What is state failure? See my conceptualisation of state failure on the right flank below.

Saturday, March 31, 2007

Meningitis belt spillovers - Questioning the 'over' in 'spillover'

The MStFB Spillover Monitor Report Series No. 5

Another day and another issue highlighting the need to see that negative spill-over effects affect states within the poorer part of the world the most of all. West African countries are being hit, as we speak, by a large meningitis epidemic, with Burkina Faso being the hardest struck in the region. From January 1 to March 21 at least 801 people have died, out of about 11,000 infected there. More info here. Foreign donor response is rather slow to meet the financing demands of a sufficient vaccination program, which is already on-going of course, but is hampered at times by a shortage in medical personnel to carry out the measures required as well as by other problems. Burkina Faso is not alone in facing the current epidemic, with Cote d'Ivoire, Niger, Mali and Benin also reporting both cases and deaths.
The epidemics in the countries of the region are very much interconnected by population movement dynamics driven by traditional market mechanisms as well as other factors. In other words, on the one hand we have states facing negative spill-over effects from each other (technically speaking that may be said so), on the other hand a more realistic interpretation might focus on a traditionally very much interconnected population that was divided into different populations or peoples quite artificially by colonial administrative borders turned into 'international' borders. To put it simply, infection is spilling 'on' (from one person to another), but it may not be legitimate or smart to say it's spilling 'over'. That is something we always have to keep in mind in looking at problems of the post-colonial world.
It's the interconnectedness I've just been talking about that makes experts of the region talk of a 'meningitis belt' across a whole string of countries from the West to the East of Africa, from Senegal to Ethiopia, all across the semi-arid Sahel region. Outbreaks of meningitis occur first of all mostly during the 'dry' season (the driest of all), from December through to June. In this period winds carrying a lot of dust and cold nights work to weaken people's immune system both in general and locally, in the area of the pharynx. Another factor affecting the probability of outbreaks is the cyclic nature of their occurrence. They come when 'herd immunity' begins to drop (the proportion of a population that is immune to the disease), as time passes after a major outbreak after which wide-spread vaccination has taken place. (Info here.)
However, it's not altogether inappropriate to talk of spillovers in connection with the topic, mostly beacuse of the issue of the Hajj, the traditional Muslim pilgrimage to Mecca in Saudi Arabia. It is a traditional population movement of course, and quite a large one at that, however, it is a security concern for the Saudi state which has to look out for the threat of meningitis and a whole other list of diseases potentially imported with it. Proof of meningitis vaccination is required by the Saudi state for the granting of visa to travellers from the region and, for instance, in the case of the largest African meningitis epidemic, in 1996, when about 25,000 people died out of 250,000 cases, the Saudi authorities even introduced a temporary ban on pilgrims from Nigeria and other countries. Fearing social unrest, the affected African countries tried to downplay the scale of the epidemic at the time, and the eventual Saudi decision led to a deterioration in state-to-state relations between Saudi Arabia and the countries of the region. The recurrence of this problem we may still see in the future, with the Islamic Calendar month of Dhu al-Hijjah, the time of the Hajj, usually coinciding with the beginning of the period that is the most critical in general in terms of meningitis outbreaks in Africa's meningitis belt.

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