The Limits of Rapid Response

Ebola is the most severe acute public health emergency seen in modern times. Begun in December 2013 in the Republic of Guinea, the West African Ebola epidemic has attracted unprecedented global attention. The Ebola epidemic provides a unique vantage point to inspect the processes that transform a single zoonotic spillover event into a transnational medical humanitarian disaster in some localities but not others. The concept of structural violence, first proposed by Galtung and refined by Farmer in relation to global health, refers to the ways in which institutions inflict avoidable harm to people by barring access to basic human needs, often in ways that normalize these practices to those most affected. Structural violence is manifest and maintained by a set of interlocking institutions that, across different spatial and temporal planes, act as vectors for interrelated patterns of economic, political, judicial and social exclusions and injustices.