Ebola is a political AND a medical disease

As Bob Geldof is at pains to point out, the purpose of the Band Aid single is to maximise pressure on politicians

Bob Geldof (Getty)

There has been a tsunami of sneering over the Band Aid record to raise money for the fight against Ebola in West Africa. The fundraising effort, it is said, is "aid pornography" filled with unremitting negative stereotypes. "The story has become," Bob Geldof said yesterday, "what a wanker Geldof is, how patronising I am to Africans and how Sky News cut me off for saying bollocks, twice… Everyone has forgotten that the real story is Ebola."

Not quite everyone. Kevin Watkins is perhaps the UK's most authoritative analyst of global aid policy. Now director of the Overseas Development Institute, he is a former head of research at Oxfam and the United Nations Development Programme. "There still isn't a recognition of how serious the threat is," he said. "There are small bits of good news – the rate of increase has started to slow in Liberia and Guinea. But the situation in Sierra Leone, where Ebola has got a grip in two urban centres, is really scary. Last week there was again an increase in new cases. This could still skyrocket."

It is not just Ebola. Medics on the ground report a big increase in measles and pneumonia, two of Africa's biggest killers. Vaccination systems are breaking down. More mothers are dying in childbirth because clinics have diverted to Ebola. Food prices have rocketed. Hunger is widespread. Child malnutrition is rising. Joblessness has doubled. All this threatens to reverse decades of progress.

Bob Geldof is not just a celebrity fundraiser. After three decades of work on Africa he has a nose for the politics and he has unerringly scented that Ebola is a political not just a medical problem.

Ebola is about poverty. If Ebola killed rich people there would have been vaccines 10 years ago. But the affected countries are at the bottom of the UN's Human Development Index. More than 60 per cent of people are below the poverty line. Health budgets are a paltry $20 (£13) per person per year. There are just 187 doctors and 2,000 nurses in all Liberia and Sierra Leone – for a population of 10 million. That's a 10th of what the World Health Organisation says is the absolute minimum. Health services, which are appallingly over-stretched ordinarily, collapse under an epidemic on this scale.

The politics is this: the region's health services ought to have been strengthened – and Sierra Leone's totally rebuilt after its civil war ended 12 years ago. A massive aid deal was agreed by the G8 at Gleneagles after global anti-poverty campaigns including Make Poverty History and Live 8 in 2005. Great advances were made on debt and improved governance as a result. And Gleneagles put 40 million more children in school, gave life-saving drugs to six million people with HIV/Aids and halved malaria in eight countries.

But not all the promises were delivered. And West African health services were at the bottom of the list. It is true, as Geldof's critics declare, that seven of Africa's economies are among the world's fastest growing. Ironically, few individuals have done more than Geldof to build up consortia of Western and African private equity investors in the continent. Yet though parts of Africa are booming, it still has the highest child mortality rate in the world.

"If the promises made in 2005 had been kept, these healthcare systems would've been more effective and might have been able to contain the disease as has been done in Nigeria and Uganda," said Adrian Lovett, a leading campaigner with Jubilee 2000, Make Poverty History, Save the Children and now with the global aid advocacy lobby, ONE, which has six million members around the world. "Geldof is putting those broken promises back on the political agenda."

You will not hear much of that in the UK, since Britain has honoured its Gleneagles pledges. But Geldof was in France on Friday and in Germany earlier in the week launching Band Aid records there. In Berlin he caused a huge stir by publicly lambasting Chancellor Angela Merkel.

Germany has no right to think of itself as the leader of the G7 when it cannot fulfil its promises to the world's poor; German spending on Ebola is less than half what it spent on one football stadium during the World Cup in 2006, Geldof blasted. "He was firing straight at the political target," said Lovett.

No doubt it would have helped had Geldof displayed a bit more cultural sensitivity with the tweaked lyrics of the Band Aid 30 record, and if he had included more African artists in the line-up. But, he countered yesterday: "It's not about culture, it's about politics. It's not about being representative, or including artists I personally like, it's about getting the biggest names to maximise sales which maximises pressure on the politicians in each place."

He is happy to endorse the dozen or more Ebola records by African artists with their various messages to maintain good hygiene, change traditional funeral practices and trust doctors. "Each is aimed at their own market, which is right," Geldof said, "as our record is aimed at ours." Unlike most of his critics, Geldof understands that market, which is why the single made £1m from downloads within five minutes of its release on prime-time UK television.

But it is not about money. Even the most successful record will raise only a tiny fraction of the substantial amounts needed from the world's governments to control Ebola.

"But the record has a halo effect," Lovett said. "It puts the issue of the chronic underfunding of these African health services in the news." The music is incidental to Geldof. His real task is to hold the politicians' feet to the fire.

Paul Vallely is co-author of the report of the Commission for Africa