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ebola
The World's Failed Response to Covid-19 in Africa Must End
Africans are paying the price of global abandonment with their lives.
Feb 22, 2022
When the Ebola virus was ravaging West African countries in 2014, health care providers, public health researchers and activists worked feverishly to stamp it out before it spread and turned into the type of life-shattering pandemic we're all too familiar with today.
COVID-19 has revealed the continued global failure to help build a long-promised meaningful, swift-acting, effective, and fair international public health infrastructure to save lives across the African continent.
But the global response to COVID-19 in Africa has been too little, too late. When The New York Times reported in January 2021 that the dead were not being counted in Africa, it failed to mention the living had been abandoned. Africans are paying the price of global abandonment with their lives. The world must improve its response, or future variants of COVID-19 and new viruses and pathogens will surely soon emerge. And we've all seen the impact an unchecked virus can have on the world.
Since the outbreak of COVID-19, Africans have once again mobilized their societies and communities to avert a health care calamity. Religious and so-called "traditional" leaders, secular grassroots associations, radio stations, and universities have joined the fight against the virus. Across Africa, people know about the veracity of COVID-19 and the effectiveness a vaccine provides in fighting its deadliness. They have been persuaded by local efforts to fight epidemics, which, post-Ebola, have been built into West Africa's health sectors, communities, and surveillance capabilities.
Yet in global politics, African engagement to stop disease spread is neither recognized nor supported. COVID-19 has revealed the continued global failure to help build a long-promised meaningful, swift-acting, effective, and fair international public health infrastructure to save lives across the African continent.
Having been part of the initial efforts to stamp out Ebola, we demand that the international community support African health care systems in reversing the spread of COVID-19 on the continent. These efforts must include dropping the patents of COVID-19 vaccines so that African countries can manufacture the vaccines without fear of legal repercussions.
Global public opinion has accepted the view that mRNA vaccines are too complex and too sophisticated to produce in Asia, Latin America, and Africa. This is a ruse. The truth is that corporate patents on mRNA vaccines are one of the greatest barriers to rolling out generic vaccines across Africa. There are 120 manufacturing sites that have the capacity to produce mRNA vaccines on all three continents.
Recently two Texas-based scientists, Maria Elena Bottazzi and Peter Hotez, have developed Corbevax, a patent-free vaccine that has been approved by the Indian government and will be produced by the Hyderabad-based company Biological E. This new patent-free vaccine has been, quite appropriately, called "a gift for the world" - and it is especially needed in Africa, where only about 11% of the continent's population is fully vaccinated.
Nobody should die for the right of the patent. "Patent protections and other IP restrictions are only the latest means of enforcing and worsening inequalities that date to the slave trade and the colonial period," said Jesse B. Bump, executive director of the Takemi Program in International Health at the Harvard T.H. Chan School of Public Health. To this day, rich countries leverage their economic power to extract African rare earth elements, cocoa, diamonds, and other resources under most inhumane circumstances. Patents for COVID-19 vaccinations are another expression of the desire of Western companies and the countries that support them to extract yet more from Africa and make the most money possible.
In addition to Big Pharma dropping the patents, Covax, the UN's facility to finance the distribution of vaccines, must be adequately funded. There is no false choice between these two positions. Essential goods like masks, PPE, therapeutics, and vaccine commodities such as syringes are facing shortages in Africa but not elsewhere.
We call upon the G20 countries to donate $10 billion to COVAX and to the support of the COVID-19 response in Africa. For too long, Africa has had to witness the world tolerate its suffering and cope with austere responses to emergency conditions. The African health care infrastructure is marked by severe austerity--epitomized by the barebones Ebola treatment units set up during the 2014 Ebola crisis-where patients received a minimum of treatment, and the imperative of disease control trumped the obligation of care. This bias, too, has deep roots in colonialism, when containing diseases was indispensable for Europeans to conquer and maintain territory. Global health, as it is currently funded, cannot compensate for the immense needs of "clinical deserts" on the African continent. To illustrate the dearth of funding: the WHO's entire budget is comparable to a large US hospital's.
Having observed the devastations of disease spread and the valiant efforts of locals to respond to them, we demand that the international community invest in African health care systems in reversing the spread of COVID-19 on the continent. Such an investment would not be just an act of morality and fairness. As this pandemic and Ebola have vividly shown, improving African health care is in the self-interest of the entire world. Africans have mobilized all their resources to beat back the spread of the coronavirus--it's time the rest of the world does its part.
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'Sickening Betrayal': Panel Finds 83 Cases of Alleged Abuse During WHO's Ebola Work in Congo
"This is the biggest finding of sexual abuse perpetrated during a single U.N. initiative in one area or one country during the time-bound period of a U.N. response effort," said one campaigner.
Sep 28, 2021
An investigation into sexual abuse related to United Nations efforts to contain the Ebola outbreak in Congo found over 80 alleged perpetrators, a quarter of whom were employed by the U.N.'s public health agency, according to a report released Tuesday.
The findings come from a panel commissioned by the World Health Organization (WHO) in response to media reports about abuse claims during the 2018-2020 mission in the African country.
"This is the biggest finding of sexual abuse perpetrated during a single U.N. initiative in one area or one country during the time-bound period of a U.N. response effort," Paula Donovan, co-director of the Code Blue Campaign, which works to end sexual exploitation by U.N. peacekeepers, told the Associated Press. The AP previously reported on some allegations.
According to the panel:
The review team was able to obtain the identity of 83 alleged perpetrators. In 21 cases, the review team was able to establish with certainty that the alleged perpetrators were WHO employees during the response... The alleged perpetrators include both Congolese nationals and foreigners. The majority of the alleged perpetrators were Congolese staff hired on a temporary basis who took advantage of their apparent authority to obtain sexual favors.
Investigators documented nine allegations of rape. The youngest victim was believed to be only 13 years old. Some survivors reported that no protection was used. Six said they experienced miscarriages. Others shared accounts of alleged abusers coercing them into having an abortion.
Allegations of sexual abuse, exploitation, and harassment "were made against WHO doctors, consultants, and senior staff, some national and some international, as well as other medical staff who were deployed by the Ministry of Health and others," the report says.
The report notes allegations were also made against staff in the immunization and risk communication team, people working in human resources, drivers, and security staff. It adds that despite detailed accounts from victims, "the majority of alleged and identified perpetrators have simply denied the facts, even in the presence of corroborating evidence, when they have not simply taken refuge behind the argument of a 'consensual relationship.'"
Sophie Harman, a professor of international politics at Queen Mary University of London, warned that the panel's revelations may be just the beginning, telling the AP that "more cases are bound to come forward across the world."
Harman also called for a shift to focus on helping survivors, which she said requires not only prosecution of perpetrators but also "full accountability on the part of WHO leadership who knew about the rumors and reports, and yet took years to act on this issue."
\u201c83 cases of sexual abuse in the Ebola response in Congo. 21 employees of #WHO \n\nhttps://t.co/z9dUJJKw0B \n\nMy blood boils. Senior leadership knew 2 years ago & only now we have findings.\n\nhttps://t.co/VmDl0Q6AmQ\n\nWHO l'ship must be held to account. Fear this is tip of iceberg.\u201d— Prof. Sophie Harman (@Prof. Sophie Harman) 1632841399
WHO Director-General Tedros Adhanom Ghebreyesus addressed the findings during a Tuesday press conference to unveil the report, which he said "makes for harrowing reading."
"The first thing I want to say is to the victims and survivors of the sexual exploitation and abuse described in the commission's report," Tedros said. "I'm sorry. I'm sorry for what was done to you by people who were employed by WHO to serve and protect you."
"I'm sorry for the ongoing suffering that these events must cause," he continued. "I'm sorry that you have had to relive them in talking to the commission about your experiences. Thank you for your courage in doing so. What happened to you should never happen to anyone. It is inexcusable."
Tedros said that "as the director-general, I take ultimate responsibility for the behavior of the people we employ, and for any failings in our systems that allowed this behavior," adding that "it is my top priority to ensure that the perpetrators are not excused, but are held to account."
The agency leader pledged that the WHO will take steps to support, protect, and ensure justice for the survivors; address management and staff failures; and reform structures and culture.
\u201c@DrTedros @UN "To further strengthen accountability, we have asked the Independent Oversight and Advisory Committee of the WHO Health Emergencies Programme to monitor and report transparently on our progress"-@DrTedros\u201d— World Health Organization (WHO) (@World Health Organization (WHO)) 1632837009
Some of those actions include banning identified perpetrators from future employment with the WHO, as well as notifying the broader U.N. system; terminating the contracts of four people identified as perpetrators who were still employed by the agency; and referring allegations of rape to authorities in Congo and, if applicable, the alleged perpetrators' countries.
The conduct described in the report "is a sickening betrayal of the people we serve," said Tedros. "But it's also a betrayal of our colleagues who put themselves in harm's way to serve others, including those who paid the ultimate price, killed by armed groups in North Kivu, while working to protect the health of vulnerable communities from Ebola."
Thanking the commission as well as journalists who previously reported on the abuse, he added that "this is a dark day for WHO--but by shining a light on the failures of individuals and the organization, we hope that the victims feel that their voices have been heard and acted on."
The National Sexual Assault Online Hotline is 1-800-656-HOPE (4673) and a live chat service is available at www.rainn.org. Both offer 24/7, free, and confidential support.
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Ebola Response Veterans Urge WHO to 'Dramatically Expand' Global Covid-19 Vaccine Access
"Those of us who gave our all during the Ebola outbreak and survived it know that we cannot let our guard down. No one is safe until everyone is safe."
May 14, 2021
Asserting that "no one is safe until everyone is safe," 30 international veterans of the public health response to the 2014 West African Ebola outbreak and over 80 other experts this week urged the World Health Organization to "dramatically expand" Covid-19 vaccine access in developing nations.
"The emotional strain of watching people in rich countries get vaccinated while we, in the poor countries, helplessly watch our loved ones die, amounts to an injustice that must come to an end now."
--Zacharia Kafuko
The Ebola response veterans and health experts are calling on the World Health Assembly, the WHO's decision-making body, to vote in its upcoming annual meeting on proposals that would greatly increase access to Covid-19 vaccines in the Global South. Due to the ongoing coronavirus pandemic, the WHA meeting will be held virtually this year, from May 24 to June 1.
The advocates' demand came in a letter to WHO Director-General Dr. Tedros Adhanom Ghebreyesus organized by Mosoka Fallah, founder of Refuge Place International, a Liberian nonprofit recognized internationally for its heroic work during the 2014 Ebola epidemic that killed over 11,000 people--almost all of them in Liberia, Sierra Leone, and Guinea--over a two-year period. More than 500 healthcare professionals died during the outbreak.
\u201c\u201cAs we learned through the #Ebola pandemic, poverty and geography should not be the determinants of access to life-saving vaccines." \n#medhist \nEbola Fighters in Africa Call for #Covid Vaccine Equity, but It May Be Too Late https://t.co/6LVVptPvfT via @pass_blue\u201d— Gregg Mitman (@Gregg Mitman) 1620832813
Noting that "the Covid-19 pandemic has claimed more than two million lives worldwide," the letter asserts:
We need global vaccine access to end a global pandemic. Covid-19 vaccines have renewed our hopes to end the pandemic. But without a global vaccine strategy in place to equally vaccinate people all around the world, Covid-19 mutations could render the current vaccines ineffective. We need to take a global vaccination approach to end the pandemic with commitments from G20 countries and pharmaceutical companies.
National and global security is at risk and we no longer have the luxury of time. Countries that are hoarding or having excess vaccines are shortsighted because it actually increases the risks of mutations from unvaccinated nations, rendering their stockpiles obsolete and thus fueling the pandemic.
Those of us who gave our all during the Ebola outbreak and survived it know that we cannot let our guard down. No one is safe until everyone is safe.
"As we learned through the Ebola pandemic, poverty and geography should not be the determinants of access to life-saving vaccines," the letter states. "Vaccines should be available to those who most immediately need them, with an emphasis on the ability to save lives."
"If we don't have global vaccine access for Covid-19, billions of lives in [low- and medium-income countries] continue to be at risk, and hundreds of thousands could be lost in the coming months," it adds.
The letter's signatories ask the WHO to schedule a WHA vote on the following proposals:
- That each country endorses the necessity and ethical urgency of supporting the goals and means of the WHO's Access to Covid-19 Tools Accelerator (ACT-A) program.
- That each country endorse the following ethical standard: All countries that ordered more doses than they can use should immediately commit to donate excess doses to COVAX or directly to those countries most in need. G20 countries and all countries above $11,200 GDP per capita should contribute 10% of their total expenditure on vaccines to the COVAX facility to help in purchasing doses for people in low- and medium-income countries.
- That all pharmaceutical companies should either use a multi-tiered vaccine pricing for low- and medium-income countries or waive their patent protection for such countries that have manufacturing capacity, and commit to supporting the tech transfer for such manufacturing.
"We are at a pivotal moment in human history," stressed Fallah in a statement. "Will the WHO fulfill its mandate of universal healthcare by instituting universal vaccine care? All eyes are on the WHO."
"Right now, there is no other public health matter that is more important than global vaccine equity."
--Tricia Wang,
Last Mile-Covid Straight Talk
Signatory Zacharia Kafuko, African chapter manager at 1 Day Sooner--a nonprofit organization advocating for people who want to take part in high-impact medical trials, including Covid-19 human challenge trials--said that "the emotional strain of watching people in rich countries get vaccinated while we, in the poor countries, helplessly watch our loved ones die, amounts to an injustice that must come to an end now."
Tricia Wang, co-founder of Last Mile-Covid Straight Talk and a signer of the letter, said that "right now, there is no other public health matter that is more important than global vaccine equity."
"The virus will continue to spread and mutate if we don't institute a global vaccine equity plan," she warned.
In what many health experts have hailed as an important step toward global vaccine equity, the United States earlier this month broke with other wealthy nations to support waiving intellectual property protections for Covid-19 vaccines. Tedros called the move a "monumental moment" in the fight against the coronavirus pandemic, while others said the U.S. must do more.
\u201cWaiving intellectual property protections on #COVID19 vaccines will be very important for increasing production capacity and achieving #VaccinEquity. This is in the interest of all countries. #InThisTogether\u201d— Tedros Adhanom Ghebreyesus (@Tedros Adhanom Ghebreyesus) 1620330254
"If the U.S. truly wants to end this pandemic, it must also share its surplus vaccines doses with COVAX now and fill the access gap until additional manufactures are able to scale up production," said Avril Benoit, executive director of the U.S. division of the international medical charity Medecins Sans Frontieres (MSF, or Doctors Without Borders), after the U.S. move. Benoit is not signatory to the Ebola veterans' letter.
"The U.S. must also demand that pharma companies that received significant amounts of U.S. taxpayer funding to create these vaccines share the technology and know-how with other capable manufacturers to protect more people worldwide," she added.
Fallah and other health experts, on the other hand, believe COVAX has been largely unsuccessful due to its failure to take into account bilateral deals and for its manufacturing and logistics shortfalls.
As Fallah bluntly told PassBlue, "COVAX is just a way for white men to absolve their conscience."
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