Democracy Lab

The Cure for Ebola Is Accountability

Africa's Ebola outbreak isn't just a health care problem. It's also about a crisis of governance.

There was a tragic irony to the discussions in Washington last week between President Obama and African leaders. The meeting took place even as the Ebola virus was brutally exposing the lack of capacity, antiquated health systems, and dearth of governance in one corner of the continent. The outbreak is gathering pace. Over 1,000 people have now died in West Africa. Hospitals and health clinics are overflowing and anger is rising as dead bodies are being left to rot in the streets.

The governments in the region and the international community are finally getting serious about a coordinated response to Ebola. Sadly, however, these measures only treat the symptoms and not the causes of the problem -- which at their core are issues of corruption, mismanagement, and a lack of accountability of those in power to their people.   

There are parts of Africa that have made incredible progress in the past two decades. Think of Mozambique, where poverty levels have been cut by almost 15 percent since 1996. Or Senegal, where equal numbers of girls and boys are now enrolled in primary school. In Liberia, one of the countries worst hit by Ebola, successful elections have been held twice and economic growth has averaged over 7 percent in the past 10 years.    

The Ebola crisis is quickly exposing how rapidly progress can be undermined, however, when it is not grounded in a fair, inclusive social compact between governments and their citizens. It is no coincidence that, in the countries at the heart of the outbreak, large groups of people have been systematically excluded from power and decision-making at all levels for decades. This means many citizens are unwilling to believe that the government can serve their interests. The health system in Liberia is a case in point. Despite millions of dollars of investment in the decade before the Ebola outbreak, there were only 150 trained doctors in the entire country of 3.5 million people. As a result, access to services is inevitably exclusionary, lending itself to networks of corruption as patients do anything they can to receive care.   

In recent years, kleptocratic and nepotistic behavior by the ruling elites have led to long civil wars in Liberia and Sierra Leone; deep ethnic tensions, a coup d'etat, and civil strife in Guinea; and a low-level insurgency and the rise of Boko Haram in Nigeria. These are places where the social fabric has been ripped apart, and trust between those in power and ordinary people is almost absent.

Sadly, by some measures governance in Africa is getting worse, not better. In 2009 there were 12 African states ranked in the lowest 30 countries of Transparency International's Corruption Perceptions Index; last year this increased to 15 countries in the bottom 30 of the list. The Ibrahim Prize for Achievement in African Leadership, awarded to democratic leaders of integrity in Africa at the end of their mandated terms, has only been awarded three times in seven years. The aid system has become part of the problem as African governments have often focused on international funding flows rather than efforts to generate the confidence of their own people.

There is a clear link between this governance failure and the current health crisis. In places where governments are so rarely willing or able act in the interests of their citizens, we can begin to understand why the disease continues to disseminate. Health services, which barely exist in many places, are shunned because the unsanitary conditions of hospitals and heath centers have made them hubs for the spread of the virus. Many hospital staff -- already underpaid and ill-equipped -- have become victims themselves. Foreign health workers sent to help are ignored and even chased away by scared locals. A group of Liberians explained to us recently that they think Ebola is a ploy by the government to steal even more money from Western donors.

As a result, the Ebola challenges are now evolving into larger problems of instability in the region. Economic activity has ground to a standstill as borders have closed, movement is restricted, and flights are canceled.  This is happening in countries where up to 50 percent of the population already earns less than 50 cents a day. Mistrust, misunderstandings, and ill-will are growing as people continue to die. In Liberia, the president has declared a national emergency and the vice president has stated that Ebola is threatening the progress made since the end of the civil war. The use of riot police to put down a recent protest against the government's failure to deal with the crisis does not bode well.

Public outreach campaigns, infection control measures, and coordinated international technical support will control the virus in the short term. But in the longer term, we must empower the governments and people of the region to build mutual trust with each other and get to grips with the corruption, mismanagement, and capacity issues that prevent effective management of these types of crises.

This requires support to ensure that laws against graft are enforced fairly and are matched with institutions mandated and resourced to do their jobs. The Liberia Anti-Corruption Commission (LACC), for example, has just two lawyers -- something that makes prosecuting corrupt officials extremely difficult.

Finding solutions also means encouraging administrative bodies to allow people to have a greater say in how they are governed. Decentralization -- delegating decision-making to local governments -- can help with this, as can processes like participatory budgeting where citizens can decide how public funds are spent. Finally, it requires a clear emphasis on funding for flexible, grassroots mechanisms for holding governments to account for the delivery of services.      

These kinds of prescriptions are difficult and time-consuming, and they rarely generate front-page news. But they can allow for a process through which governments in West Africa can begin to build the trust that is essential in times of emergency. This is the real cure for Ebola.



Those Who Play Politics With History's Mistakes

In order to get Iraq right in 2014, politicians have to admit that they got Iraq wrong in 2003.

Since the White House announced plans to bomb Iraq on Aug. 7, a predictable set of Washington players has taken the opportunity to blame the Obama administration's missteps for the capture of broad swaths of Iraq by radical jihadists. But while U.S. jets pound the Islamic State's positions in northern Iraq, President Barack Obama has been firing back at critics at home.

When a reporter asked Obama last Saturday if withdrawing U.S. troops from Iraq had caused the current situation there, the president pointed the finger back at the Bush administration and its supporters. "So that entire analysis is bogus and is wrong. But it is frequently peddled around here by folks who oftentimes are trying to defend previous policies that they themselves made," the president said.

Meanwhile, the president's critics, including notably Sen. John McCain, have accused Obama of not just doing too little in Syria or Iraq, but having "lost" a war in Iraq that George W. Bush had "won."

"We had the conflict in Iraq won thanks to the surge," McCain said. "If we had left a residual force behind we would not be facing this crisis today. Those are fundamental facts. And now we are paying a very heavy price."

Nevertheless, by claiming that the threat now metastasizing in Iraq vindicates Bush's policies in the country, Obama's critics are only reinforcing the president's innate caution, while also making it harder for Americans to emerge from the long shadow of the Iraq War. The United States is unlikely to ever approach consensus over what to do about the Islamic State as long as proponents of robust U.S. policy persist in blind historical revisionism. In fact, McCain and others might do well to reflect on the history of U.S. involvement in Vietnam, where McCain served with heroic distinction. It was from Vietnam that the Arizona senator recently issued another of his stinging broadsides, accusing Obama of setting up straw men when the president suggested that anyone opposing his approach to Iraq was trying to restart the ground war there.

What McCain forgets is that the searing Iraq experience has indelibly colored American views about the U.S. role in the Middle East and beyond. Even among Republicans -- and even after the successful "surge" of 2007 -- support for the decision to go into Iraq among Americans has declined precipitously and almost uninterrupted since the invasion was launched back in 2003.

In the aftermath of the Iraq debacle, Americans have demonstrably narrowed their appetite for overseas military intervention. Over two-thirds of voters from both parties told pollsters last month that U.S. military action should be strictly limited to direct threats to national security, as opposed to fulfilling the country's inherent moral responsibility. Yet there is absolutely no consensus on whether the rampaging extremists in Iraq actually pose a threat to the United States, with a bare majority confident that what is happening there will have little or no effect on America's security. While President Obama has invoked the plight of the stranded and threatened Yazidi population as a justification to act now in Iraq, he surely remembers that a year ago, 55 percent of Americans opposed his call for limited strikes in Syria, despite the ghastly videos of Syrian civilians dying from chemical weapons.

As these polls suggest, the domestic landscape is deeply hostile towards even limited military action to stop the worst human rights violations. Baseless triumphalism over the Iraq War and schadenfreude over the administration's predicament will only further push Americans away from wanting to become involved in the Middle East, reinforcing the suspicion that Washington learned nothing from the Iraq fiasco.

The task for anyone concerned about the parlous developments in the Middle East is to persuade Americans that the previous administration's blunders over Saddam Hussein's illusory weapons of mass destruction should not prejudice the current administration's efforts to deal with the very real threat of a brutal, highly capable extremist group attempting to take over the heart of the Middle East. That change in American public opinion won't happen as long as proponents of greater U.S. intervention in Iraq run away from the reality of the Bush intervention.

Indeed, the charge of having "lost" the Iraq War only prompts critics of that war, like Senate Majority Leader Harry Reid, to issue pointed reminders of the litany of Bush-era Iraq mistakes. "We're stuck listening to the very same neocons who pushed us into the Iraq War in the first place, as they try to plunge our military into another foreign misadventure," Reid said on the Senate floor.

Instead of measured consideration of the serious threats spilling out of Iraq and Syria, the polarized debate only hardens skepticism, reinforcing the widespread belief -- particularly among Democratic voters -- that the United States is better off letting the Middle East burn while Washington walks away.

Advocates of more robust policy, like McCain, must make a fundamental choice: Either they can attempt to rewrite the history of the last Iraq War and take political pot-shots at the president, or they can acknowledge the folly of the earlier misadventure and, in so doing, begin to build public support for an urgent struggle against a determined, audacious foe.

No one is in a better position to grasp the need to come to terms with a divisive war than McCain himself. Among the longest serving American prisoners of war in Vietnam, McCain is acutely aware of how acrimony over that war colored and complicated U.S. foreign policy. "No more Vietnams" became the clarion call of foreign policy from the moment the last Huey helicopter took off from the Saigon embassy compound in May 1975. Not until George H. W. Bush sent troops to Iraq in 1990 did the ubiquitous concern about avoiding another "Vietnam quagmire" truly recede.

Today, "no more Iraqs" threatens to paralyze American foreign policy while massively raising the bar for employment of hard power -- anywhere -- and reinforcing the president's own, innate reluctance to employ it.

Senator McCain might also recall a crucial difference between the post-war debates over Iraq and Vietnam. Once the war ended, Vietnam hawks quickly abandoned the hyped characterization of the war as an existential test of U.S. power and prestige. Even those who believed the war could have been won largely conceded that fighting it was a mistake.

In other words, candor by the war's proponents helped end the debate, even if the trauma persisted for years. Even prominent architects of U.S. strategy in Vietnam conceded their mistakes. Former Secretary of Defense Robert McNamara, who oversaw the Vietnam escalation under President Lyndon Johnson, published a searching re-examination of what went wrong in Vietnam. He called it In Retrospect: The Tragedy and Lessons of Vietnam and used words like "failure" to characterize the war. McNamara wrote a companion volume devoted entirely to "the search for answers to the Vietnam tragedy."

In stark contrast, former Secretary of Defense Donald Rumsfeld's 2011 memoir Known and Unknown does not even include the word "lessons" in the index. Instead, Rumsfeld's book is a litany of selective remembrances. He shifts the blame for the iconic errors of the war -- the spurious weapons of mass destruction justification, the inadequate number of U.S. troops deployed, the abuse of prisoners at Abu Ghraib prison -- to others or minimizes them entirely.

Searching for lessons implies failure. And there is little inclination among Iraq War architects and proponents to acknowledge even the most incontrovertible errors of the war: By wrongly invoking intelligence on alleged weapons of mass destruction, the Bush administration fatally damaged the principle of pre-emption. By decapitating a minority Sunni regime, the invasion paved the way for Iranian projection of power in a country that had been Tehran's most formidable adversary and sparked the sectarian conflict that continues to roil the Levant and Persian Gulf. By vastly underestimating U.S. force requirements, thousands of Americans were killed or maimed unnecessarily, as were more than 100,000 Iraqis. For none of this has there been any apologies or, it seems, even self-reflection.

Unlike Vietnam, the prideful, futile insistence on justifying an ill-conceived invasion and a botched occupation sustains Iraq as a bitterly divisive issue in American political discourse. By contrast, given tacit consensus over the Vietnam trauma, President Ronald Reagan was able to rally adequate support for interventions in Central and South America, the Middle East, and Asia throughout the 1980s.

In the end, the United States emerged from Vietnam with a greater ability to address continuing challenges to national security than it has today in the wake of the Iraq experience. McCain and others are right that the United States must attack the Islamic State hard. But getting Americans to view the threats from Iraq with fresh eyes requires politicians to acknowledge the disastrous wrong committed when the United States invaded the country 11 years ago. In other words, what Washington needs today is statesmen-like candor, not opportunistic vindication.