Spread risk: a Monrovia classroom serves as a rudimentary isolation ward. Photo: John Moore/Getty
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West Africa on a hope and a prayer: the desperate efforts to contain ebola

The 16 August attack on an ebola clinic in the Liberian capital, Monrovia, is a sign of just how deeply western medicine is mistrusted.

Ebola, a virus with a 60-90 per cent death rate, has already killed at least 1,145 people in West Africa. There is no cure, which adds to the rising sense of fear in the affected countries and their close neighbours. There have been no confirmed cases yet in Gambia, but on crowded buses, crackling radio reports relay the latest death toll, a constant reminder that the threat is not far from home.

Having spread from a single Guinean village across swaths of Liberia and Sierra Leone and into Nigeria, this outbreak is the deadliest to date. There is little trust in doctors, a by-product of local traditions and popular reliance on faith healers. After months of bad news, many people lack hope.

The disease was first detected in February and was declared a Liberian national “public health emergency” by the president, Ellen Johnson Sirleaf, in June. In early August, the World Bank pledged $200m to Sierra Leone, Guinea and Liberia, and the UK offered a further £3m in aid. Yet the death toll continues to mount.

The 16 August attack on an ebola clinic in the Liberian capital, Monrovia, is a sign of just how deeply western medicine is mistrusted. It is hard to convince people to put their faith in new medicine when it can offer no cure.

The fragile economies and weak infrastructure of many countries in the subregion also limit their ability to manage the disease. On average, West African states spend $100 per capita on health care each year – nothing compared to the $3,600 per person in Britain.

The slow response by affected governments hasn’t helped. Kudzi Makopa, a student volunteer from London, flew to Sierra Leone in late May. “When we arrived there, the disease was the subject of jokes among the general public and there was even a comedy film on the matter being sold nationwide,” he told me. “No one really believed ebola was happening because they’d never seen it, and they thought that witch doctors or God would send it away.” Today, posters and billboards line the streets of the capital, Freetown, reading “Ebola is real”, but perhaps it is too late.

In Liberia, experts called in by the government insisted that the first wave of a disease is often less destructive than those that follow, which arguably made the country’s response slower than it might have been. “We were acting appropriately. But because of weak health systems, the disease spread, and now we are responding again,” Tolbert Nyenswah, an assistant minister in Liberia’s health department told me.

Gambia risks making some of the same mistakes. Despite its proximity to the epidemic, few plans have been put in place to combat the virus. There is no sign of the ebola isolation facility that was due to be set up months ago, and testing for the disease is not available in the country.

At the Medical Research Council in Fajara, on Gambia’s Atlantic coast, doctors are disappointed that promises of resources have not been met. Outside the hospital, crowds of patients, including rows of mothers cradling malnourished babies in their colourful wraps, sit waiting on benches in the heat. Should an ebola victim be treated inside, these walk-in patients would be turned away. Doctors say people are turning to prayer to deter the virus.

West African countries have tightened their border controls, but the World Health Organisation has said that official figures may “vastly underestimate” the spread of the virus, making it harder to contain. Despite the international attention, the measures in place to combat ebola are inadequate. It feels as though people are still waiting for some intervention, whether governmental or divine, to end this crisis. 

This article first appeared in the 20 August 2014 issue of the New Statesman, What the Beatles did for Britain

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Theresa May's big thinker - an interview with George Freeman

The Conservative policy board chair on the meaning of Brexit, state intervention and whether "Mayism" exists.

Theresa May’s three months as Prime Minister have been marked by ruthless changes of both personnel and policy, from grammar schools to fiscal targets. The man tasked with overseeing the latter is George Freeman, a newly bearded 49-year-old who jokingly describes himself as “a designated thinker”.

“It’s a huge privilege,” Freeman told me when we met recently in Westminster. “As [May] has indicated, she’s determined to open up the policymaking process to good ideas from a much wider pool.”

After entering parliament as the MP for Mid Norfolk in 2010, Freeman distinguished himself as one of the most intellectually energetic Tory MPs. He founded the 2020 group of Conservative modernisers and became the first ever life sciences minister in 2014. Before this, he had worked for 15 years as a biotech entrepreneur.

Politics is in his blood. The Liberal prime minister William Gladstone was his great-great-great-uncle and Mabel Philipson, the first female Conservative MP, his great-aunt. Yet Freeman attributes his reformist zeal to the belief that “with privilege comes responsibility”. He boarded at Radley College after his parents, both alcoholics, divorced and has spoken of his “emotionally damaged” childhood.

It is unsurprising that May, confronted by the greatest policy challenge since 1945 – EU withdrawal – has called on his services. The chair of the Prime Minister’s policy board, to give Freeman his official title, was a passionate Remainer but told me “we are now all Brexiteers”. The “Brexit roar”, he explained, was “a mixture of very deeply felt concerns and complaints about globalisation, powerlessness and the growing gap between London and [other] places . . .

“There’s an understanding that if we simply delivered Brexit, and didn’t tackle the rest, we would only have dealt with some of the problem.”

His ambition was “to do for our generation what Disraeli did in the 19th century, in understanding that the extraordinarily challenging pace of franchise extension was also a huge opportunity to harness and fashion a New Model Conservative Party”.

Besides abandoning the surplus target (“to boost growth and investment in infrastructure”), Freeman cited welfare policy as a point of departure. The government would “better differentiate” between changes in the welfare budget and systemic reform – a division that May believes was eroded by George Osborne.

The Prime Minister underlined her commitment to industrial strategy by naming a new department after it. But what does it mean? “I think there is a recognition that we are embracing something unrecognisable from the failed ‘beer and sandwiches’ interventionism of the Sixties and Seventies,” Freeman said. “Twenty-first-century Conservative industrial strategy is about backing our science, innovation and knowledge economy, and other sectors where we have serious global leadership.” He spoke of “stepping in where only the state can”, citing the publicly funded Diamond Light Source synchrotron facility, which he recently visited with the astronaut Tim Peake. The government must be not merely “pro-enterprise”, but “more enterprising”.

May has endured her heaviest dissent over education, and Freeman was notably lukewarm about the idea of new grammar schools. “As well as her position” on the latter, he emphasised, “the Prime Minister set out a much broader vision”. Asked whether he understood MPs’ objections to academic selection, he said “there will be all the usual consultation and discussions through parliament about specific measures”.

The Prime Minister has entered office with greater ideological definition to her thinking than David Cameron, who struggled to reconcile his early vision with austerity. Can we speak of “Mayism”? “I’m not sure the ‘ism’ is helpful or appropriate at this stage. The Prime Minister is very strongly driven by her conservative values, and converting those values into effective policies to tackle the challenges we face. I think we have to wait for the judgement of history to define the ism.”

Freeman is close to “DC” (as he calls Cameron) and praised his premiership. “I was very sorry to see him go. But in the end, given the way the referendum turned out, it was inevitable. I thought he handled that whole last week in the most exemplary way: typical of the man. In time, I think he will come to be recognised as a transformational leader who brought the Conservative Party to terms with modern Britain.”

He rejected the former education secretary Nicky Morgan’s suggestion that May would struggle to “reach into” the marginal seats that the Tories won under Cameron. “Theresa May is appealing widely across whole swaths of the country as a One-Nation leader,” he declared.

With the re-election of Jeremy Corbyn, Freeman said, “the centre ground of British politics, once dominated by Blair and New Labour, has been vacated . . . That is a huge opportunity for a One-Nation Conservative Party to demonstrate our relevance beyond our core vote to those around the country who have clearly felt so marginalised.”

Corbyn’s triumph “illustrates the extraordinary challenge for mainstream political parties in this age of asymmetric, post-Brexit politics . . . We now have to use the opportunity of incumbency in government to tackle the root causes of the insurgency that has taken out the Labour Party.”

Freeman acknowledged the risk that Labour’s divisions would produce an internal Tory opposition.

“It also creates a question for the Conservative Party. Will we turn in on ourselves and generate our own arguments, or unite and reach out into the space that Corbyn has vacated?” 

George Eaton is political editor of the New Statesman.

This article first appeared in the 29 September 2016 issue of the New Statesman, May’s new Tories