Written by Meredeth Turshen
Professor Turshen is a Professor in the Edward J. Bloustein School of Planning and Public Policy at Rutgers University. Her research interests include international health, particularly African women’s health, and she specializes in public health policy. A second interest is in the impact of war on women. Meredeth Turshen is the author of “Privatizing Health Services in Africa” Rutgers University Press, 1999.
29 August 2014
Submitted to the New York Times
To the Editor:
This Ebola epidemic follows the route of the second Liberian war—from Guinea into Liberia into Sierra Leone. The NYT article (“As Ebola Grips Liberia’s Capital, a Quarantine Sows Social Chaos”, 28 August 2014) mentions the war, but not that it destroyed whatever network of rudimentary government health services existed in the 1980s.
The Times article does not mention that health networks were never rebuilt; that the diamond industry, which profited from the wars, was never taxed for funds to rebuild health and education services; that the armaments industry got away with murderous profits and contributed nothing to rebuilding these nations. The Times article does not discuss the opportunism of the private sector, including NGOs and the churches, to use every crisis (the wars, AIDS, Ebola) to undermine government welfare programs and set up private health services in their stead.
The private initiatives underway now are the least efficient ways to procure supplies, the most profitable to pharmaceutical and medical supply companies, and the surest way to guarantee that nothing will have changed after the epidemic recedes. The supplies people are sending from the US are purchased at retail prices instead of ordering in bulk through international tenders for lowest bids. Many of these supplies are for single use and will be discarded. No permanent trace of the goodwill efforts will remain.
Since the 1980s, WTO and World Bank policies of globalizing neoliberalism have destroyed nascent drug industries in African countries. Of 46 sub-Saharan countries, 37 have “pharmaceutical industries,” that is, 34 have secondary level production (formulation of pills using imported pharmaceutical ingredients), and 25 have the ability to repackage imports. Only South Africa has limited primary production. Nine countries have no production capacity. These troubling facts should be part of the national conversation on how to strengthen basic health care in Africa.
Meredeth Turshen, D.Phil.
E.J. Bloustein School of Planning & Public Policy
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New Brunswick, NJ 08901 USA
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