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The Fight Against Ebola Is a Fight Against Inequality

Jim Yong Kim's picture
A woman walks by an Ebola awareness sign in Freetown, Liberia. © Tanya Bindra/UNICEF
A woman walks by an Ebola awareness sign in Freetown, Liberia. ​© Tanya Bindra/UNICEF


As the spread of the Ebola virus in West Africa shows, the importance of reducing inequality could not be more clear. The battle against the virus is a fight on many fronts — human lives and health foremost among them.

But the fight against Ebola is also a fight against inequality. The knowledge and infrastructure to treat the sick and contain the virus exists in high- and middle-income counties. However, over many years, we have failed to make these things accessible to low-income people in Guinea, Liberia, and Sierra Leone. So now thousands of people in these countries are dying because, in the lottery of birth, they were born in the wrong place.

If we do not stop Ebola now, the infection will continue to spread to other countries and even continents, as we have seen with the first Ebola case in the United States this past week. This pandemic shows the deadly cost of unequal access to basic services and the consequences of our failure to fix this problem.
The virus is spreading out of control in Guinea, Liberia, and Sierra Leone. As a consequence, our ability to boost shared prosperity in West Africa — and potentially the entire continent — may be quickly disappearing.

Ebola Epidemic's Cost Looms Large

Jim Yong Kim's picture
Ebola Epidemic's Cost Looms Large


​The Ebola outbreak in West Africa started with just one case. More than nine months later, it’s now outrunning the ability of fragile countries and relief organizations in the three most-affected countries to contain it. Clinics and hospitals are overloaded. Sick people are being turned away. Things could get much worse unless something changes.

Campaign Art: Ebola In Town

Roxanne Bauer's picture

People, Spaces, Deliberation bloggers present exceptional campaign art from all over the world. These examples are meant to inspire.

Ebola virus is experiencing a break out summer. The latest outbreak in Guinea, Liberia and Sierra Leone is the worst ever, resulting in the death of almost 900 lives and infecting more than 1603 people across West Africa. The virus is also experiencing unexpected popularity on the dance floor.  

A new song, "Ebola in Town," recorded by a trio of West African rappers, warns of the dangers of Ebola over a catchy electronic beat. Residents of Monrovia and Conakry, the capitals of Liberia and Guinea, and have created a dance to go along with the song.  The lyrics warn "don't touch your friend" and "no eating something, it's dangerous," and the dance, fittingly, does not include any touching.

This advice is technically incorrect (you cannot contract Ebola virus from simply touching another person but rather through contact with bodily fluids) and may increase the social stigma that people recovering from Ebola face, an issue health workers are attempting to adress.  While the song is off-message, it may nonetheless be helpful in raising awareness. Many people in West Africa are not sure of the actual danger level, which may be exacerbated by illiteracy-  43.3% of adults in Sierra Leon, 42.9% in Liberia and only 25.3% in Guinea's are literate.  In these countries, music, theater, and radio are popular media to spread public information.

The Ebola Threat: A “new normal”?

Patricio V. Marquez's picture



A couple months ago while stationed in Ghana, I was approached by colleagues and friends with questions on how to prevent contagion from the deadly Ebola virus. Their concern was stoked by reports in media outlets about the rising number of confirmed cases and deaths in neighboring countries. 

Africa Impact Evaluation Podcast: Economic Empowerment of Young Women in Africa #AfricaBigIdeas


When it comes to helping young women in Africa with both economic and social opportunity, what does the evidence tell us?  Broadcaster Georges Collinet sat down with researchers and policymakers to discuss the hard evidence behind two programs that have succeeded in giving girls a better chance at getting started in their adult lives.

Lives on the line: reducing under-five child mortality rates in Africa

Dereje Ketema Wolde's picture
As countries all across Africa recognize International Day of the African Child today, I thought it would be a timely opportunity to blog about the progress of under-five child mortality rates over the past two decades.  But first, some data for us to understand the big picture:
  • On a global level, the rate of under-five child mortality has been cut in half, from 90 deaths per 1,000 live births in 1990 to 48 per 1,000 in 2012.  The estimated annual number of under-five deaths has fallen from 12.6 million to 6.6 million over the same period.
  • Since 1990, 216 million children worldwide have died before their fifth birthday — more than the current total population of Brazil, the world's fifth most populous country.
  • Disparities between children in the high-income and low-income countries have narrowed, but many gaps still remain.  Case in point: In Luxembourg, the under-five mortality rate is just 2 deaths per 1,000 live births; in Sierra Leone, it is 182 deaths per 1,000 births.

As we stand a year away from the Millennium Development Goal (MDG) 4 – which aims to reduce the global under-five child mortality rate by two-thirds between 1990 and 2015 – the pace of reduction would have needed to quadruple in 2013-2015 to achieve this goal, according to the United Nations Children's Fund's (UNICEF's) Committed to Child Survival: A Promised Renewed – Progress Report 2013.

A closer look at regional rates
Now let's take a look at the regional and country level data by viewing the World Development Indicators (WDI) 2014 and the indicator under-five mortality rate. The WDI also features a short progress report on MDG 4, which complements the detailed analysis of the World Bank Group's Global Monitoring Report.  This report uses the same methodology to assess whether countries are on track or off track to meet the 2015 targets.

Sub-Saharan Africa (SSA), where one in ten children die before the age of five, faces the biggest challenges in achieving MDG 4, followed by South Asia.  The SSA region reduced its child mortality rate by 45% during 1990 to 2012, the only region to reduce its under-five mortality rate by less than half during this time.  SSA also lags behind other regions in its pace of decline in the total number of under-five deaths.

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Breaking Down the Silos: Reflection on the “Invisible Wounds” Meeting

Mike Wessells's picture

Speaking as a psychosocial practitioner-researcher, the World Bank's recent “Invisible Wounds” conference, which enabled a rich dialogue between psychologists and the Bank's economically-oriented staff, was a breath of fresh air. In most war zones, humanitarian efforts to provide mental health and psychosocial support and economic aid to vulnerable people have frequently been conducted in separate silos. Unfortunately, this division does not fit with the interacting psychosocial and economic needs seen in war zones, and it misses important opportunities for strengthening supports for vulnerable people.
 
A case in point comes from my work (together with Susan McKay, Angela Veale, and Miranda Worthen) on the reintegration of formerly recruited girl mothers in Sierra Leone, Liberia, and northern Uganda. These girls had been powerfully impacted by their war experiences, which included displacement, capture, sexual violence, exposure to killing and deaths, and mothering, among others. After the ceasefire, they were badly stigmatized as “rebel girls” and were distressed over their inability to meet basic needs and to be good mothers. The provision of economic aid alone would likely have had limited effects since the girls believed that they were not fit for economic activity (many saw themselves as spiritually contaminated and as having “unsteady minds”), and they were so stigmatized that people would not do business with them. Similarly, the provision of psychosocial assistance alone likely would have had limited effects because the girls desperately needed livelihoods in order to reduce their economic distress and be good mothers.

When It Comes to Tackling Inequality, Start Early

Ana Revenga's picture

It seems that everyone is talking about inequality these days, and I, for one, am happy to see this issue at the forefront in the development discussion.

We can look at inequality in a number of ways, which are not unrelated. One of the most visible types of inequality on the radar is inequality of outcomes — things like differences in academic achievements, career progression, earnings, etc. — which, in and of themselves, are not necessarily bad. Rewarding an individual’s effort, innate talents and superior life choices can provide incentives for innovation and entrepreneurship, and can help drive growth.  

However, not all inequalities are “good.” When inequality perpetuates itself because those born poor consistently do not have access to the same opportunities as those born rich, what emerges is a deep structural inequality that is bad for poverty reduction, bad for economic growth, and bad for social cohesion. How pervasive are these deep inequalities? Much more than we would like. Indeed, when we examine what is happening in many countries around the world today, we find large and persistent, even growing, gaps in earnings between rich and poor. And we find that those who start out in poverty or are part of a disadvantaged group tend to remain there, with little opportunity to work their way out.

How do we explain this, and what can we do to tackle it? We need to take a step back and look at where this inequality originates, and that is where the concept of equality of opportunity comes in to play. This concept broadly refers to access to a basic set of services that are necessary, at the minimum, for a child to attain his or her human potential, regardless of the circumstances — such as gender, geographic region, ethnicity, and family background — into which he or she is born. Too often, access to such basic services like electricity, clean water, sanitation, health care and education is much lower among children born into circumstances that place them at a disadvantage. Children from disadvantaged groups thus set off on an unequal path from day one, which curbs their opportunities and potential into adulthood.

Measuring Development Success in Difficult Environments

Laura Ralston's picture

The challenge of moving from conflict and fragility to resilience and growth is immense. More than half of the countries counted as low income have experienced conflict in the last decade. Twenty per cent of countries emerging from civil conflict return to violence in one year and 40% in five years.

While the use and production of reliable evidence has become more common in much of the international development debate and in many developing countries, these inroads are less prevalent in fragile and conflict-affected situations (FCS). Programming and policy making in countries affected by conflict and prone to conflict is often void of rigorous evidence or reliable data. It is easy to argue, and many do, that it is impossible to conduct rigorous evaluations of programs in conflict-affected states. However, in spite of the very real challenges in these environments, such evaluations have been conducted and have contributed valuable evidence for future programming, for example in Afghanistan, the DRC, Colombia, northern Nigeria and Liberia.

My unit Center for Conflict Security and Development, (CCSD) is teaming up with the Department of Impact Evaluation (DIME), as well as the International Initiative for Impact Evaluation (3ie), and Innovations for Poverty Action (IPA), in a series of activities to enhance the evidence base on development approaches to peace- and state-building challenges. A first goal is to scope out where our evidence base is thinnest: what are the programs and interventions that remain least tested, but have theories of change suggesting great potential? We are hoping to take stock of what we and other donor institutions have been doing in this area of development, and map this into what we have learnt and what we most need to learn more about. USIP, USAID, IRC as well as leading academics in this field and IEG, are kindly helping in this endeavor, and we hope to be able to share some initial findings at our fragility forum later this year.


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