An Ebola outbreak is raging in the northeast corner of the Democratic Republic of the Congo — and Goma, a city home to more than a million people that serves as the main trade route on the border of Rwanda, recently confirmed its first cases.
One local resident shared he had been “praying that Ebola comes to Goma so we can make money too.”—
Fears are spiking over the global spread of the virus. Yet, what fails to make headlines is that the international emergency response to Ebola brings with it a massive flood of capital to one of the world’s poorest countries. While the world wrings its hands over the disease, some in the region view Ebola’s arrival in Goma as a moment of divine favor. One local resident shared he had been “praying that Ebola comes to Goma so we can make money too.”
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While newspaper stories are focusing on how community skepticism, misinformation, and mistrust are hindering the response, the role of money and its unequal distribution may not only be hurting the efforts but may actually be creating perverse economic incentives that are exacerbating the outbreak.
In July, two Congolese Ebola response workers in the city of Beni were murdered. The death threats that preceded these murders were not rife with ignorance, but dripping with jealousy over the lucrative salaries the staff were receiving from the World Health Organization. Daily wages for agricultural workers in this part of North Kivu average $1.87 for women and $2 for men.
However, connected individuals who are able to obtain jobs with the relief effort are able to earn wages closer to $30-100/day, while foreign consultants have all expenses paid as well as earning typically more than $600/day. Indeed, well trained local accountants, administrators, and educators are quitting stable careers to do menial jobs on outbreak response teams at these exponentially higher salaries. Effects of these life-changing, and sometimes life-ending, decisions will linger long after the disease is contained.
How much money is at stake in a response like this? While it is difficult to get a full picture in the course of the current outbreak, recent history is revealing. During the West Africa Ebola outbreak of 2014-2016, the worst to date, approximately $48,900 per contracted case was spent on means to control the disease, according to the UN’s Financial Transparency Service. This is the equivalent to 70 years of income for an average Liberian. A lifetime of accumulated capital was deployed for each person with a disease that, since 1976, has killed less than 3% of those in Africa that die of malaria every single year.
Virtually none of this money actually affects the livelihoods of those most vulnerable to the disease. Money swirls around them as response teams in vehicles move from village to village with most of the dollars funding the massive administrative apparatus of disease response. Beyond the doctors and international experts brought in to suppress the contagion, the financial benefit to local political and business elites from the Ebola gold rush is significant.
One hotel in Goma, booked indefinitely by WHO for staff housing, is being paid $15,000 per day on retainer. Local elites quickly purchased and leased out dozens of Land Cruisers to WHO, at a base rate of $180 per day for rental fees. One such individual owns 37 trucks, bringing in over $200,000 a month in revenue. Operators working in fuel, restaurants, leisure zones, and logistical support services are bringing in hundreds of thousands of dollars.
Rumors swirl that these elites are behind some of the violence against the Ebola Treatment Centers. These rumors suggest that the hope is to extend the life of the disease response and thus, maintain once-in-a-lifetime revenue streams. Elites, even those inhabiting outbreak epicenters, are almost totally unaffected by the disease — typically only the poorest and most exposed people, such as health workers, family members caring for the ill, and grave diggers contract the virus. A perverse incentive for disease spread emerges among powerful local business people who are instrumental in managing the response effort.
Why focus on the dollars behind this Ebola response? One could argue that every dollar spent is worthwhile if it prevents a pandemic. We understand it is incredibly difficult it is to tackle the disease. Our issue is not with the amount spent, per se, but rather how it is disbursed.
Who stands to benefit from the Ebola gold rush? Can we afford to be naive about the effects of such funding on affected communities, especially in war-ravaged and poverty-stricken zones? The direst unintended consequences of the international lack of concern around the “Ebola Economy” could well be the exacerbation of the persistence and spread of the disease. Local dynamics, in all their complexity, matter. All the while, Ebola both takes lives and makes fortunes in eastern Congo.