Maloy Distinguished Lecture On Global Health 2018

Good afternoon, everyone My name is Joel Hellman I’m the dean of the School of Foreign Service I’m very pleased to welcome you here today for the Maloy Distinguished Lecture on Global Health Let me just say a few words I’m not going to introduce our distinguished lecturer today Dr. Emily Mendenhall has the privilege to do that But I do wanna just start off a bit with the perspective of the School of Foreign Service, and then a warm thank you to the Maloy family for giving us the opportunity to have this discussion Let me start off first why I’m so excited that we have this lecture series available to us It started in 2000, when Paul and Catherine Maloy endowed The Maloy Family Fund, which would help us support health-related projects in our Science, Technology, and International Affairs Program This was an important boost to our efforts to engage issues of global health, integrate issues of global health into the traditional areas of security, diplomacy and international affairs, which have been an important, and always been, an important part of what the School of Foreign Service stands for When we think about global health, it is a remarkable arena that straddles so many of the things that have been so important to the School of Foreign Service for so long It transcends nations It requires cooperation and engagement across nations It has an element of defining international affairs and diplomacy It brings issues of economics, of science, of political science, of international relations It sits at the intersection of so many things that we do As a result, I’m so pleased that we’ve had the opportunity each year to bring in someone who really represents the truly multidisciplinary nature of thinking about and solving issues in global health, and bringing all of the strengths of the School of Foreign Service and the ideas that motivate the School of Foreign Service into one critical issue area Let me thank very much Paul and Catherine Maloy Paul is here with his family His grandchildren are here His son-in-law is here I am so thrilled that we’re starting early and getting you engaged in these critical issues Thank you so much for your support I’m particularly pleased to be welcoming this lecture today on megacities and biosecurity threats in Africa because, again, thinking about global health as the intersection of issues that we’re so concerned about in the School of Foreign Service, I cannot think of an issue area that is so relevant You have the dynamics of urbanization, which is, I think, one of the critical and fundamental and defining features of the last sort of 50 years Myself, who’s lived in Africa, one sees it, feels it every day, the remarkable pull of megacities and how that’s changing the landscape of Africa Biosecurity and understanding biosecurity risks is remaking the way we think about security, and is critical to the way in which we redefine security threats in the next century It is critical to the kinda traditional interests and area Bringing global health, biosecurity, urbanization in Africa, it’s just this incredible intersection of the kinds of things that we are so passionate about here at the School of Foreign Service and at Georgetown University, and why I’m so thrilled that Dr. Akin Abayomi is here to discuss these issues Let me welcome you Let me thank you for being part of this series Let me thank you for working in this area and being interested and engaged in this area Let me thank the Maloy family for their support and engagement with us to ensure that we are working at the intersection of these critical areas Let me, with you, look forward to what I’m sure will be a fascinating lecture on this important topic Thank you very much Look forward to hearing from Dr. Akin Abayomi (audience applauds) – Thank you very much, Dean Hillman

It is always a pleasure to welcome all of you to Georgetown and especially to the Maloy Distinguished Lecture It’s something I look forward to every year as we engage with some of the leading scholars on some of the most critical global health issues The Maloy Distinguished Lecture is a special evening hosted nearly every year for the past 15 years, although the first was in 2000, by the Science, Technology, and International Affairs Program, or the STIA Program, in the Edmund A. Walsh School of Foreign Service It’s truly a pleasure to welcome Dr. Akin Abayomi this year to be our, to deliver our distinguished lecture Dr. Abayomi joins an impressive list of Maloy Distinguished Lectures, which we have listed on the back of the program for you Last year, we hosted Dr. Helene Gayle, a leader in global health development Two years ago, we hosted Dr. Vikram Patel, a true visionary who has transformed the movement for global mental health The year before, we hosted editor-in-chief of the medical journal The Lancet, Sir Richard Horton These enriching lectures have been made possible by the generosity and the vision of Paul and Catherine Maloy In 1999, Paul and Catherine Maloy endowed the Maloy Family Fund to support health-related projects in the STIA Program This was around the time that the STIA Program itself was founded These initiatives focus on international health issues, benefiting students from both the School of Foreign Service and the School of Nursing and Health Studies Paul J. Maloy is a 1968 graduate of the School of Foreign Service, and Catherine Fowler Maloy is a 1968 graduate of the School of Nursing and Health Studies Both have been active in Georgetown alumni relations for many years We are so grateful for your continual engagement Dr. Akin Abayomi was born in Lagos, and schooled at King’s College, Loyola College and the International School, University of Ibadan Akin studied at the Royal Medical College of St. Bartholomew’s Hospital and the University of London, where he attained his first graduate degree in medicine Akin is a specialist in internal medicine, hematology and oncology, obtaining fellowships from both Royal College of Medicine in the United Kingdom and the College of Medicine in South Africa Akin has worked in several countries around the world in both internal medicine, hematology and transplant medicine, and has been exposed to a variety of geographical variations of disease patterns within these disciplines Dr. Abayomi also trained in ecosystem integrity and wilderness management, and has a special interest in environmental health and climate change, and its impact on human health He uses the term syndemics, which is very exciting to me Dr. Abayomi manages a bio habitat conservation project in his spare time, which doesn’t seem to be much. (laughs) He is emeritus in the Department of Pathology, faculty of medicine in health sciences at the University of Stellenbosch in Cape Town, consultant to the University of the West Indies on biosecurity, principal investigator of the Global Emerging Pathogens Treatment Consortium, or GET, which was established at the height of the Ebola outbreak The mission of GET is to establish an African-based public health advocacy and biosecurity response mechanism to the threat of emerging infectious diseases in Africa Dr. Abayomi is also a member of the H3Africa and B3Africa consortia in promoting the concept of precision medicine for Africa It’s my great honor to welcome you to Georgetown We’re very much looking forward to your lecture today Thank you (audience applauds) – Good afternoon, or good evening It depends on your time clock I just flew in from Ghana this morning, so my time clock is advanced. (laughs) But it was a fairly good flight, and I was received very well here Thank you very much to the presence of the Maloy family and the opportunity to give this lecture And to my distinguished colleagues, thank you very much for that very outlined introduction When I was asked to give this talk, I could have pitched it in many guises But what influenced me the most was the name of the faculty, or the School of Foreign Services I thought I should do a talk that reflects international diplomacy and the relationship between continents,

global powers and Africa I developed this talk to try to understand, try and give you an understanding what our perspective is in Africa, in terms of security, of global health security We’re very concerned on the continent because many things are happening We are almost at the position where we can’t find solutions to the myriad of problems that we’re experiencing It then begs, why are we experiencing so many problems and why are we not able to cope with the problems that we’re facing? It requires a root cause analysis, in my opinion This could be an uncomfortable lecture, but I believe that I have academic license because I am in one of the most liberal institutions in America I would beg that you don’t take offense at some of the things I’m gonna say Many of the things I’m gonna say are historical, and many of them have had significant impact on the continent of Africa, for which we’re still struggling and trying to find a way to rise above As a brief introduction, these are some of my affiliations The GET Consortium, the University of the West Indies, the National Institute for Medical Research in Nigeria, H3Africa, B3Africa I was born in Lagos This is a nice picture of Lagos Much of Lagos is not so nice, but where that arrow is is the Island Maternity Hospital where I was born some decades ago I did my medical first degree in St. Bartholomew’s Hospital, which is famous for being the oldest hospital in the world, established in the 11th century by King Henry VIII I did quite a bit of time in the University of the West Indies I’m very pleased to have here at this talk the current principal of the Cave Hill Campus of the University of the West Indies, which is where I spent 12 years In this picture, that’s Professor Eudine Barriteau In this picture, she’s talk Is it possible to have these stage lights off? In this picture, she’s talking to Sir George Alleyne, who I believe has been one of your previous distinguished lecturers in 2003 I spent 10 years in the University of Stellenbosch in Cape Town That was a teaching hospital that I worked in It’s one of the largest teaching hospitals in Africa It’s called the Tygerberg Hospital, which is multidisciplinary, serving about six to 10 million population catchment We established a Global Emerging Pathogens Treatment Consortium in 2014, at the height of the Ebola outbreak Thank you I’m starting to move my base from South Africa back to West Africa, and I’m beginning to develop a relationship with the Nigerian Institute of Medical Research, where I will be based in the near future What is the scope of this talk? I thought I should try and establish the linkages between centuries of global foreign policies towards Africa and the current-day biosecurity risks that we are seeing Why is Africa so prone to biosecurity threats? Africa is a unique setting with profound historical perspectives Africa’s growth was stunted Why? Why Ebola emerged in West Africa, as opposed to where it’s traditionally supposed to emerge? Why was it so badly managed? What is the biosecurity significance of exploding populations? What is the link between failed states and bio-insecurity? What interventions are necessary and what must happen? What is the nature of reparative justice, the role of the global community, and what is our role as Africans? What is the role of academia on civil society? Have we, or will we, run out of time?

I’ll try and touch on these things I appreciate that we have a vast diversity in the audience I’m trying not to make this talk too medical or too scientific, and to touch on a variety of topics, which I believe may trigger some discussion We know in biosecurity that all actions have immediate and long-term consequences What goes around, comes around I believe the law of karma always applies It’s not divine retribution It’s simply reaping what you sow The question is, is Africa’s underdevelopment rooted in slavery, colonialism and neocolonialism? Was that the reason, or one of the reasons, why Ebola devastated West Africa and the continent? Let’s try and examine some of these issues I’m gonna be talking about three countries, really I’ll talk about Sierra Leone in this talk I’ll be talking about Nigeria and, to some extent, I’ll be talking about the Democratic Republic of the Congo Ebola almost broke the back, was the straw that almost broke the back of West Africa It was a harrowing timeframe for us, between 2013 and the end of 2015 At one point in time, we were wondering, according to the models, this thing was going to escalate completely out of control, and we just didn’t have the infrastructure or the capacity to manage it Now, David Suzuki, a famous environmentologist, I love this quote that he captures here He says, “There are some thing in the world “that we can’t change “We can’t change gravity, the speed of light, “our biological nature that requires clean air, “clean water, clean soil, clean energy “and the biodiversity that we were born into, “that we so depend on for our health “and our well-being “Protecting the biosphere should be our “highest priority, or else we sicken and we die “Other things, like capitalism and free enterprise, “the economy, currency, the markets, “are not forces of nature “We invented them “They are not immutable, and we can change them “It makes no sense to elevate economics “above the biosphere.” There’s a right way, and there’s a wrong way I don’t know if any of you have read this book, The Collapse It was written by Jared Diamond some years ago This is the second of two books he wrote He talks about how societies choose to fail or succeed In a nutshell, he said global empires or global powers have failed because they’ve ignored certain things The things that he point out are typically environmental issues He’s gone through his history to try and pick out issues that he felt have contributed to the collapse of major empires Deforestation and habitat destruction, climate change, the buildup of toxins in our environments, water and energy scarcity, full use to the max of the resources of Earth But he also points out that apart from ignoring or mitigating or adapting to environmental issues, some of the reasons why great powers collapse is because of their hostility towards other countries or the collapse of trading partners Now, I lived in Cape Town for 10 years As part of my job, it was to advise the government on the impending calamities of climate change We warned the government of South Africa that certain parts of South Africa were moving into a climate stress, and sooner or later, we’re gonna reach a tipping point where we’re gonna run out of water That is happening as we speak We’re now counting down to what’s called Day Zero in Cape Town, which is the western cape of South Africa It is estimated that on the 20th of May of this year, in about two months’ time, the taps will run dry In other words, there won’t be a drop of water provided by the municipal government to the people of Cape Town

Six to 12 million people will have no access to water We talk about water scarcity, we talk about water conflict This is real In my opinion, the simple definition of biosecurity or global health security means good custodianship and maintenance of the integrity of our biosphere, and what we do in it Human behavior towards the ecosphere has become dysfunctional, and now, arguably, threatens our own survival The modern world is dangerously deluded when it thinks that it can expand its attributes unlimited and human enterprise can decouple itself from the environment This phenomemon is obvious all over the world, but it’s poignant in Africa because Africa is feeling the heat of global warming, excuse the pun We’re finding it difficult to adapt It’s not our job to mitigate There’s a difference between adaptation and mitigation Mitigation is you stop producing greenhouse gases Adaptation means you learn how to live under the new circumstances of a deranged environment It’s not our job to mitigate because we didn’t produce those gases in the first place Those gases were produced by the Industrial Revolution, of which we did not participate Yes, we provided the raw materials, but we didn’t participate in the Industrial Revolution The setting is Africa Demography is exploding We’re about to go into our industrial growth, but we don’t have the luxury of the free labor and the cheap energy that the Industrial Revolutionary countries had to grow their economies Now, the first time I saw this slide, I thought it couldn’t be possible, that in the next 50 years, Africa’s population will expand four times, from about 1 billion to 4.2 billion I thought this is just an impossibility, but that’s the modeling In about 40 to 50 years, 40% of the people on Earth will be Africans Now, when you examine that, space is not actually the issue because most of Africa is underdeveloped What the problem is, is bad governance and the legacy of exploitation If you do the maths, simple maths, the United States has 330 million people China has 1.4 billion India has 1.3 billion You can fit all those countries into the space, the geographical space, of Africa Therefore, Africa’s 1 billion, really, we can expand our population without stressing ourselves too much, but no, we can’t because we live in a cultural environment and a political environment of instability and poor governance Africa is the richest endowed, minerally, in the world All our wealth is in the ground Our wealth is in our people If we’re so rich, why are we so poor? Why are we not able to rise to the challenges that we feel and we experience on the continent of Africa? Why does everyone look at Africa as this poor place? This place that is constantly subject to environmental stresses, subject to conflict, unable to respond to its own problems? The problem is there’s too much leaving the continent, and not enough retained and not enough value added on the continent We have corrupt leaders that are extracting our wealth through illicit outflows, up to the tune of over trillions of dollars But these people don’t operate on their own They operate in cahoots with people all over the world When we do a global comparison of generated wealth, we find on the right there the developed world The GDPs, 6 trillion, 7 trillion, Brazil, Indonesia, 10, United States, 34 trillion India, China Africa is sitting on 3.3 But the world economies think that Africa, in the next 30 years, 20 to 30 years,

will be operating on a GDP of 29 trillion only if we can stop illicit outflows out of the continent, add value in continent and put in place better governance Africa struggles with a legacy of slave trade with colonialism, the Cold War, forced labor camps, extraction of our wealth, degeneration of the traditional moral fiber of our society, with preferences for Eurocentric lifestyles, the culture of blinding political corruption Sometimes we’re so shocked at the amount of abnormal wealth that is extracted out of our government coffers The numbers keep rising Mass injection of returned and rescued slaves forced on indigenous communities Wars caused by abnormal boundaries Conflict between returned slaves and Indigenes After our independence, there’s a continued quest for the mineral wealth of Africa There are numerous governance and infrastructural, logistical issues in Africa Poor civil service structure and capacity Low expenditure on science and technology This is the bane of our problem All the medical schools, all the high institutions of research complain that the governments don’t understand, they don’t appreciate the budget that needs to go into science and technology Poor rural and urban planning Dependency on foreign grants and aid A continent so wealthy still depends on foreign grants and aid Communication is expensive, transportation is expensive We can’t even move from one country to another in Africa without getting visas It’s like saying you want to go from Texas to California, and you require a visa I as an African need a visa to go to another African country These are the problems we grapple with Power supply is erratic and insufficient Yet, we’re the hotbed of emerging and re-emerging infectious diseases The historical perspectives in Africa have created chaos They’ve arrested our renaissance and they’ve stunted our growth and eliminated our resilience The Atlantic chattel slave trade commenced in the 15th century with devastating effects I’ll define what chattel is because I actually only understood it recently It is estimated that between 16 and 20 million young, productive members of the African society were extracted from mainly West Africa over a period of 400 years This was soon followed by 150 years of colonialism Now we’re living in the era of neocolonialism This diagram just shows you where the points of extraction really were, from the tip of Senegal to the Bight of Biafra, going down into the Congo and Angola These are where the slaves were taken to, to South America, to the Caribbean and to North America What were these definitions? I think it’s important for us to understand what we mean when we talk about slavery Chattel Chattel means an enslaved person who is owned forever, and whose children and children’s children are automatically enslaved Chattel slaves are individuals treated as complete property to be bought and sold Chattel slavery was premised on the fact that Africans were considered to be subhuman, like pets or work animals What’s a Krio or a Creole? A descendant of slaves of mixed European and black ancestry Who are the Maroons? The Maroons were Africans who had escaped from slavery somewhere in the Americas or the Caribbean, and who mixed with the indigenous people of those areas They protected each other, and they lived as independent and free people There are many example of Maroons from Haiti to Jamaica to Suriname in South America Now, Africans are a proud and organized people, deceived and subdued by superior firepower Here you have the Portuguese coming in with their ships, pretending to be traders Then sooner or later, using their superior

firepower, they were able to subdue kingdoms and extract people from the continent of Africa by force It’s easy to dehumanize people if you don’t know who they are or where they come from This was the fate of these proud and illustrious people from Africa They were subject to harsh conditions, planting sugar in the Caribbean, and planting cotton in the southern states of America What’s the impact of slavery on Africa and America? In Africa, it meant significant loss of nation builders Most of the people taken were young, strong males Communities were emotionally devastated because they were disrupted The Europeans came with weapons, and they traded weapons for slaves That corrupted the moral fabric of our society and our leadership African chiefs used these guns to wage wars to get more slaves It increased in conflict that persisted till today Africa’s social, cultural, economic development was arrested On the other hand, what happened in Europe and the Americas? Tremendous wealth was generated Huge economic growth Sugar, cotton, tobacco Shipping industry boomed, job creation Major cities developed around the ports Population was booming It positioned Europe to colonize Africa and set up perfect systems of extraction to maintain economic imbalance Now, slavery was abolished in 1807 by Britain, who are primarily responsible for most of the slavery, but yet they were the main movers in the abolition movement, based on humanitarian grounds But when you examine it, the only reason why the House of Lords or the House of Commons, who approved the abolition of slavery, was because they realized that there was an economic incentive What was that economic incentive? There’s an oil produced in West Africa called palm oil By about 1800, the British were requiring more and more palm oil to drive their Industrial Revolution They realized that if they allowed slavery to continue, there was not enough workforce in the whole of West Africa to harvest this oil and to produce palm oil because it’s a very labor-intensive effort Here you can see the palm branches on the floor Indigenous people producing this product called palm oil, which was necessary for the Industrial Revolution Britain set up the Africa Squadron After they abolished slavery, they parked their squadrons of navy fleet off the coast of West Africa Anybody that was involved in slavery was arrested at this point All the ships, the Spanish, the Portuguese ships, the French ships who were trying to carry slaves to the Caribbean or to America were intercepted by the British squad The slaves, instead of taken back to their point of origin, they were dropped in a place called Freetown Hence, the name Freetown, of Sierra Leone The slaves that were arrested at mid-sea were carried to Sierra Leone and deposited in Sierra Leone Chattel slavery across Africa was enforced by Great Britain The abolition was enforced by Britain, and replaced by brutal colonialism This provided free labor for other European countries Now, HIV We’ve tried to understand where HIV came from It evolved during the colonial era, and it was one of the biggest eco, biological accidents of all time because it arose in the setting of multiple factors of injustice, medical, ethical abuse, breakdown of communities and habitat The setting was the Belgian Congo in the Democratic Republic of Congo We know that HIV didn’t start before the 1910 to 1940 Otherwise, the slaves that were carried over to the Caribbean and Americas would have all been infected with HIV, and they weren’t Therefore, HIV emerged after the abolition

of slavery It happened at a time in the Belgian Congo where there was these brutal labor camps that were set up for the extraction of rubber out of the Belgian Congo, again, to drive the Industrial Revolution in Europe At that time, it is estimated that 10 million people, indigenous people, died in the Belgian Congo It coincided with these labor camps, the introduction of the hypodermic needle and the artificial experiment that created the opportunity for HIV to evolve out of SIV There is no precursor of HIV It was SIV, which is a primate virus that managed to get into the human population, probably by some unethical experience, experiment, and it was propagated by these circumstances that allowed HIV to transform out of SIV SIV in itself is a dead-end infection of human beings If you’re infected by SIV, it doesn’t go anywhere, but it managed to evolve into HIV That’s a whole lecture in itself, but just suffice to say that HIV was not a known pathogen until this timeframe The Belgian Congo is responsible for the evolution of a pathogen that has caused millions and millions of infected people, and millions of people to die from HIV and the consequences thereof Extensive deforestation of Africa for the export to Europe and the rest of the world This is what Africa is accustomed to looking like Dense forests with humidity Good rainfall, good agricultural output But forests precede civilizations, and deserts follow them I like this phrase Because this graph shows that the Guinea forest, which extends from Sierra Leone, Guinea, Liberia, all the way to Nigeria, has lost 90% of its integrity in a timeframe of a hundred years Our ecosystem is completely distorted by this extraction of hardwood out of Africa How does poverty come about? It’s not an accident of misfortune There’s more than enough for everyone But if one person wants a hundred times their share, then 99 people must go without Extreme poverty is also known as the trap because in extreme poverty, you can’t get yourself out of extreme poverty There is no way out of it You need to be released from extreme poverty Extreme poverty, or the trap, is another form of genocide because it’s systematically engineered and it has certain features It is an insidious, calculated process, and not an event It diminishes a people’s capacity to regroup politically, emotionally and demographically In Africa, slavery, followed by colonialism, followed by boundary wars, followed by neocolonialism, and the isolation from the global corridors of power has caused the African continent to be merged in a poverty trap The poverty trap creates nations in a state of continuous chaos Any of us who are from Africa know that we live in countries that are in a state of continuous chaos Either directly or inadvertently, or by neglect, forces are unleashed on us Perpetual deep poverty and hopelessness is a feeling that we are accustomed to As I said, it is impossible for you to rescue yourself from deep poverty Let’s look at a tale of two cities to illustrate the story of biosecurity, or bio-insecurity, as I prefer to call it, in Africa, and why much of Africa seems dysfunctional Let’s look at Sierra Leone and let’s look at Nigeria, Freetown and Lagos Sierra Leone, small, little country 6 million, 7 million people About 10 to 15 major tribes who were put together by the British protectorate These tribes, which were independent nations, were forced to live together as one country Sierra Leone, historically, is blessed with gold and diamonds, and yet it’s one

of the poorest countries on Earth It was comprised of densely tropical rainforest The culture there was complex indigenous knowledge systems The Portuguese started visiting early in the 15th century, and by the end of the 17th century, 1 million Sierra Leones were extracted out of that area At that time, the population of Sierra Leone was only 1.5, so slavery almost took 1/3 of the people out of Sierra Leone You can see this demographic chart, this is the impact of slavery Then there’s slow growth Then those devastating wars that I’ll describe in a minute caused a dent in the population growth They recovered from that Then at this point, we have Ebola and mudslides The creation of Freetown in Sierra Leone happened in 1787 There was a plan to establish what was called London’s poor black repatriated to Africa in a place called Sierra Leone, or Freetown A few years later, more than 15 ships sailed from Halifax, just up the road from here By 1978, Freetown had 300 to 400 houses with architecture resembling that of America in the deep South They were joined by 500 Jamaican Maroons Collectively, the British, the Nova Scotia freed slaves and the Jamaican Maroons formed the Krio community of Freetown They displaced the indigenous population up into the countryside, so thereby setting up indigenous conflict The same thing was happening in Liberia, and the same thing was happening in Lagos, Nigeria, with returned slaves from Brazil For some reason, the Brazilian slaves integrated much better in Lagos, Nigeria, but that wasn’t the case in Liberia and in Sierra Leone That led to the conflict between the Krios and the Indigenes The Krios are the returned slaves The Indigenes were the people that lived in that area As a result of that, the long and short of the story is that there was a brutal war, which lasted 12 years in Liberia and Sierra Leone between the Krios, or the returned slaves, and the indigenous people Of course, the central issue was access to the amazing mineral wealth that Liberia and Sierra Leone have The diamonds fueled the conflict That war was responsible for 100,000 deaths, over 100,000 amputations and 300,000 gender-based violence incidences I’m not sure what it is about amputation, removing limbs This happened in Sierra Leone It also happened in the Democratic Republic of Congo during the brutal, oppressive regime of the Belgian rule there Something about cutting off hands and cutting of legs and cutting off parts of people’s anatomy Now, this war was fueled by mercenaries from South Africa, called Executive Outcomes I like that name because you make executive decisions that have outcomes that are not based in the place where the conflict takes place That’s where the word blood diamonds comes from Because a lot of these mercenaries were paid with diamonds, and they fueled this conflict, which is why it went on for 12 years Freetown A beautiful part of Africa, built on hills, very picturesque as you’re coming in from the sea Freetown and Sierra Leone, so rich, but yet, many people are living in absolute squalor Some of the deepest poverty that I have ever seen, and I live in Africa The stage is the West African Ebola outbreak, 2013 to ’16 You all know these figures Thousands of people, cases Thousands of deaths, thousands of survivors 10 countries affected Crippling our economy The question was Ebola typically arose in Central and East Africa Why all of a sudden are we seeing this massive explosion of an outbreak in West Africa, where we’ve never heard of Ebola before? Ebola exposed so many issues, the good, the bad and the ugly There were many disturbing events that took place during that outbreak, which I don’t have the time to talk about today, but we refused, as Africans, to be discouraged

We know that, historically, Ebola had many outbreaks in East and Central Africa Maximum 300, 400 people dying before the outbreak comes under control We know quite often what the precursor event was This outbreak in West Africa came as a bit of a surprise to us Now, Ebola is classified as a Category A pathogen Usually, Category A pathogens are easily spread They have no treatment They have high mortality and they have a potential for causing major disruption and economic collapse You’re supposed to keep dangerous pathogens in high-containment facilities, BSL-3 or 4 BSL-1 and 2 are where you do simple work on simple, non-dangerous pathogens But if you’re gonna be managing things like Ebola and anthrax, then you want to be doing that in a BSL-3 or BSL-4 Now, in Africa, we have Lassa fever, we have Rift Valley, we have Ebola, we have Marburg, anthrax and monkey pox But yet, we don’t have any biocontainment facilities The hotbed of emerging pathogens that are classified as Category A, and yet we don’t have the infrastructure or the human capacity to deal with them An epidemic was unfolding in rural Sierra Leone and Guinea There were many conspiracy theories Was this an attack on Africa? Was it a depopulation agenda? This is the map of Guinea, Sierra Leone and Liberia The outbreak happened around there Right next to that outbreak is a place called Kenema Kenema is a hemorrhagic fever laboratory that has deep collaborations with the United States of America Obviously, the conspiracy was that this was something that was planted in the society, not a natural event Luckily, to debunk the conspiracy theories, there was some samples that were kept from 2009 from a Lassa fever outbreak in Sierra Leone Those samples were re-tested Now they were re-tested, and the surprise was that as far back as 2009, we were finding evidence that some of these hemorrhagic events were not caused by Lassa, but were actually caused by Ebola, and even Marburg There’s evidence that Ebola and Marburg existed in West Africa This was further corroborated by the fact that a vet did a post-mortem on a gorilla that died in the Tai National Park in Ivory Coast, which is next to Liberia That vet caught Ebola from the gorilla That means that Ebola did exist in West Africa, and it wasn’t something that was alien to the environment It’s alleged that on the 23rd of December in 2013, a group of small kids were playing near a burnt tree that housed a bat colony at the village What I want you to notice is the bareness of this hill here That hill was part of the Guinea forest You notice that there are no trees on it Completely deforested These kids are playing around and catching bats, which they would roast and they would eat these bats One of those kids developed a sickness Of course, they didn’t know what to do with this child They called in the traditional healers The traditional healers did their traditional rites The traditional healers became unwell The traditional healers, even though you are talking about three countries, Guinea, Sierra Leone and Liberia, the people that live in this region don’t know boundaries because they’re all one people They move across boundaries without visas Traditional healers came from Sierra Leone or Liberia into Guinea to treat these cases of Ebola Then they would go back into their country having been contaminated Here we have a WHO’s cartoon placement of how the outbreak was spread I put here the map of the East Coast of America just to show you the comparison If you had an equivalent outbreak that was emerging like it was emerging now, events happening all across the East Coast

of America, how would you cope? How did we cope? Well, we didn’t It was devastating Before we knew it, it had spread to many countries It spread internationally That was the first time Ebola had done that Why did Ebola spread so rapidly in three countries and beyond? Well, the first thing was the profound poverty of that area and the lack of human resources The centuries of instability, war and conflict The lack of manpower Liberia, Sierra Leone and Guinea are one of the poorest countries in the world, despite their enormous mineral wealth As the epicenter was a very remote location and Ebola was unheard of in West Africa, the clinical features were atypical We didn’t have the experience of managing Category A pathogens Lack of specialized infrastructure That shows you the kind of poverty in Sierra Leone Obtaining water from such sewage-ingested streams Typically, we were expecting to see hemorrhage from the mouth or from mucous membranes, but in the West African outbreak, we didn’t see much hemorrhage We saw more diarrhea and vomiting For three months, we were foxed We thought this was cholera or typhoid or some kind of other infection In that three months’ timeframe, this pathogen was spreading across different countries Look at how we were able to manage the early cases of Ebola, in sheds that were built in the open air because we just didn’t have the infrastructure This was across West Africa, even in Nigeria Until we had developed these very sophisticated what were called ETUs, or Ebola Treatment Units, people were managed in the open, thousands of people This was the kind of scenes that we experienced during the Ebola outbreak Lots of lamentation Civil unrest Physical violence Trauma against each other The bereavement Human beings in Africa are not accustomed to people dressed in gowns coming into their homes, wrapping up their dead and taking them up, and they’ll never see them again Ebola spread to Lagos, Nigeria, and across the globe What are the historical perspectives of Nigeria? Nigeria was created in 1960 200 million people now, but 250 distinct tribes forced to live as one country Here, we just have an idea of what these tribes are There are a lot more tribes, but these are the main tribes The British forced these tribes into one country As a result of the attempts to break apart, in 1964, Nigeria fought a very bitter war, the Biafra Secession War Subsequently, Nigeria’s being governed by the three leading power brokers in Nigeria There’s the Hausa-Fulani tribe, the Yorubas and the Igbos The political game is to rotate power between these three main power brokers But the source of conflict in Nigeria is resources Now, the desert is encroaching on Nigeria The Sahara Desert is moving south We’re wondering how to break the cycle of food crisis We have many non-state actors in Nigeria You’ve heard of Boko Haram You’ve heard of Al Qaeda and ISIS There’s the Niger Avenger Deltas, or Niger Delta Avengers The cattle herding conflicts and the indigenous people of Biafra Now we’ve got a pandemic of kidnapping Nigeria is water stressed, the north of Nigeria is water stressed because the Lake Chad here, on the edge of Nigeria, is contracting significantly This is what the lake was supposed to look like, and this is what it looks like now These are the forces, the environmental forces, that are causing this lake to contract When you go from 1963, where you’ve had this full lake, which is almost the size of a whole country, down to about now, where this lake is down to almost a little piddly pool You’re wondering this whole environment was dependent on this lake, and all of the sudden, there’s no more water That creates stress in the environment

The government of Nigeria is wondering how to cope with this stress This is what it looked like then This is what it looks like now The Sahara Desert, which is above this green belt, is moving south all the time We’re trying to build this green belt of trees to retard this migration of the Sahara, but it’s not working As a result, there’s conflict between cattle herders and people There’s the Boko Haram People think that Boko Haram is a religious sect Yes, they have a religious basis, but it’s all about resources Then, Nigeria, who is very rich in oil, what have we done with our oil? The oil has been a curse for us because it’s polluted much of the area where the oil is being produced Look at this kind of pollution into the environment This is happening on a daily basis The big oil producers have been held responsible for these kind of environmental poisoning with crude oil We had an activist called Ken Saro-Wiwa, who was opposing this kind of reckless extraction of oil in the southern states of Nigeria He came against the mighty force of the military establishment at the time, and he was found guilty of treason, and he was hanged That was the end of Ken Saro-Wiwa and his plight for the people of the Delta region of Nigeria That’s his son, who tried to carry on his legacy, but he also demised As a result, we have the Niger Delta Avengers These are just examples of how competition for resources and lack of good governance is setting up non-state actors, who are likely to be the people that will use biological weapons or chemical weapons as a state or as an act of aggression In the background of post-colonial conflicts and the scramble for resources, there are a plethora of expanding African megacities with these features Wholly planned and governed, urban and suburbia They have poor regulation of their entry ports They lack necessary infrastructure to cope with the population growth There’s insufficient water sanitation and sewage management The air is toxic, the streams are dying There’s chemical and sewage pollution on the surface of the, of the surface water table There’s severe pollution of the sea There’s lack of security We have a lot of stressed people Our cities are now beginning to expand across the continent This is what they’re looking like Unplanned People just moving in from the rural communities and building These are what our streams are beginning to look like Full of pollution, dead to all kind of living organisms We’re producing too much toxic air into the environment Our sea coasts are beginning to look like this Lots of plastic, lots of debris You can’t even go out into the sea on the major cities for recreation anymore without encountering this kind of pollution No regulation of emissions in these cities We’re beginning to see brown smog and fumes and the smell of gasoline in the cities In this setting, Ebola moved from Liberia to Nigeria, to the capital, or the commercial capital, Lagos This is the other picture of Lagos I showed you the first picture, which was the nicer picture, but Lagos is 23 million people Overall population of Nigeria is 200 million 23 million people live in Lagos When Ebola arrived in Lagos, we were worried that Ebola was going to infect this aspect of the city Look at the dense number of people that live This is not unusual It’s in many cities across Africa Now, we know that people from West Africa are very mobile, particularly Nigerians About 12,000 Nigerians fly out of Nigeria every day to different corners of the globe

This diagram shows how mobile Nigerians could be If that outbreak had taken hold of Nigeria, and had infected or affected that highly dense part of Lagos, then we might have been telling a different story today Luckily, the index case that brought Ebola into Nigeria was a diplomat He was taken to the most expensive private hospital in Lagos, where they soon recognized that he didn’t have malaria or typhoid, but he was actually infected with Ebola, and he was quickly quarantined As a result, only 20 people were affected But if you are able to spread the virus into the international aviation network, then it could have quite easily spread to every corner of the globe As African medical personnel, we realized during the Ebola outbreak that we as a continent are in trouble We have a limited capacity to respond to biosecurity threats By extension, the rest of the world is in danger We formed the Global Emerging Pathogens Treatment Consortium on the 21st of August, 2014 We’re now over 300 members What we do is we’re a consortium of experts, mainly Africans, but we have deep collaboration with people all over the world We have diverse skills from 54 countries We have offices in Nigeria, Ghana, Sierra Leone and America We implement biosecurity projects We have projects in Sierra Leone, in Lagos We carry out initiatives and we train personnel and we are engaged in high-level advocacy We have expertise in a myriad of infrastructural development, which are necessary for infrastructure and human capacity development This is the hospital in Lagos, as its state was before the outbreak That whole hospital has to be revamped very quickly These are colonial buildings that are almost a hundred years old that couldn’t take an outbreak of Ebola as we saw it After the revamping, we had all these makeshift tents that were prepared for the potential of thousands, if not millions, of people that were going to be infected with HIV GET is assisting in the domestication of the international instruments of the biosecurity conventions These are some of our team members In this picture, we were in Sierra Leone working on a project, trying to extract convalescent plasma as the only form of treatment for Ebola at the time At the time in Sierra Leone, we realized that there were thousands and thousands of samples during the Ebola outbreak that were lying around the country in totally unprotected facilities Now, I’ve just explained to you that there are a number of non-state actors operating in the region These facilities, you could easily just walk into a facility A guard may or may not be there You could walk in, open the freezer, pick out a bag of Ebola-infected samples and walk away That was how easy it was We embarked on trying to establish a project that would rescue all these samples, curate them and put them into secure environments because those samples are very valuable to us We soon realized that Ebola is not Ebola in everyone, and that there are different categories of Ebola Some people get Ebola, get very sick, and no matter what you do, you die Others catch Ebola, they get sick, but they survive with reasonable healthcare Others have a mild illness and doesn’t warrant them even going to hospital Some people get Ebola, and didn’t even know they got it We see now that the interaction between your genes and the virus is different in different types, in different people We need to understand what those genetic differences are, which will give us a clue to the treatment of Ebola As we stand now, we actually don’t have, still, a treatment that is effective against Ebola We managed to collect all these thousands of samples that were distributed throughout Sierra Leone We consolidated them into secure biobanks With the help of the government of Canada, we’re building a permanent biobank in Freetown

where these samples will be housed permanently for the use of the science community to try and understand the relationship between man and Ebola virus Hopefully the outcome of that will be the discovery of treatment options for Ebola Unfortunately, we were unable to do the same thing in Liberia and Guinea because all the samples in those countries were extracted by the partners that came in to assist those countries before we were able to implement a sample rescue project These are just members of the Sierra Leone security service When we’re moving the samples around, the military security agents, logisticians, health personnel and members of the GET Consortium We’re able to find the samples in all these various laboratory locations, and bring them into safe location We’re also involved with strengthening national legislation to cope with the severe gaps that exist in the laws and legislative parameters of countries to deal with biosecurity and biosecurity threats We’ve been embarking on biosecurity training with some of our colleagues Biosecu.re, that’s Piers and Kathryn, who are members of Biosecu.re who’ve been working with us to train people in Sierra Leone on the concepts of biosecurity We’ve been able to secure the funding for building a BSL-3 facility with a biobank attached to it This was generously donated by the government of Canada This is a new type of facility It’s a hybrid BSL-3 with a biobank That’s BSL-2, BSL-3 and the biobank component One of the things we said was that in Africa, we have energy issues We cannot maintain a biobank facility or a BSL facility because of the need for constant energy One of the things that is incorporated into this hybrid design is that the roof would be full of solar panels, which will help to keep this facility almost in a state of non-dependence on national grid for its power supply Thereby, we’ll be able to keep the samples cold continuously, without dependence on national grid We’re also involved in arranging conferences and workshops We have an annual conference, African Conference on Emerging Infectious Diseases and Biosecurity We’ve had one in Dakar During the outbreak, we had one in Lagos in 2016 The last one was in Accra, Ghana The next one, which will be in September of this year, will be in Freetown, where we’re going back for the first time as an international community to see the progress that has been made by Sierra Leone in its ability to ramp up its infrastructure and its human capacity development in order to cope with an outbreak of this magnitude Our focus is shifting from capacity to policy We’re trying to influence global policy that frame regional integrity We’re looking at reparative justice Curriculum development for students in secondary and tertiary academic levels We are involved in high level and grassroots awareness raising We find that our policymakers, our politicians, don’t really understand global health security agenda or biosecurity threats Thereby, they’re not able to divert the necessary amount of funding into what is required for us to have secure biosecurity frameworks and platforms We’re hoping to develop biosecurity curriculums for schools and universities, secondary, universities, diplomas, masters and doctorate We’re currently having discussions at the tertiary, quaternary institutions in Nigeria and in the Caribbean to develop biosecurity programs in the university curriculums We also have a book project, which is complete It’s been sent to the editors It’s broken down into five sections I’m one of the editors The first section was Emerging Deadly Pathogens and the Clinical Practice, Social Determinants of Emerging Infectious Diseases, Global Health and Governance, Ethics and Policy In the Context of EIDs, and the Narrative from the Ebola Virus Disease Experience

That book should be published in the next month or two from Springer In conclusion, biosecurity threats have precedence and multifactorial causes Slavery and colonialism created seemingly perpetual instability on the continent, and conflicts which we must address There is disordered governance, which creates expanding cities and ecosystems that are bio-insecure If we want to be sincere, we must address these root causes It requires a holistic approach Reparation is a prerequisite for global health security The Biological Weapons Convention and all the international treaties around biosecurity will amount to nothing if there is not a genuine partnership based on repairing the exploitation of the countries in Africa Reparative justice holds our moral compass to task, and insists that countries that benefited should selflessly be involved in a no-strings-attached reparative strategy of the exploited regions These countries that I’m talking about, these countries that I come from in Africa, we’re finding it difficult to recover from these past events After such a history of plunder, it is virtually impossible for us to do it alone Aid in the form that we’re getting now is simply just not good enough This is a slide of Sir Hilary Beckles, who is the vice chancellor of the University of the West Indies He set up a Center for Reparative Research in the University of West Indies in Jamaica He describes the facets of reparation It is the collective recognition of the harm done by the perpetrators on the people of Africa and their descendants A Marshall-like plan to rebuild all institutions in affected countries I’ll explain what the Marshall Plan is in a few slides A strategic alliance between the exploiters and the exploited The World Bank and the IMF are not solutions Neither are grants, with strings attached It’s not about money It’s about allowing a disadvantaged people the opportunity to recover from sequential misfortunes If you’re interested and you have this presentation, you can Google this YouTube debate on reparation for slavery, which was conducted by the BBC There have been many examples of reparative justice on people that were trapped The Great Depression in America in 1929 The European Depression after the Second World War and the Depression of the Asia subcontinent, which were very successful This is the Marshall Plan The Marshall Plan, and this is the speech of General Marshall, the US secretary of state in 1947 This was America’s position for Europe because Europe was going through a massive depression after the Second World War “Break the vicious cycle of poverty,” this is the trap, “and restore the confidence of the people of Europe “and the economic future of their own countries “and of Europe as a whole “The manufacturer and the farmer must “be able to exchange their products for currencies “Such assistance must not be on the piecemeal basis, “but should be sustained and provide a cure, “rather than a mere palliation.” The Marshall Plan was a partnership between the United States and the countries of Europe to collectively lift Europe out of depression because Europe could not lift themselves out of depression A true African Marshall Plan is therefore required to ensure global health security A partnership to restore, not a series of government agencies from the North telling us what to do in Africa In the Marshall Plan, just replace Europe with Africa To restore the confidence of the people of Africa, if you like The American Marshall Plan for Europe was highly successful The impact on Europe was instantaneous stability Two decades of unprecedented growth The same thing happened with the Asian Tigers, Korea, Taiwan, India, Japan There was huge investment from the United States, which built the Asian Tigers That’s why they’re so successful as we speak

We’re waiting for a Marshall Plan We’ve been talking about reparation for a long time It comes in seasons, but we believe that the time is right I just want to take this opportunity to invite you to a one-day symposium that we’re going to be hosting at the University of the West Indies on the 2nd of August, where we’re going to have a one-day symposium on Biosecurity in the Caribbean We feel that the Caribbean requires an effort to raise the awareness and the consciousness of its policymakers towards the issues of biosecurity There are many vulnerabilities in the Caribbean that need to be addressed What is our part, as Africans? Don’t get me wrong, apart from the atrocities committed against Africa, we also are holding our politicians accountable But the system of exploitation was based on corruption Slavery is corruption in its highest form Colonialism, which replaced slavery by false labor camps, was built on the foundation of corruption Neocolonialism has perfected the art of undercover corruption It is impossible to put garbage into a system and expect anything good to come out of it Our African political elite have lost their moral compass We accept that We in Africa need to address that We need to address our politicians that are stooges of neocolonialism, and we need to find a solution A famous political activist called Chinweizu defined or outlined some key points He said what predictable dangers await Africa in the 21st century? Is Africa equipped to evade or defeat these dangers? Are African states failed states waiting to implode? What are the key feature of the global environment that have led to these states failing, and how will they operate in the 21st century? What are the vital interests of the African population? What are the global strategic conditions for defending and advancing these interests? What are the attributes of state security, and how does that impact global security? This is an African proverb, called Ubuntu It says, “I exist because of you.” I like this indigenous American proverb, as well, which says, “We do not inherit “the Earth from our ancestors “We borrow it from our children.” Our children are warning us They’re not happy But we could make them happy We need to raise our conscious to become better custodians of each other and of our environment Going to war is no longer acceptable We’re in the 21st century Enabling social injustice is old school Let us learn from those two indigenous proverbs Our time as a caterpillar has expired Our wings are ready on the continent of Africa We in Africa promise to enforce accountable politics and fiduciary standards on our leaders We’re on the verge of demanding accountability We’re going to diligently work towards improving biosecurity and building capacity on our continent We’re going to curtail deforestation, and switch to green energy We’re gonna start planning our rural and urban cities We’re gonna limit our population growth in a humane way In the spirit of Ubuntu, we forgive all past atrocities, and look to a brighter future of global harmony We will ignore the comments of S-H countries Here is the message we have to the leaders of the developed world from Africa Please stop looking at Africa as poor Our stolen wealth has built empires Stop calling Africa corrupt ’cause you can’t get more corrupt that stealing human beings, dehumanizing them, and ransoming whole countries and setting up systems that perpetrate extraction Stop accepting billions of stolen wealth from African despotic leaders into your great banking institutions Stop making rules in the capitals of the West

that affect us in Africa without our involvement Stop calling reparation aid, and attach strings to your support, reminding us of how accountable you are to your taxpayers, while you refuse to acknowledge our calls for blood tax Commit to a grand Marshall Plan for Africa and its diaspora to recompense and repair the damage of 500 years of brutal exploitation Accept that there were major atrocities committed against sovereign rights of the African people that crippled their projected growth and development Just simply say “sorry.” We haven’t receive a sorry yet Stop your clandestine security excursions into Africa We’re not out to get anyone We just want to live in peace Africa has finally woken up, and our renaissance is in full swing Africa is rising I’m gonna take this opportunity to invite you to the Fourth African Conference on Emerging Infectious Diseases I thank you for your attention (audience applauds) (woman speaks too low to hear) – Hi, my name’s Nia Thanks for your presentation Especially when you have loads of conclusion, those were fantastic, but that the rule of the system is in such a shape, I don’t know what mechanism you have You have your vision, but I don’t know actually how are you going to handles those corruption and handle those partnership who are for their benefit, rather than for your benefit I just wonder what specific plan that you think you can implement to make it successful? – The general attitude in Africa is non-involvement in politics Politics is for politicians We’d normally say that the people that get involved in politics are the dropouts in school Academics have resisted involvement in politics, but that paradigm is changing We recognize that you cannot be an armchair critic of a government if you’re reluctant to get involved in governance More and more, we’re seeing academics vying for positions now in government, for presidents, for governors, so that we’re injecting academia into the policy streams of our countries It’s beginning to work We’re now beginning to see governments in Africa that are being held accountable by the people that are being elected, and setting up independent panels that are going to adjudicate over corrupt practices We know what’s wrong in Africa We’re not hiding the fact that our politicians are corrupt as sin We know that But they are enabled externally You can’t be corrupt on your own You’ve got to steal that money and put it somewhere You’ve got to be enabled We’re asking you to stop that enabling environment We will deal with our politicians But if they can’t siphon their money out of the continent, they’ve got to keep it in Africa Then we can hold them accountable Governance and the interest in people getting into politics is changing I myself am getting interested in politics, and I’m encouraging all academics to participate in politics They think politics is a dirty game Yes, it is a dirty game, to some extent, but the only way you can change it is to get involved We’re seeing more and more enlightened people, we’re seeing more and more academics vying for political position As we see that, we’re seeing the landscape transforming slowly, and people holding their leaders accountable to delivery I hope that addresses your question to some extent Sorry

– I thought that your proposal for a Marshall Plan-style initiative in Africa was very interesting, but I was just wondering whether or not you would wanna put emphasis on financial support from developed countries or actual initiatives that help combat some of the issues that you presented? – What did they do with Europe? It wasn’t financial Well, of course, there’s always money involved, but it was a partnership There was an exchange of information There was an exchange of technology There was almost like a mentorship to raise the capacity It wasn’t a business venture It was a genuine partnership It wasn’t aid with strings attached It was we want Europe to be a bonafide trading partner of America You can’t trade with us if you are in a poverty trap We’re gonna elevate you out of a poverty trap In Africa, we don’t know what those dimensions would be Of course, Africa is not Europe, but there are the political scientists and there are the economic scientists who can figure that out if we come to the table and understand that what we’ve been doing up to date has not worked Therefore, we need a new paradigm shift We need a new effort Africa has not received any form of reparative justice Aid is not reparative justice – [Man In Green Shirt] Thank you – This is a comment rather than a question One of the aspects of the Marshall Plan that doesn’t get much attention was a very large productivity program that brought thousands of Europeans to the US after World War II to see how things worked It was very much a partnership program, and American industry cooperated quite well to show the Europeans, and from other countries, as well Very hard-working missions that came over, spent six weeks, didn’t go shopping (laughs) They looked at how things worked Wasn’t health oriented, it was mostly industrial and agriculturally oriented Most people are not aware of this If you’ve already studies this, my compliments – I took the spin on your comment about going shopping because what we find is when people go for capacity development, the wrong people are chosen to go from Africa to America or to Europe or to Asia to learn skills That’s our duty to choose the right people But your comment is very valid We don’t know how best to develop this Marshall Plan We would like to sit around the table and everybody put their heads together, and define and design a Marshall Plan for Africa Everybody, as a partnership If we send the wrong people for capacity development, then that’s our problem Then the Marshall plan is doomed We’ve got to be ready for the Marshall Plan, too – These study tours brought people, and this is 1948, so it’s a long time ago, but they brought everyone, union people, legislators, regulators, bankers A very broad cross-section Foremen, factory foremen, too, to see, for these tours They were given quite a broad-ranging experience They’d look at farms, they’d look at distribution networks, banking, regulation, the whole structure of the sector, which is roughly what you’re describing – I believe that The Center for Reparative Research in Jamaica and other centers in Africa will be in a position to try and figure out what facets and what aspects of this Marshall Plan, what it should look like I don’t think that we can come to the table and start discussing what it’s gonna look like until there’s an agreement that there is a need for a Marshall Plan I think that’s the first objective There is a need for a Marshall Plan If we’re denying it, then we just need to keep advocating because there is definitely a need for a type of Marshall Plan to lift Africa

out of the state that it finds itself in, for no reason of its own fault (audience applauds)