International Political Economy and the 2014 West African Ebola Outbreak

The Ebola crisis dominated Western media in late summer 2014, even though the first case was reported six months earlier. Sensational news coverage contributed to fears of Africa as a disease-ridden continent and to the dehumanization of Africans navigating the epidemic (Dionne & Seay 2015). International responses to the health crisis in West Africa have been slow in coming and not always particularly effective, despite the efforts of local health workers and nongovernmental organizations including Médecins Sans Frontières and Samaritan’s Purse. Western governments’ designation of the Ebola crisis as a crisis of security for the West also seemed to put Africans who were ill and dying in the same category as politically motivated terrorists.

Analysts attribute the outbreak’s severity to slow response by domestic and international decision makers and to the persistent poor health care conditions in Guinea, Liberia, and Sierra Leone. In this commentary, we demonstrate how these conditions are shaped by historical and contemporary contexts of international political economy. After providing a brief background on the epidemic and then setting the scene that led to the emergence of Ebola in West Africa in 2014, we document the response by domestic and international decision makers to the outbreak, identifying critical junctures in which domestic and international responses—in the forms of action and inaction—produced the current and rapidly evolving situation. We conclude by discussing policy implications of this response and potential directions for future research.

Background

The 2014 West African Ebola outbreak was the first recorded in the region, and the largest on record.¹ Researchers estimate it began in Guinea in December 2013 in Méliandou Village, Guéckédou District (Baize et al. 2014). It was not until March 21, 2014, however, that Guinea’s Ministère de la Santé et de l’Hygiène Publique (Ministry of Health and Public Hygiene) reported its first suspected Ebola cases to the World Health Organization (Dixon & Schafer 2014). By the end of March, Liberia reported Ebola cases in Foya District, located near Liberia’s border with Guinea. By late May Ebola cases were reported in Sierra Leone in Kailahun District, which borders both Foya District in Liberia and Guéckédou District in Guinea. Ebola has since spread within these countries and beyond.

The outbreak is ongoing, and by the end of 2014 20,206 people had been infected. Of those, 7,905 died (WHO 2014a). Previous Ebola outbreaks often occurred in remote locations and were contained in a single country. This outbreak, in contrast, has been regional in scale, spreading into densely populated urban areas and across multiple international borders. More than 99 percent of recorded infections have been in Guinea, Liberia, and in Sierra Leone. Cases linked to this outbreak were also reported in Mali, Nigeria, Senegal, Spain, the United States, and the United Kingdom (see map below).

Historical and Contemporary Political Economy in Ebola-Affected Countries

Initial international media coverage of the 2014 Ebola outbreak focused largely on the cultural practices that heightened risk for contracting and transmitting the disease (e.g., Fox 2014; Thompson 2014; see also McGovern 2014). However, analysis of earlier epidemics demonstrates that an emphasis on individual behavior or “exotic cultural practices” often obscures the larger political economic context shaping the likelihood of a major disease outbreak and the ability of relevant actors to respond. In this commentary we follow the advice of Schoepf (1991), who, writing about HIV/AIDS in the 1990s, urged analytical approaches to epidemics that use a social lens and consider a dynamic relationship between political economy and culture, rather than viewing them as a function of institutional failures, cultural practices, or individual behaviors. We focus in particular on international political economy—what has been described elsewhere as “geographically broad and historically deep” analysis (Farmer 2006:xiii)—and how it has shaped the conditions that spurred and intensified the spread of Ebola in the region. Following chronological order, we examine the continued relevance of (1) the trans-Atlantic slave trade, (2) colonialism, (3...