The Ebola epidemic which has killed scores of people in West Africa is spotlighting weaknesses in leadership, health systems and the continent’s response, writes Chris Maxon.
‘A healthy population is a necessary catalyst for economic and social development. As Southern Africa improves industrial capacity and economy, the health of its citizens remains paramount in ensuring a sustainable future,” reads the Southern African Development Community (SADC) Health Programme document. However, the recent outbreak of the Ebola virus in the west African countries has exposed poor or lack of leadership between countries in Africa, which will prove harmful to innocent and poor populations.
Just like the Western leaders, some African leaders have made “almost zero” response to the Ebola outbreak, with many more interested in protecting their own countries than helping contain the crisis that has now claimed more than 1 200 lives.
While we cannot downplay the call by President Jacob Zuma, speaking at a panel discussion during the US-African business forum in Washington DC, when he said; “Let us see Ebola as a disease affecting humanity, rather than looking at it as an African problem,” we cannot ignore Tanzanian President, Jakaya Kikwete, who was clear to point out that Ebola was a disease affecting the west of Africa, and Tanzania was in the east.
The outbreak began in March in Guinea. And,
interestingly with Ebola, there is knowledge on how to stop it. Find patients, isolate and care for them; find their contacts; educate people; and strictly follow infection control in hospitals. If we do those things with care, Ebola goes away.
We must be clear to declare that the magnitude of the Ebola epidemic is unprecedented. The continent has never had an Ebola outbreak with so many people contracting the virus in so many different countries at the same time and in such high numbers.
The other particular issue about this epidemic is it has reached urban areas at quicker speed, whereas in the past it’s always been in isolated, remote, rural areas. This is what makes it different, and this is what makes it much more concerning as well.
In 1996 for example, South Africa had cases of this disease which were traced to a medical professional who had travelled from Gabon to Johannesburg after having treated Ebola virus-infected patients and thus having been exposed. He was hospitalised, and a nurse who took care of him became infected and died. In the same year Gabon reported 97 cases with 66 deaths.
The continent, and its regions, has thus never had such a large outbreak and that is where weaknesses are emerging. It needs no Pythagoras to know that many of the affected countries have fragile health-care systems and weak governments and no experience in fighting the disease. Panic, suspicion and fear have overrun concerns that could best be addressed in concerted manner.
What has been lacking since the beginning is an entity or body that will somehow portray themselves as co-ordinating leadership and the response to the Ebola epidemic. The truth is affected governments are trying to do their best, but the reality is they don’t have the capacity. They don’t have the experience.
In the space where a united voice is lacking, space is created for unscrupulous multinationals to consider using the continent as a testing laboratory and its people as guinea pigs.
Not long after three Westerners received the experimental Canadian drug Zmapp, reports of untested drugs and vaccines immediately being brought to the continent came in the spotlight. The Canadian government also announced it would donate up to 1 000 doses of a potential Ebola vaccine that is in the development stage.
We cannot forget that in Nigeria in 1996, when a meningitis epidemic was under way, the American pharmaceutical company Pfizer arrived in the hot zone in Kano.
Its representatives immediately set up their clinic next to the make-shift tents of a hospital then staffed mostly by Doctors Without Borders. Meningitis, an inflammation in a membrane surrounding the brain or spinal cord, affects mostly children, and without treatment, about half of those infected will die.
Pfizer had a new treatment that it wanted to test, so its doctors gave Trovan (floxacin) to about half the 200 children they treated, while the other half received an approved drug for meningitis. About 5 percent of the patients taking the experimental Trovan died, while some others were left blind, deaf and/or paralysed.
In the aftermath, the US Food and Drug Administration refused to approve Trovan, hundreds of Nigerian parents sued Pfizer and the company eventually settled in 2009.
Pfizer claimed to have had permission from the local hospital to conduct its experiment, but the approval letter was said to be a forgery. Pfizer claimed it had informed consent from the patients’ families but could not provide written proof.
It is a known reality that people in the West often talk about the Africans as if we are only beneficiaries. They forget that because of the huge risks patients here undergo, our people are actually delivering an enormous financial boon.
The pharmaceutical industry conducts two out of five clinical trials in the developing world because they can do higher quality trials more cheaply and more quickly here, and they save a great deal of money by testing drugs on our people. They owe us an immense debt and here’s a chance to help pay us back. But with lack of leadership we remain vulnerable to the villains.
However, it’s also worth noting that despite the lack of tested and working treatment being available, the fundamental problem is the lack of public health infrastructure on the continent. That infrastructure is what is needed right now, and on that front, a concerted African response would have come handy.
Another driver which was exacerbated by poor leadership was witnessed in places where the concept of infectious diseases is unknown. Ebola victims and their families were often stigmatised. Some believed Ebola comes about as the result of a curse.
Community life was disrupted and there was fear and hostility when health workers suddenly appeared, dressed in what appeared to be space suits. Health workers have met with hostility and violence in several locations.
In conclusion, despite the vast resources the bulk of African people live as if they were citizens of deserts. Despite being home to millions of skilled and talented innovators, African leadership struggles to stimulate and retain its strongest resource – the people.
People either live in unnecessary frustration, hopelessness and poverty or die of preventable disease, while leaders run to the West.
The current outbreak should stimulate a complete shift in public health policy and reflection on collective responsibilities to one another before this becomes a completely missed opportunity.
An effective leadership would be good, developing preventative vaccines now to prevent the disease from reoccurring again. The best thing that could come out of this is more organised and trusted public health systems in all countries.
Public health is all about preventing diseases before they happen and in African settings, the need is even greater. When it comes to costs, it is better for African countries to avoid being penny wise and pound foolish by investing more in preventive rather than curative measures.
Moving forward, individual African nations – and in collaboration with the African Union – should formulate public health responses that are suitable for Africa and individual countries.
Resources do not make countries rich, people do. Prosperous countries are those that enable their people to operate at maximum efficiency.
* Maxon is a government communications official and a social commentator writing in his personal capacity.
** The views expressed here are not necessarily those of Independent Newspapers
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