Briefing: Ebola-myths, realities, and structural violence

TEN MONTHS AFTER THE FIRST INFECTION, Margaret Chan, Director-General of the World Health Organization, described the Ebola epidemic in West Africa as the ‘most severe acute public health emergency in modern times’. The disaster, she said, represents a ‘crisis for international peace and security’ and threatens the ‘very survival of societies and governments in already very poor countries’. As of October 2014, the disease had killed 4,951 and infected 13,567. It has crippled families, health systems, livelihoods, food supplies and economies in its wake. These numbers are likely to be vastly underestimated. How did it get to this? Why has this outbreak been so much larger than previous ones? The scale of the disaster has been attributed to the weak health systems of affected countries, their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This answer, however, is woefully de-contextualized and de-politicized. This briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. To move past technical discussions of “weak” health systems, this briefing highlights how structural violence has contributed to the epidemic. Structural violence refers to the way institutions and practices inflict