To some Africans, the claim last week that the continent’s largest health agency had already bungled its response scratched a familiar wound, reports The New York Times, with recriminations flying as global health officials scrambled to defend their response to the Ebola outbreak in East Africa.
First, the Africa Centres for Disease Control and Prevention faced criticism when the World Health Organisation suggested that it acted too slowly in announcing the spread. Then, reports quoted US Secretary of State Marco Rubio accusing the WHO of being late in its own efforts.
Responding to those reports, Tedros Adhanom Ghebreyesus, the WHO’s director-general, said: “We don’t replace the country’s work, we only support them,” subtly redirecting the backlash toward African health officials.
But the suggestion that African health officials had already botched their response to the Ebola crisis scratched an old wound: the perception that only outsiders know what is best when it comes to deadly outbreaks on the continent.
They say they have been battling diseases on the continent for decades, and in some cases with great success. Yet, they say, those successes receive little global attention as African health workers suffer grave consequences and make life-or-death sacrifices, only to come under international criticism.
African health workers have provided the bulk of the frontline care during a series of Ebola outbreaks on the continent. More than 500 of them died in the 2014 epidemic in three West African countries alone.
Dr Christian Happi, a Professor of Molecular Biology and Genetics at Nigeria’s Redeemer University who was born in Cameroon, recalled an incident at the height of the West African Ebola outbreak. A Liberian-American man with symptoms landed in Lagos and was immediately isolated in a clinic, he said.
When the man attempted to discharge himself, the doctor treating him, Ameyo Stella Adadevoh, forcibly detained him, citing the public good. In the scuffle that followed, the man infected her with the virus. He later died, and so did she. But the outbreak in Lagos – the continent’s most populous city – ended in a matter of months, and Adadevoh is credited with giving her life to help prevent its spread.
Reflecting on that time, Happi said he feared for his life the night he genetically sequenced the virus. His laboratory in Lagos lacked the appropriate safety equipment, he said, but if necessary, he was willing to sacrifice his own life.
“It’s a wrong stereotype where they believe the health system in Africa is very rudimentary,” he said, referring to some global health officials. He noted the success of Rwanda in containing an outbreak of Marburg Virus in 2024 as another, more recent example of effective health co-ordination in Africa.
A week ago, the WHO announced that the Ebola outbreak was a global health emergency, but by then the virus had more than likely been raging for weeks. Early laboratory results kept coming back negative because local health officials in the Democratic Republic of Congo did not have the equipment to test for Ebola Bundibugyo, the rare species responsible for the current outbreak.
There is no vaccine available to treat it.
The Trump administration dismantled the United States Agency for International Development last year, crippling foreign aid distribution. It also formally withdrew from the WHO in January. Many African nations have relied on US foreign assistance to help manage disease outbreaks, and the US aid cuts have already taken a toll.
Last Monday, the Trump administration invoked an emergency public health rule to seal American borders to those who had recently travelled to Congo, Uganda or South Sudan.
The African CDC said it recognised each country’s sovereignty and right to control travel during outbreaks, but warned that generalised travel restrictions and border closures were counterproductive.
“This current Ebola outbreak highlights a deeper structural injustice in global health innovation,” read a statement from the agency. “Many African leaders believe that if this disease had predominantly threatened wealthier regions of the world, medical countermeasures would likely already be available.”
So far, there have been at least 220 suspected deaths and more than 900 suspected cases, according to Health Ministry data, with the WHO warning that the rapidly moving epidemic is outpacing containment efforts.
Testing capacity in the northeastern Congolese province of Ituri, the heart of the current outbreak, is still ramping up.
Health workers in Ituri must overcome years of mistrust caused by the failure of the authorities to prevent violence and massacres carried out by local militias against civilians. In 2021, the government declared a state of siege in the area, which effectively amounted to martial law.
Even so, Africa CDC has defended its record. “From the earliest stages of the current Ebola outbreak, Africa CDC acted rapidly, transparently and responsibly,” the agency said in its statement.
It also suggested that Africa was forced to deal with a double standard when it came to health emergencies. The agency pointed out that thousands of Africans had died during the 2014 Ebola outbreak, but an effective global response was only achieved after an American doctor became sick.
The doctor, Kent Brantly, a missionary, contracted Ebola in Liberia and was flown to Emory University Hospital in Atlanta for treatment. Last week, it was announced that an American doctor named Peter Stafford had tested positive for Ebola in Congo. He was flown to Germany for medical care.
In later interviews, US public health experts stressed the importance of partnership with health authorities in countries affected by Ebola and acknowledged that foreign officials have, at times, taken the limelight.
“Ebola care is often seen as an international force flying in and saving Africans. But the majority of people saving lives and risking their lives are Africans,” said Lina Moses, an associate Professor at the Tulane University School of Public Health and Tropical Medicine, who worked in Sierra Leone during the 2014 epidemic.
At the same time, democracy activists in Africa have complained for decades about the failure of governments to invest in health infrastructure, which has led, in many cases, to a reliance on donor aid to fill the gaps.
Corruption has siphoned funds meant for public health into the pockets of government officials, critics say.
Dependence on outside help for fighting outbreaks in Africa also speaks to a broader concern about the troubled relationship between the continent and the West, stretching back to the colonial era, said Yvonne Adhiambo Owuor, a novelist from Kenya.
“It’s a cultural pathology,” she said. “It’s always Africa that needs saving.”
See more from MedicalBrief archives:
SA’s Ebola risk ‘low’ as rare virus strain rips through Congo
Ugandan nurse dies in first Ebola outbreak in two years
Rwanda’s rapid response to Marburg outbreak lauded