, the worst-hit countries.

In addition, the Liberian who brought Ebola to Nigeria landed – and died – in the commercial capital Lagos. As it happens, for all its chaos, Lagos is generally a well-run state under the imaginative Governor Babatunde Fashola. The result might have been different if the virus had come into the country through some corrupt and inept governed state at the borders.

Institutionally, then, there is little to learn from the Nigerian success. The case of Senegal is statistically insignificant to bother about – it had only one case.

What is striking about this latest episode of Ebola is how little the continent has done, and how it exposed the shambolic state of health care in Africa. There was only one major African Union meeting on the Ebola crisis, and besides offering a few doctors, it hardly came up with a penny to help fight the virus.

Most of the money and doctors on the ground are coming from outside the continent – from the US, Europe, and in particularly large numbers, China and Cuba.

The more the world and continent open up, and travel increases, it is important to prepare for the next virus. It cannot be that a disease that breaks out in Africa, then becomes mostly the concern of the rest of the world, and not the continent itself.

Those who are criticising America and Europe for “not doing enough” to fight Ebola, should ask African leaders the same question; “what are African governments doing for themselves?”

It’s politics, not disease

In Liberia and Sierra Leone, corrupt soldiers and police took bribes to allow people walk through quarantine lines. In Liberia senior government leaders were too scared to return home from trips abroad, and had to be sacked by president Ellen Johnson Sirleaf. All this speaks to the fact that in most of Africa, disease is not always a medical problem – it is a governance one.

Also some uncomfortable questions need to be asked. In Guinea, villagers murdered eight health workers who had gone to educate them on Ebola. Yes, there was “superstition”, ignorance, fear at play, but it is not usual that medical workers are killed in Africa this way – even the continent’s murderous rebels mostly spare them. The Guinea incident has disappeared from the media. It shouldn’t.

The fact that medical workers can be lynched, is partly because medical services are alien in remote parts of Africa are often seen an “invasion”. Again, it is an indicator of the lack of services. But also it is not enough to excuse villagers for being ignorant and superstitious. These people, after all, vote. Even as illiterate citizens, they have a responsibility to the commonwealth – and someone needs to begin giving them some tough love.

In the 1980s and 1990s it was popular to hate the World Bank and IMF for “imposing” policies, austerity, and generally playing hardball with bankrupt African governments in exchange for aid and loans.

Controversial as they were, the best things that came from that period were the much-hated conditionalities; African governments were bullied to collect taxes, and set up professional institutions to do so, hence the various “Revenue Authorities”.

New health conditionalties

They were arm-twisted into reforming their financial sectors, to dismantle foreign exchange controls that fuelled a deleterious underground money market, and to fight inflation.

It is easy to forget, but the investments that many citizens have made in their home economies, the blossoming of enterprise that we see today, the inflows of foreign direct investment (FDI), all of which have partially contributed to the “Africa Rising” euphoria, were a result of very painful policy births.

Now the same must be done with Ebola. Countries like Liberia, Sierra Leone, and Guinea must accept far-reaching health care reform and make commitments to invest significantly in the sector in return for continued international help for them in fighting Ebola.

There is a need for new health conditionalties for the countries getting external money for their health sectors: Improve medical training; have nearly world class regional test labs; invest in medical research and monitoring; have mandatory stockpiles of gloves, face masks, and protective suits; create a crisis fund for things like Ebola. Otherwise, not a penny.

What is the use of Africa getting richer, if every few years there will an Ebola or something like it to kill people off and knock the wind of economies?  The state of health care in Africa, is atrocious and appalling. The time to act is now because, as the earlier battles against HIV/AIDS proved, African governments will accept to take those measures only in the face of great peril.


•Additional reporting AFP.

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