Angola's Secret Health Crisis

Angola is facing a public health emergency.  The UN agency has declared the outbreak a “grade two emergency” on its three-point scale. (Other grade two emergencies include the conflict in northeastern Nigeria, Cyclone Pam in Vanuatu last year, and floods in Myanmar, Mozambique and Malawi that displaced tens of thousands of people.) No one knows the true mortality figures – a product of both Angola’s poor data-keeping and the government’s preference to bury bad news. But there have been media reports of 50 people (or 25 children) dying daily from malaria, yellow fever, dengue and typhoid.

Its under-funded hospitals, inadequate at the best of times, have been overwhelmed by a series of disease outbreaks, and the government has been forced to turn to private business and charities for help. The UN Resident Coordinator Pier Paolo Balladelli and the heads of UN agencies called a meeting with the Angolan Industrial Association to appeal for private sector donations and logistical help with the yellow fever crisis. Paula Roque of Oxford University said she had heard of Angolan doctors based in South Africa sending medical supplies back home to help ease the shortages in a country that is Africa’s second largest oil exporter, and until recently was a rising economic star on the continent. 

“Angola is going through a very serious economic crisis as it’s heavily reliant on oil,” said Vibeke Skauerud, from Norwegian Church Aid. “Revenues have fallen by more than half. Hospitals are running out of basic supplies. That, coupled with bad governance, has led to the deep crisis that we now see.”

An outbreak of mosquito-transmitted yellow fever has killed 168 people since it emerged in Luanda’s poor neighbourhood of Viana in December – with suspected cases now reported in 16 out of 18 provinces.  Health officials launched a vaccination programme in Luanda in February, but the World Health Organization says the campaign has been hit by a number of constraints. “These included availability of vaccines, inadequate number of vaccination teams and limited funds to cover operational activities," a WHO briefing said.  The immunisation campaign has so far reached only six out of a targeted 12 municipalities in Luanda. Cases seem to be accelerating across the provinces, with reports of yellow fever reaching the northern border with the Democratic Republic of the Congo, WHO said.

Oil accounts for 95 percent of government revenue. “Of course the oil price crash could be considered one of the reasons [for the crisis], but the huge corruption across the health sector is another one, and maybe the most important one,” said Alves da Rocha of the Centre for Studies and Scientific Investigation at the Catholic University of Angola.

“Civil servants haven’t been paid their salaries. Inflation has tripled food prices. Angola is going through a real financial crisis,” Paula Roque told IRIN. 

Rafael Marques de Morais catalogues in scary detail how health workers lack even some of the most basic items, like gloves and masks. Not the best backdrop for an emerging crisis that has so far flown largely under the international radar.

Author Ricardo Soares de Oliveira, an associate professor in comparative politics at the University of Oxford explains :

"Throughout modern history, the accumulation of capital has rarely been a pretty sight, but post-socialist Angola is in a febrile class of its own. It is virtually impossible for meaningful activity to occur outside the charmed circle of the politically protected.” Mr de Oliveira describes the ditching of "ill-cut uniforms" and their replacement with "Savile Row suits" as the country's elite embraced what he calls "oligarchic capitalism, Angola style". He observes how instead of the slave masters and mercenaries of years gone by, today armies of suited overseas advisors pull the strings within ministries and state-owned firms. Mr de Oliveira also explains how corruption has permeated every stratum of Angolan society, from having to pay for "free" primary school places and university pass marks, to body disposal by the state morgue. And he notes sadly how "most people in power are perceived as thieves", but criticism is muted by a desire for emulation and a share of that "easy-oil money" from this petro-state prosperity.