Patrice Riemens on Thu, 25 Sep 2014 06:01:15 +0200 (CEST)

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<nettime> Guillaume Lachenal: Ebola: a brilliantly scripted disaster movie

Original (French) to:

Ebola: a brilliantly scripted disaster movie
by Guillaume Lachenal

"It is useless to laboriously interpret these films in terms of their
relation to an "objective" social crisis or even to an "objective"
phantasm of disaster. It is in another sense that it must be said that it
is the social itself that, in contemporary discourse, is organized along
the lines of a disaster-movie script." wrote Jean Baudrillard in 1976.
Apocalyptic movies have for some time been the object of analysis in
serious publications, as they are the mirror of our societies' angst in
the face of pandemics. But the Ebola
epidemic ravaging West Africa calls for a more radical critique.

The current crisis is not some nightmare taking place under our very eyes
"just like in a disaster movie". It is not an anomaly, nor an accident
taking health authorities by surprise; it is also not, to use development
gobbledygook, an organizational, financial, and political 'challenge'  the
international community needs to rise up to. The exact reverse needs to be
told in no uncertain terms:  the Ebola crisis is the outcome of 20 years
of political choices and deliberate policies. It is a man-made
catastrophe, not only through the intentional hollowing out of African
primary health care  systems thanks to neo-liberal reforms (aka
'structural adjustments' -tr), but also because of the willful
mobilization of all private and public health actors towards the advent of
a new era of "Global Health". This mobilization, effective since 2005, has
been characterized by an unheard of increase in health-directed funding
for countries in the global South, which had made Africa its number one
priority  - for the sake of world-wide sanitary security. The glorious
times of the big narrative are back:
success stories about the eradication of diseases, glossy brochures with
smiling children, Bill Gates and Big Pharma joining hands on the world
stage are at the order of the day. We have entered a new era where nifty
smartphone applications, public-private partnerships, and 'sustainable
innovation'  are going to work out their magic on African health issues,
one at a time. Gone from the picture are the decrepit primary health
centers, the continuous power outages, and depleted stocks of medicines.
The world of Global Health shines like an advertisement for beauty
products. The disaster unfolding under our eyes is the direct result of
these security-oriented, spectacle-driven, scripted health policies, which
have all ben implemented at the expense of the African health systems and
the people working in them.

" Pandemic Preparedness" has been the leading principle in world health,
both in the Global North and the Global South since the SARS and avian flu
crisis of 2003-2005. And in the slipstream of US post-September 11
mobilization, the grants earmarked for 'bio-terrorism' et 'emerging
diseases' research - by definition, research on  not yet existing
pathogenic agents - have all but wiped out public research funding for
'ordinary' health issues, and this was especially the case during the Bush
presidency. Contrarily to what has been written, Ebola has never been a
neglected subject - rather the reverse: ever since the first outbreak in
1976, the virus has been knock-out argument to buttress fundamental
virological research  ( building high-security labs in particular, during
the early eighties) while being used to talk down preventive health
policies and other 'old school' social approaches. No tender, no press
release on 'bio-security' would fail to mention the Ebola virus, so potent
it is, and that even before the current outbreak, to conjure up the
spectre of an emerging threat. For the past twenty years Ebola, together
with SARS, smallpox, and the avian flu has been the true raison d'etre of
governmental pandemic preparedness programs. With full-size simulated
emergency drills, guarded godowns filled with surgical masks and gloves,
preparedness was the political parole of the new millenium,  partially
inherited from the cold war military programs. The H1N1 flu pandemic of
2009 saw it come to its own, big time - indeed, one can say that never has
the world been so well 'prepared'.

Africa has not stayed in the margin of these endeavors. Fired up by the
WHO and the American CDC (Centre for Disease Control),  African state
joined enthusiastically  the 'preparedness' drive. And the continent did
not lack experts to lead the initiative: in several African countries the
'search for emerging viruses' employs scores of international researchers
and their local partners. Considerable progress has been made over the
past years regarding knowledge about pathogens, among them Ebola and HIV,
originating in animals such as bats and big apes. Just as in Europe did
the threat of fresh pandemics, and especially flu-related ones, stimulate
the set-up of preparedness action plans, all starting with the obligatory
"mock-up practice drills": scripted role-plays intended to test the
readiness of authorities - playing their own role - in the face of a
(virtual) pandemic. All well, but for the fact that in context of the
actual situation in African countries, the word 'simulation' must be taken
in a very literal sense indeed.  Gathering in a conference room, ministers
and WHO experts plot virtual  interventions, whether of the military,
police, or sanitary kind - with all participants knowing full well that
these are devoid of any real  bearing _on the ground_  due to the woeful
lack of equipment, troops, police personnel, and medical infrastructure.
The very idea of _preparedness_  fulfills itself in the realm of the
absurd: public health boiling down to a simulated war against an imagined
threat.  Africa is getting ready as never before, it does nothing else
than that, so to speak.  Yet another jaded tale  - save that these
pandemic preparedness exercises siphon off a major part of the African
health authorities' energies and resources, even as these are confronted
with far more urgent sanitary emergencies.

Thanks to Wikileaks, we now know that the US Embassy in Sierra Leone was
already worrying about this state of affairs in 2007.  But the main
problem with these simulation exercises is that they represent, in
condensed and unadulterated form the new paradigm of Global Health, Africa
style:  a type of intervention where real action on real diseases has
become secondary to vast, assumptive and speculative 'viral surveillance'
programs. A good example of the latter is provided by the Californian
'virus hunter' Nathan Wolfe and his initiative on 'preventive treatment'
of HIV, or his 'mobile health' projects whereby smartphones are supposed
to abolish distances and make good for the lack of medical personnel and
other failings of African health systems.  The 'real economy', to borrow a
term from the financial world, stands only in distant connection with the,
symbolic, but also monetary, profits brought into play by the largely
virtual interventions in the realm of Global Health. As the 2014 Ebola
epidemic has by now killed almost as many people as September 11 it does
indeed look like a crisis: namely the blowout of a speculative bubble.

"Just as in  a disaster movie", to quote Baudrillard again, reality and
fiction have ended up in a feedback loop.  This because pandemic
preparedness has raised the _script_ and the _(computer) game_  to the
level of a full-fledged political procedure, a method to 'organize the
social', marginalizing the prevention-based approaches of 'old school'
public health policies, paving the way in the process for fresh outbreaks
of 'old' epidemics such as cholera (25.000 African cases in  2013 !). The
advent of 'Global Health' is nothing but the last phase of a destructive
historical sequence inducted by structural adjustment policies in the
1990s transforming African (public) hospital wards into a Mad Max style
rust belt of squalid slums. But it marks also the triumph of
_storytelling_  blossoming into a full-fledged discipline, a crucial
competence, maybe even the only legit one left in the world of Global
Health. The superstars of the fight against future pandemics like the US
biologist Nathan Wolfe have completely blurred the line between fiction
and reality, public health action and cash machines: Dr Wolfe has built
his career on emerging viruses in Cameroon (Ebola among them), and then
embarked on a 10 years stint of television appearances, plugging his
surveillance project of African pathogens. That his efforts did not in
anyway translate into substantial advances on the ground was
inconsequential to him obtaining a six-digit advance on his latest book
"The Viral Storm'. Wolfe morphed his research team into a start-up,
financed among others by the Google Foundation dishing out $ 1m for every
new virus identified. His seductively scripted TED conferences overwhelm
his audiences and play in a loop on YouTube. He was also scientific
advisor for the zombie film 'I am a Legend'. His little company Metabiota
Inc. naturally took up pole position in the Ebola campaign. On the ground
by last May, the start-up's virologists were true to their promise to save
the world, with marching orders from the US  Department of Defense to
organize Sierra Leone's _'preparedness'_  at the moment the epidemic was
devastating neighboring Guinea. _A complete success story_, Sierra Leone
has never been better prepared"_ his team wrote on May 12.
By now we know how that particular movie ended.

Guillaume Lachenal is assistant professor at Paris-Diderot University and
the Paris School of Political Sciences. He lectures on "Global Health in
Africa, Critical perspectives".

Q&D translated by yrs truly
Amsterdam September 23, 2014

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