Power imbalance at play in Kenya-US Ebola deal

President Donald Trump and the US Government have suggested a plan to set up a 50-bed quarantine and treatment facility at the Laikipia Air Base for American citizens exposed to Ebola in the Democratic Republic of the Congo (DRC) or in any neighbouring countries.

This move resembles the typical ethical dumping strategy where nations classified as First World unethically conduct research in low setting resource countries or Third World countries. Such research is unacceptable in their own countries where the ethical guidelines cannot condone it. This means taking advantage of the Global South countries' weak or ethical loopholes to do so.

Can the US agree to host such a facility for their neighbouring countries should there be an outbreak or emergency? Some of the tropical diseases like malaria already scares the developed countries.

Power imbalance continues to play a big role in the world. There cannot be genuine and voluntary consent to some of the suggested activities like setting up a quarantine centre in Kenya or other African countries for Ebola cases or suspected ones.

Such requests raise suspicion on the motive behind it and whether there are valid reasons to do so.

The risk of Ebola and its aftermath is equally delicate, and a probable disaster for every nation. The ongoing negotiations to set up the quarantine and treatment facility on the Kenyan soil is an abuse to the sovereignty of our country.

Contemplating to do so is to lack respect for the entire nation. If the US Government or President Trump is not willing to accommodate affected Americans on their own soil, why should Kenya bear the burden and risk?

The US should consider its affected citizens as vulnerable, who need care back at home. The time needed to fly Americans affected by Ebola back home is probably less than the time they will spend in the intended quarantine centre in Kenya.

There is no doubt that the Ebola risk is high, and the World Health Organisation declared that it constitutes a public health emergency of international concern. Therefore, Kenya cannot risk or sacrifice its citizens at the expense of American citizens.

Every person, regardless of their nationality, social status, race, condition or gender enjoys inalienable dignity and respect.

Imagining that some states can enjoy this innate right more or better than others is an abuse of power and a misconception. It is treating other people inhumanely against the declared and universally acceptable human rights.

The low and middle-income countries may lack infrastructure and capacity in many aspects. If the intended Ebola facility was in good faith, then it should also serve non-US citizens infected by the virus.

The right place should be in DRC where the virus erupted. Again, despite plans to set up the facility in Kenya, local medics are not being trusted with the care and treatment of the suspected or infected US citizens.

If the US truly trusts Kenya to host the quarantine centre, this trust is not mutual when it comes to the specialised medical human resources.

The fact that this virus is in Africa, local experts ought to have more experience than the doctors who might be brought in to handle affected US citizens. As much as each nation protects its citizens in such situations, the intended facility does not seem to be in good faith.

The leaders of the African nations have to stand firm when such demands come with inducements. The right decisions have to be made using the right channels. This matter involves serious ethical issues which need more than the head of state and the Cabinet secretaries involved. Just as we have the regulatory bodies in matters of research, clinical trials or vaccines; the current matter carries ethical concerns which needs ethical experts and wider consultations on board.

Neocolonialism is a reality to date. Are African nations really sovereign? Why do we want to sell the health of our citizens through economic or infrastructural support? The historical injustices committed against humanity and the African race still continue.

When individual leaders consent to unethical and risky interventions, they do so against the best interest of the entire nation.

I suggest that the funds intended for developing the centre be used without any unethical conditions. We need such facilities for other emergencies. It would be good to build our capacity for developing vaccines, especially for the type of Ebola which has no cure yet.

Let us stand up and fight this insult and abuse of power that comes in the name of economic benefits, which may end up in the hands of few people while risking the lives of many. We shouldn’t sell our dignity.

Dr Mwakio is a bioethicist and current Bioethics Programme Lead at AMREF International University Nairobi and a faculty member for a Bioethics Training Initiative (CK-BTI) Co-Directed by KEMRI. [email protected]