Rising incidents of health epidemics in Africa is mostly to do with poor governance, systemic corruption and lack of inclusive development of countries, provinces and municipalities. Early in August, the Democratic Republic of Congo announced a new outbreak of the deadly Ebola virus, just weeks after the country declared a previous outbreak, which killed 33 people, have been contained.
In early August four new cases of Ebola were confirmed in the northeastern North Kivu province of the DRC. Before that the country had an Ebola outbreak in the northwestern Equateur Province, the ninth successive outbreak of the virus. The DRC is among the worst governed countries in the world. It is high levels of corruption. The delivery of public services has basically collapsed.
Parts of the country are run by militia, political barons and unscrupulous companies, allied to the country’s president Joseph Kabila. Opposition parties and leaders, independent media and civil society are heavily repressed. The collapse of the state, public institutions and governance is a fertile environment for health epidemics to flourish.
The Ebola virus causes hemorrhagic fever, with fatal bleeding from internal organs, ears, mouth and eyes.
In 2014, the Ebola epidemic swept through West Africa ravaging Sierra Leone, Liberia and Guinea – countries that are noticeably disastrously governed. All three countries came out of civil wars in the 1990s. The 2014 Ebola outbreak in these countries killed nearly 9000 people, in the worse outbreak in history, collapsing public health systems and dramatically reducing economic output.
In March 2018, saw a Lassa fever outbreak in Nigeria, which even experts called “terrifying”. Lassa fever is a hemorrhagic virus, which starts of looking like a flu, then attack the bloodvessels, causing a patient to bleed from the gums, nose and eyes. A quarter of people who get the disease die. Early intervention can stop the disease, but there is no cure for advance Lassa fever.
Lassa fever is carried by rats. Over the most recent past, more than 300 000 people every year are infected by the Lassa fever in Nigeria, Sierra Leone, Liberia and Guinea.
Nigeria is notoriously poorly governed. The 2015 elections was the first time in Nigeria’s post-colonial history, that an opposition party democratically took power from the ruling party, without a coup. Successive governments have ruled Nigeria either for self-interest, for their ethnic group, region or religion, rather than the widest interest of all the country’s people.
Poor governance, neglect of certain ethnic, religious and regional communities, and corruption has collapsed public administration, including health systems in many parts of Nigeria, making the country vulnerable to health epidemics.
In 2016, a yellow fever epidemic spread across the DRC and Angola, in the worse incidents of the disease for decades. Mosquitoes carry the yellow fever disease. The yellow fever virus also poses risks to Sudan, South Sudan and Uganda.
There is a vaccine for yellow fever, introduced in 1936, which is effective. However, the collapse of health systems, whether through corruption, mismanagement or neglect has meant that many African countries have not kept up with vaccinations. Long-standing leader Eduardo dos Santos, leader of the governing MPLA ruled the country from 1979 to 2017, enriching his family, allies and friends.
Members, supporters and regions supported by opposition parties were excluded from government, denied development and public resources. According to World Bank figures half of Angola’s population of 24 million people lives on less than US$1.25 a day. Angola was in a decades-long civil war between the MPLA and the opposition Unita which left the country’s public institutions, including the health system in disarray. The governing MPLA by stripping public services further collapse the public sector.
Early the year, the World Health Organisation said South Africa’s Listeria outbreak in 2016, which saw 750 confirmed cases, to be the largest ever outbreak of the bacterial disease listeriosis.
Listeriosis is caused by the bacterium, listeria monocytogenes, which is found in soil, water, vegetation and animal faeces. Fresh produce, meat and dairy and seafood can be contaminated.
The collapse of governance, mismanagement and corruption at South Africa’s municipalities, which in the post-1994 governance model, is supposed to play implement public health standards, regulations and policies are one of the main reasons for the listeriosis outbreak. Early this year, Cooperative Governance and Traditional Affairs Minister Zweli Mkhize said only 7% of South Africa’s municipalities are functioning properly, the rest are dysfunctional, in distress or have totally collapsed.
Unless poor governance, mismanagement and systemic corruption is tackled, and governments govern more inclusively, democratically and spread development more equitable, health epidemic outbreaks will continue to remain become a regular feature in Africa.
William Gumede is Associate Professor, School of Governance, University of the Witwatersrand, and author of South Africa in BRICS (Tafelberg).