Ebola: Difficult Questions for Development

Ideological positions and poor understandings have created a set of assumptions about development that are fundamentally challenged by the Ebola experience. Can this terrible crisis provide a moment for reframing development? Surely now is the time for a fundamental rethink of development approaches.
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As the horrific Ebola crisis unfolds across West Africa, and the international community belatedly responds, there are some bigger questions that arise beyond the immediate challenges on the ground. These are worth raising and discussing, as they challenge our understanding of 'development' as framed and practised over the last few decades in fundamental ways.

The Ebola crisis has exposed the consequences of a pattern of systematic 'underdevelopment' or 'structural violence', and the implications of deep-seated unequal global relations. Yet poverty, inequality, conflict and unsustainability in poor, far-off places can usually be ignored. Pigeon-holed into suitable labels of 'conflict prone', 'failed state' or 'weak governance', development acts to displace such challenges. Yet viruses know no boundaries, and the threat of the Ebola outbreak has rung alarm bells far away in the seats of global economic and political power.

While much of the response is about control and containment, to avoid spread to richer more privileged settings, our attention must turn to why such outbreaks occur and have such devastating impacts in some places and not others. What responsibility does 'development', as practised in recent decades, have?

Unsettling questions are raised. We must ask whether the Ebola crisis is in large part the result of failed development, and indeed systematic underdevelopment and inequality entrenched by development policies imposed by western countries. For many years, West Africa has suffered the consequences of structural adjustment and economic reform pushed as a condition of aid. This has resulted in the hollowing out of states and the decimation of public services, including health systems. In poor countries in West Africa, this active neglect has surely been a contributory factor to the devastation being wreaked by Ebola. This in turn has been compounded by shifting service provision to the private sector and failing to train professionals and support state capacity in health and other services. This has resulted in an inability to spot and respond to the crisis, both in West Africa, but also internationally.

Zoonotic diseases such as Ebola initially emerge due to a complex combination of ecological, economic and social drivers. We don't know the details of the recent Ebola emergence, but we must ask whether development policies have been part of the cause. For example, does an advocacy for private sector investment - in mining, large-scale agriculture and so on - result in forms of ecological and social dislocation and disruption that feed into such crises, facilitating spill-over and spread of disease? Complex ecological dynamics in forest-farm ecosystems may have resulted in changes of bat-human interactions causing the disease to spread. But again, we must ask whether environmental and land use policies have at least been in part a cause. For example, have our poor understandings of environmental and forest change, and the top-down interventions that have been promulgated by donors, NGOs and governments made things worse?

The most affected countries in West Africa have been subject to long-running conflicts. These have resulted in population movements, changes in social dynamics and deepening poverty. Development aid efforts have invested considerable sums in post-conflict 'reconstruction'. But we must ask if much of this has missed the mark, failing to build social relations, community fabrics and institutions that provide the basis for effective responses to disease outbreaks, and the forms of resilience needed to weather crises. Reconstruction may have been only superficial, creating new forms of vulnerability to unexpected shocks such as Ebola.

Where growth has happened following conflict, it has been exceptionally uneven. Inequalities and vulnerabilities have risen. We must ask whether rapid urbanisation, precipitated by unequally distributed economic growth, has created new forms of vulnerability, especially for the poor. In the absence of urban planning and effective service provision due to inadequate state finances, the conditions for rapid spread of disease is set, exposing the most marginal to heightened risks.

In the last weeks we have seen a late rush to intervene in the Ebola crisis. Too often this has been without attention to the social and cultural logics that underpin local disease responses, and included a failure to involve local players. Some have argued that this could actually made matters worse, particularly for some social groups. This pattern replicates the past failings of development, rooted in a lack of understandings of root causes, structural drivers, and the complexity of local settings.

The Ebola crisis then poses some harsh questions. Has 'development' and the wider development business, including the research community in organisations like my own, been at fault, pushing failed development models based on poor understandings. Is 'development' in some ways culpable for the Ebola crisis?

The questions are multiple, troubling and profound. They also raise important challenges for the future of development. The Ebola crisis demonstrates how the development model of the last decades has failed; and indeed made matters worse, entrenching global, regional and local inequality, undermining sustainability and fuelling conflict. These conditions have led in part to the Ebola crisis.

Ebola is not the first major disease outbreak emerging out of conditions of structural poverty, political marginalisation and deep inequality, but it is perhaps the most dramatic in recent times, and acts to shine a spotlight on development failings as well as future challenges in the most stark of terms.

We must ask what are the alternatives that rebuild state capacity, draw on local community understandings and practices, and shift attention to reinforcing resilience in health systems, urban planning and land use?

Ideological positions and poor understandings have created a set of assumptions about development that are fundamentally challenged by the Ebola experience. Can this terrible crisis provide a moment for reframing development? Surely now is the time for a fundamental rethink of development approaches.

Photo: The fight against Ebola in West Africa by European Commission DG ECHO on Flickr. Published under a Creative Commons attribution-no derivatives licence.