Socio-cultural Dimensions of Emerging Infectious Diseases in Africa: An Indigenous Response to Deadly Epidemics

296 Pages·2019·5.247 MB·English

by  Godfrey B. Tangwa, Akin Abayomi, Samuel J. Ujewe, Nchangwi Syntia Munung

Godfrey B. Tangwa · Akin Abayomi 
Samuel J. Ujewe 
Nchangwi Syntia Munung Editors
Socio-cultural
Dimensions of
Emerging Infectious
Diseases in Africa
An Indigenous Response to Deadly
Epidemics
Socio-cultural Dimensions of Emerging Infectious
Diseases in Africa
Godfrey B. Tangwa • Akin Abayomi
Samuel J. Ujewe • Nchangwi Syntia Munung
Editors
Socio-cultural Dimensions
of Emerging Infectious
Diseases in Africa
An Indigenous Response to Deadly
Epidemics
Editors
Godfrey B. Tangwa Akin Abayomi
Department of Philosophy Global Emerging Pathogen Treatment
University of Yaounde 1 Consortium (GET) Consortium
Yaounde, Cameroon Lagos, Nigeria
Cameroon Bioethics Initiative (CAMBIN) Nigerian Medical Research Institute
Yaounde, Cameroon (NIMR)
Lagos, Nigeria
Global Emerging Pathogen Treatment
Consortium (GET) Consortium Faculty of Medicine and Health Sciences
Lagos, Nigeria University of Stellenbosch
Stellenbosch, South Africa
Samuel J. Ujewe
Global Emerging Pathogens Treatment Nchangwi Syntia Munung
Consortium Department of Medicine
Lagos, Nigeria University of Cape Town
Cape Town, South Africa
Canadian Institute for Genomics
and Society Global Emerging Pathogen Treatment
Toronto, ON, Canada Consortium (GET) Consortium
Lagos, Nigeria
ISBN 978-3-030-17473-6 ISBN 978-3-030-17474-3 (eBook)
https://doi.org/10.1007/978-3-030-17474-3
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Preface
Epidemics caused by emerging infectious diseases (EIDs) are fueled by a variety of
complex drivers, and it becomes imperative that a strategic plan to prevent or man-
age epidemics or outbreaks of EIDs will have multiple facets.
The West African Ebola outbreak which commenced in December 2013 and was
only recognized as Ebola in March or April 2014 is a perfect example of a multifac-
eted health problem. It soon became apparent that indigenous medical and cultural
practices were the key catalysts of the rapid spread of the epidemic. The Global
Emerging Pathogens Treatment Consortium (GET), was born at the height of the
epidemic in August 2014. GET is a consortium made up of African indigenous
experts drawn from all walks of life, with the required expertise to mount a holistic
response to an EID outbreak. GET grew rapidly with the support of many interna-
tional collaborators, and organized itself into work groups addressing issues related
to: research ethics; clinical trials; blood product component therapy; community
engagement; anthropological and social issues; biobanking; biocontainment; and
logistics.
One of the major drivers of the rapid spread of the EVD outbreak in West Africa
were social and cultural practices; thus, the Cultural, Anthropological, Social and
Economic (CASE) work group was formed and became a leading player in the stra-
tegic response to the outbreak. Cultural practices that were driving the outbreak as
well as those that were retarding response strategies were quickly targeted by the
CASE work group with the aim of mitigating and adapting to the changing dynamic
of the situation.
It could even be said that one of the  interventions that helped to  turn
around the momentum of the outbreak were in the socio-cultural domain - interven-
tions related to: sanitation,  traditional burial practices, stigmatization and
discrimination.
The CASE work group has grown from strength to strength. Led by its
Chairperson, Professor Godfrey B Tangwa, the work group rapidly conceptualized
a documentary of cultural, economic and anthropological issues on the micro and
macro levels. It was clear that, as a global community, we often forget, during public
v
vi Preface
health emergencies, to address socio-cultural issues that could engender global
secuity risk.
The 2014 Ebola outbreak has taught us many things. It has taught us, most
importantly, that during periods of a dangerous epidemic, it is easy for human rights
to be abused and for cultural sensitivities to be sidelined. This is amplified when
the epidemic has the potential of transforming into a pandemic. 
This book is concieved as an inter-/intra-disciplinary publication with contribu-
tions from several knowledge domains. Some of its chapters are jointly authored by
experts from different disciplinary perspectives. It would therefore have a broad
appeal across disciplines including: medical sciences, research ethics, regulation
and governance, health communication and the social sciences. It is our hope that
this book will be an encouragement for all global health stakeholders, who are com-
mitted to improving basic health standards in Africa, a continent that has histori-
cally borne the heavy burden of enslavement, colonisation, exploitation, poverty and,
disease, all in spite or perhaps because of its enormous resources and
potentialities.
We are therefore happy to present this compilation that highlights many of the
philosophical, scientific, social and anthropological issues experienced during the
2014 Ebola outbreak in West Africa. This by no means exhausts issues that need
discussion. However, it is arguably the first comprehensive attempt by African schol-
ars, researchers  and their collaborators to address  major socio-cultural  con-
cerns linked to the management of EIDs such as Ebola, Lassa Fever, Monkeypox
and Zika for all global communities to deliberate upon because pandemics know no
boundaries, and all communities are at risk and vulnerable.
We hope that you will enjoy this collection and that it would stimulate further
reflection and preparedness on how to contain future epidemics of EIDs.
Lagos, Nigeria Akin Abayomi
Yaounde, Cameroon Godfrey B. Tangwa
Cape Town, South Africa Nchangwi Syntia Munung
Toronto, Canada Samuel J. Ujewe
February 2019
Contents
1 Editorial: African Perspectives and Approaches
for African Healthcare Challenges . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Samuel J. Ujewe, Nchangwi Syntia Munung, Akin Abayomi,
and Godfrey B. Tangwa
Part I Emerging Deadly Pathogens and Clinical Practice
2 How and Why the Global Emerging Pathogens
Treatment Consortium Was Created . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Akin Abayomi and Diran Makinde
3 Emerging Infectious Diseases: A Historical and Scientific Review . . 31
Gibril Ndow, J. Radeino Ambe, and Oyewale Tomori
4 Epidemiology and Management of Lassa Fever
in the West African Sub-Region:
Overcoming the Socio-cultural Challenges . . . . . . . . . . . . . . . . . . . . . . 41
Godsent Chichebem Isiguzo and Michael Onyebuchi Iroezindu
Part II Social Determinants of EID
5 Socio-cultural and Economic Concerns on Use
of Convalescent Blood or Plasma for the Management
of Ebola Virus Disease in Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Nchangwi Syntia Munung, Godfrey B. Tangwa, David Houeto,
Awa Keita, J. Radeino Ambe, and Akin Abayomi
6 The Impact of Ebola Virus Disease on Government
Expenditure in Sierra Leone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Fuein Vera Kum, Saheed Olayiwola, and Njong Mom Aloysius
vii
viii Contents
7 Public Health Emergencies: The Role of Science
Education and Communication in Africa . . . . . . . . . . . . . . . . . . . . . . . 91
Elizabeth Rasekoala and African Gong
8 Ebola and the Reimagining of Health Communication
in Liberia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Sally Deffor
Part III Global Health and Governance
9 A Political Conception of Pandemics and Epidemics in Africa . . . . . 125
Frank Aragbonfoh Abumere
10 Global Emerging Pathogens and the (Prescriptive)
Role of the World Health Organization . . . . . . . . . . . . . . . . . . . . . . . . 135
Godfrey B. Tangwa and Muhammed O. Afolabi
11 Disease Outbreaks in Africa and the Response
of African Governments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Oyewale Tomori
12 Africans in the Diaspora-The Hidden Force:
Economics, Investment, Skilled Workforce and Public Health . . . . . 161
J. Radeino Ambe, Marion Koso-Thomas, Samuel G. Adewusi,
and Muhammed O. Afolabi
13 Insufficiency of Pathogen Focused Approaches Towards
Managing Deadly Epidemics in Africa: Harmonising the Roles
of Governments, Health Systems and Populations . . . . . . . . . . . . . . . 173
Samuel J. Ujewe and Alice Mungwa
Part IV Ethics and Policy in the Context of EIDs
14 Context and Ethical Challenges During the Ebola
Outbreak in West Africa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
J. Radeino Ambe and Francis K. Kombe
15 Scientific Response to Deadly Novel Epidemics:
The Role of Good Clinical Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Francis K. Kombe, Jennyfer Ambe, Gibril Ndow,
and Korlia Bonarwolo
16 Scientific Response to Deadly Novel Epidemics:
The Role of Health Research Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Francis K. Kombe, Jennyfer Ambe, and Gibril Ndow
17 Criminalisation and “Reckless” Ebola Transmission:
Theorizing Ethical Obligations to Seek Care . . . . . . . . . . . . . . . . . . . . 229
Morenike Oluwatoyin Folayan, Bridget Haire, Kristin Peterson,
Aminu Yakubu, Jemee Tegli, and Brandon Brown
Contents ix
18 Global Emerging Pathogens, Poverty and Vulnerability:
An Ethical Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
Mbih Jerome Tosam, J. Radeino Ambe, and Primus Che Chi
19 Why Justice is Good for Healthcare in Africa:
Towards an Ethical framework . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Samuel J. Ujewe
Part V Narratives from the Field: The Ebola Virus Disease Experience
20 Beyond Mere Statistics: Case Studies from the Field
During the Ebola Epidemic in West Africa . . . . . . . . . . . . . . . . . . . . . 271
J. Radeino Ambe, Nchangwi Syntia Munung, and Godfrey B. Tangwa
21 Lagos the Mega-City: A Report on How the Metropolis
Handled an Outbreak of the Ebola Epidemic . . . . . . . . . . . . . . . . . . . 281
Jide Idris and Adesina Fagbenro
About the Editors
Godfrey B. Tangwa is emeritus professor of the University of Yaounde 1, Cameroon,
where he was head of the Department of Philosophy from 2004 to 2009. He is a
fellow of the Cameroon Academy of Sciences (CAS) and the African Academy of
Sciences (AAS), vice chairperson of the Cameroon Bioethics Initiative (CAMBIN)
which he founded in 2005, an executive committee member of the Pan-A frican
Bioethics Initiative (PABIN) and chairperson of the Cultural, Anthropological,
Social and Economic (CASE) work group of the Global Emerging Pathogens
Treatment Consortium (GET). He has extensive teaching and research experience in
the domains of philosophy and bioethics. He obtained a BA (1977) from the
University of Nigeria, Nsukka; an MA (1979) from the University of Ife (now
Obafemi Awolowo University), Ile Ife; and a PhD (1984) from the University of
Ibadan, all in Nigeria. He has served on several expert advisory committees for the
WHO, has been a member of the Scientific Ethics Advisory Group (SEAG) of
Hoffmann La Roche since 2005 and is currently also an advisory board member of
both ALERRT and SARETI. His publications’ record shows about 10 books, 35
book chapters and 45 journal articles.
Akin Abayomi is professor of Medicine at the Nigerian Institute of Medical Research
in Lagos, Nigeria. Prior to that, he was the chief pathologist and head of the Division
of Haematology, Faculty of Medicine and Health Sciences, Stellenbosch University,
Cape Town, South Africa. A specialist in internal medicine and haematology, envi-
ronmental health and biosecurity, Professor Abayomi studied at the Royal Medical
College of St Bartholomew’s Hospital in the University of London where he attained
his first graduate degree in Medicine. He has obtained fellowships from the Royal
College of Medicine and Pathology in the United Kingdom and the College of
Medicine of South Africa. He has worked in several countries around the world in
both internal medicine and haematology and has been exposed to a variety of geo-
graphical variations and disease patterns within these areas. His focus has mainly
been on the concept of emerging diseases like Ebola, HIV and TB and the develop-
ment of laboratory and clinical capacity in Africa. He is the cofounder and principal
investigator of the Global Emerging Pathogens Treatment Consortium (GET).
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