At the UK Labour Party conference in 2000, Tony Blair said, “The state of Africa is a scar on the conscience of the world. But if the world as a community focused on it, we could heal it. And if we don't, it will become angrier and deeper.”
Last month he used remarkably similar words to launch the report of his Commission for Africa.
If his words haven't changed it’s because the state of Africa hasn't changed, and if the state of Africa hasn't changed in five years, it’s because the western approach towards Africa hasn't changed in a century.
In describing the horrors of Africa today, Blair's typically prosaic speech echoes that of Joseph Conrad in his description of one of the Congo's most infamous villains, Mr Kurtz. He symbolised all the evils of colonialism in one man, a colonialism that was cruel, exploitative, and ignorant of the needs of African populations.
In the attitudes of the west towards Africa today, Mr Kurtz still exists.
The parallels between colonial Africa and the Africa of today are disturbing. Where slavery and enforced labour were rampant in colonial Belgian and French Congo, the citizens of the continent are now effectively slaves to their own sickness and poverty.
We have looked towards highly capitalist economic systems to improve health and welfare. In return for development grants the World Bank imposed a system of enforced cost-recovery for health care in 1994. Initially this was designed to semi-privatise health care and assist poor governments in providing it. But in the African milieu of rampant disease and extreme poverty, a system that requires the consumer to have a minimum level of wealth cannot possibly survive. These “Bamako accords” have left quality health care beyond the means of millions.
Such philosophies have limited rather than enhanced progress. In 2000 the United Nations outlined its Millennium Development Goals as targets to improve the health and welfare of the third world over the following decade. As it stands, these goals have hardly been met, nor are likely to be met in the near future. The World Health Organization's '3 by 5' project, to have 3 million citizens of the developed world on AIDS treatment by 2005, is instead languishing in the 100,000's. The British Chancellor of the Exchequer commented that the Millennium Development Goal of educating all African children of primary school age by 2015 will not be met until 2130 at current rates of progress.
The results of inadequate health and education are clear. On an individual level workers with substandard education have limited negotiating power.
In my hospital in the Republic of Congo we receive one serious amputation a month from the factory of an Italian timber company, Likouala, the employees of which are lucky to be paid once every two months. Poverty forces them to work for a pitiful wage in unsafe conditions far from the watchful eye of the International Labour Organisation (ILO). Inadequate health, particularly where AIDS is concerned, decimates the effective working life of an adult in Africa, perpetuating the poverty cycle.
Blair's report effectively rejects the philosophy that economic progress will bring with it improvements in the health and welfare of African nations. Health and welfare are the stumbling blocks to economic progress, rather than the other way around. It calls for a massive increase in development funding that will not be tied to damaging agreements such as the Bamako accords. In contrast to Kurtzian philosophy it recognises rather than ignores the continent's poor and infirm.
The second parallel between Kurtz's Africa and today is the favouritism of certain leaders by the developed world. Belgian Congo in the early 20th century was torn by conflict between supporters of a colonial regime that employed entire tribes to war against those who rejected the regime. The civil wars after “independence” devastated Angola and Mozambique, where warring factions were supported by the two super-powers of the Cold War.
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