Scientists may have discovered the cure for Ebola, trials in the DRC show

This is from the FT:

Two anti-Ebola drugs have proved so effective they will be rolled out to all patients in the Democratic Republic of Congo, raising the prospect of a potential cure for the deadly disease. In a trial conducted since November, more than 90 per cent of patients survived when they were treated early enough with one of the two drugs, scientists said. Under normal circumstances, some 70 per cent of people infected with the virus die. In the latest outbreak in Congo, the second worst in history, some 1,800 people are known to have died out of about 2,800 infected.

The success builds on the lifelong work of a Congolese doctor:

muyembeThe two drugs, called REGN-EB3 and mAb114, attack the Ebola virus with antibodies, preventing the virus from entering cells. They build on a treatment developed by Dr Jean-Jacques Muyembe, director of Congo’s National Institute for Biomedical Research, who has helped lead the fight against Ebola for four decades.

Dr Muyembe, 77, was recently put in charge of the Congo’s response against the Ebola outbreak, which has taken place in the east of the vast central African country where lawlessness and lack of trust in authorities has hampered the response.

Here is Dr. Muyembe-Tamfum’s WHO profile.

Incidentally, Dr. Muyembe-Tamfum “was part of the research team that investigated the first known outbreak of Ebola virus disease in 1976.” He earned his medical degree from the University of Lovanium in Kinshasa (1969), and PhD in virology from the University of Leuven in Belgium (1973). He was appointed dean of the Faculty of Kinshasa University Medical school in 1978.

Here is his Wikipedia page.

And here is another profile in the Lancet from 2015.

On external interventions to improve village-level governance and development: The DRC Edition

This is from an excellent JDE paper by Humphreys, de la Sierra and der Windt:

We study a randomized Community Driven Reconstruction (CDR) intervention that provided two years ofexposure to democratic practices in 1250 villages in eastern Congo. To assess its impact, we examine behavior in a village-level unconditional cash transfer project that distributed $1000 to 457 treatment and control villages. The unconditonal cash transfer provides opportunities to assess whether public funds get captured, what governance practices are employed by villagers and village elites and whether prior exposure to the CDR intervention alters these behaviors. We find no evidence for such effects. The results cast doubt on current attempts to export democratic practices to local communities.

Here’s a description of the program:

Our study takes advantage of a large UK funded CDR program, called “Tuungane,” implemented by the International Rescue Committee andCARE International in 1250 villages throughout eastern Congo. The program had as a central goal to “improve the understanding and practice of democratic governance ….”

… Over a four year period, the program spent $46 million of development aid, reaching approximately 1250 villages and a beneficiary population of approximately 1,780,000 people. A large share of this funding was used for facilitation and indirect costs, with only $16m, 35% of the total program costs, going directly towards infrastructure. These shares reflect the fact that the main focus of the intervention was institutional change, not the use of existing institutions to deploy development funds.

This very cool paper raises important questions about the role of elites in African development (read it to get a better understanding of the futility of these kinds of “democracy promotion”, too).

It might seem logical to assume that short-circuiting elite power, whether at the local or national level, may lead to accelerated development. However, because a lot of “development” is often elite-driven, an explicit agenda of effective elite disempowerment might actually yield suboptimal outcomes. All else equal, elites are often better organized, better-placed to take risks (on account of having more economic slack), better able to protect their property rights, and routinely deploy the state to further advance their economic interests. $46m in the hands of a powerful and secure elite class might yield jobs in firms that provide economic stability for whole districts. It is also true that less powerful or stable elites are likely to squander it on consumption, quick profit schemes, or stash it abroad.

These observations are not unique to African states.

Overall, when I look at most African states, what I see are a lot of very weak elites lacking social power, constantly unable to bend their societies to their will, and resigned to low-equilibrium forms of  political and economic organization (for example, by being mere middlemen in lucrative global commodity markets). In the case of the DRC, this is true whether one looks at Kabila/Tshisekedi or the leaders of armed groups in the east of the country. The same goes for so-called “traditional” leaders. Throughout the country and in the wider region, such elites lack infrastructural power in profound ways. Importantly for economic development, many often lack the ability to protect their own property rights. Our stylized idea of the nature of societal power relations on the Continent needs some updating. Consider this paragraph:

Eastern Congo is a well-suited environment to examine the adoption of democratic practice in local governance. The state has largely with-drawn from the rural areas of the east and enjoys low legitimacy. Local governance is often described as “captured” by traditional chiefs and vulnerable to corrupt practices by state officials. These features are not unique to the Congo. Multiple accounts suggest that in many Sub-Saharan states, colonial rule used pre-colonial institutions to create “decentralized despots” in ways that are detrimental to development.

topographies.jpgAre local elites in the modal African country this powerful? Is this the sense one gets traveling in rural Ghana or Zambia? Do these (mostly) guys look like they are in charge? As the paragraph notes, “traditional leaders” often lack the means to coerce their constituents (the state is largely absent). Despite Mamdani’s persuasive (Rwanda) story, these are not powerful and unchecked “despots” in the standard sense.

At times Africanist scholarship on state/elite society relations can seem schizophrenic: Africa is the land of “imperial” big men elites who can scarcely project their power on account of state weakness (see here, here, and here). Since the early 1990s, a lot of effort has been put into taming the allegedly imperial political elites in the region. Missing in our analyses and in donor programs have been attempts to understand the structural weakness of these same elites and the attendant consequences. The presence of an erratic and parasitic elite class might be the proximate cause of underdevelopment in the region. However, I would argue that a deeper cause is persistent elite weakness in the region. Catherine Boone’s book (see image) is the best I’ve ever read on African elites’ strategies of power projection in a context of state weakness (Boone is easily the most underrated Comparativist of her generation).

The tenures of Africa’s Amins, Mobutus, and Bongos took the form they did in no small part because these were structurally weak leaders (long leadership tenure is not synonymous with state capacity). Throughout their times in office they did all they could to destroy any and all alternative centers of power (including institutions such as legislatures). Their failures reinforced their respective counties’ two publics problems whose legacy is chronic elite weakness that is obvious for all to see. To this day, very few African countries have stable economic elite classes with easily identifiable immovable assets in-country. Most operate like little more than Olsonian roving bandits.

I am yet to see a clear theory that links greater vertical accountability to state/elite capacity. The historical record suggests that democracy works best in contexts with pre-existing state/elite capacity. In my own work, I’ve shown how strong autocratic legislatures beget strong democratic legislatures.

This is not a defense of autocracy. It is a reminder that the processes of state and political development, while related, often run on separate tracks and should therefore be decoupled in programs such as the one above and in our studies.