The speed with which the current Ebola epidemic swept across parts of West Africa, claiming over 3 000 lives in the first six months and affecting millions more, exposed the extreme fragility of primary health care facilities in the region, the disproportionate impact on particularly vulnerable groups, as well as the increasingly globalized implications of the outbreak.
Almost overnight, the ‘Africa Rising’ narrative from the August 2014 US-Africa Leaders’ Summit was replaced with the more familiar refrain of ‘death, destruction and disease.’
Ebola has laid bare significant deficiencies and deficits in Africa’s development path and highlighted the urgent need to emphasize the security and prosperity of the individual, as we laud successive years of real GDP growth across the continent.
While substantial resources are expended to contain the virus, more attention should be paid to the profound micro-economic impacts that are made worse by entrenched socio-economic inequality.
Although Guinea, Liberia and Sierra Leone were among the star macroeconomic performers on the continent in recent years, they are also among the poorest and least developed.
Numerous scholarly publications and policy documents have been devoted to understanding and addressing the apparent paradox of high-growth, high-poverty economies.
The answer lies somewhere within the labyrinth of the human security debate. Countries that fail to invest in their citizens and in basic infrastructure will always struggle to translate productivity gains into tangible and broad-based economic progress.
These countries were hardest hit by Ebola because rural communities were not well-educated, primary health care facilities were virtually non-existent and relevant state institutions were poorly prepared and quickly crumbled under the weight of the resultant deluge of cases.
In addition, decades of poor governance have sown the seeds of distrust between citizens and their governments, thereby making it difficult to reach the most affected communities.
Ebola is having dire economic ramifications in the affected countries. Lost productivity in Guinea, Liberia and Sierra Leone is expected to exceed $350 million in 2014 and $800 million in 2015. But the most severe economic challenges have been at the household level.
In countries where over half of the workforce are minimum-wage earners in the non-formal sector, an epidemic that incapacitates the bread-winners and constrains market access seriously constrains household budgets.
In addition, entire agrarian communities will be forced to miss the annual planting season, putting next year’s harvest in peril. For many the sharp downturn in household income would persist well into 2015 — even if the endemic is contained by end-2014, optimistically.
Ebola is also having a deleterious effect on household wealth, as beleaguered and isolated households liquidate assets (like jewelry and livestock) and incur debt in order to survive. Consequently, humanitarian interventions must be swift and focus on both income- and wealth-generation in affected communities. This calls for creativity beyond the business-as-usual approach to economic regeneration in crisis-affected regions.
Inequality has been a prominent factor in the recent Ebola outbreak. Stark rural-urban disparities in West Africa not only facilitated the transmission of the virus, but also attracted scores of infected cases to the towns and cities where the few available facilities became overwhelmed. This precipitated the virtual collapse of the health care system, which worsened the humanitarian crisis.
Ebola is also demographically selective, affecting vulnerable groups like women, the elderly and the poor the most. One of the lessons of this Ebola outbreak is that countries that ignore pronounced inequality do so at their peril. Not only are such societies more fractured and unstable, they are also less resilient to socio-economic shocks.
Moreover, the effects of inequality also play out on a global stage with travelers from Ebola-affected regions making their way to countries with appropriate treatment facilities. This is why world leaders have described the outbreak as a “global crisis.”
West Africa could easily become the epicenter of a global pandemic if immediate steps are not taken to contain transmission, care for the infected and address resilience in currently affected communities/countries.
Ebola is a complex global security emergency that demands much more than a focus on the virus, as we learn from theories of social epidemiology.
Desperate people will find ways to leave affected regions. Resilience is key because it helps establish a modicum of trust, provides some assurance of equitable socio-economic progress and helps stabilize communities.
For example, President Obama’s decision to send some 4 000 troops to bolster efforts to contain Liberia’s Ebola crisis must be complemented by sustained efforts to establish more credible primary health institutions, equitable wealth and income generating initiatives, and robust governance structures and national and local levels. Medical units would improve detection and treatment, while also providing public health education facilities.
These facilities could become overwhelmed if concomitant steps are not taken to tackle economic malaise and social disruption caused by the Ebola crisis in both rural and urban areas.
This crisis is an ideal opportunity for the United States to lead in the provision of balanced, targeted and sustainable assistance that goes beyond ameliorating the symptoms and addresses the root causes. In the spirit of the US-Africa Summit, such assistance should take the form of a partnership with the affected countries in West Africa doing their part to invest in their people and govern wisely.
By Raymond Gilpin- This story is reproduced from African Arguments