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Daily Maverick
02-06-2025
- Politics
- Daily Maverick
Political agreements alone won't heal Sierra Leone's deep social divide
Constitutional and legal reforms are needed to address divisions rooted in the overcentralisation of power and resources. Despite a veneer of national cohesion, deep ethnic and political divisions persist in Sierra Leone. These were evident during the 2023 contested elections, which required a national unity agreement to defuse tensions between the government and the opposition All People's Congress (APC). The APC had rejected the declaration of President Julius Maada Bio as the winner, citing irregularities and procedural infractions. While the next general election is still three years away, it's critical to prevent a resurgence of tensions that could escalate into violence and instability. Since the end of its civil war in 2002, Sierra Leone has been on a democratic trajectory, holding five consecutive elections and experiencing peaceful transfers of power in 2007 and 2018. The country has consistently ranked high on the Global Peace Index, although with a slight decline since 2016 – and was ranked eighth -most peaceful in Africa in 2024. Combined with its postwar stability, religious tolerance and conflict prevention awareness, this progress has fostered a semblance of national cohesion and led to reduced regional and international interventions in recent years. Nevertheless, deep-rooted sociopolitical cleavages continue and were especially apparent before and after the June 2023 elections. The antagonistic relationship between the ruling Sierra Leone People's Party (SLPP) and APC continues to reflect pronounced ethno-regional cleavages. The SLPP draws its primary support from the Mende ethnic group in the south and east, while the APC is largely backed by the Temne in the north and northwest. These divisions were implicitly acknowledged in the agreement, in which both parties jointly condemned 'all citizens at home and abroad who incite violence, spread hate speech and disrupt national cohesion'. They reaffirmed their commitment to interparty dialogue. The agreement aimed to resolve the post-election impasse, leading to the APC ending the boycott of its participation in elective offices – parliamentarians, mayors, council chairs and councillors. The parties agreed to establish a cross-party committee to review the 2023 electoral process and address issues such as election-related detentions and politically motivated legal actions. However, it did not address the overcentralisation of power and resources that have historically fuelled divisive politics, often centred more on access to state control than genuine policy differences. The 1991 constitution (as reinstated in 1996 and amended in 2008) and Mines and Minerals Development Act vest full ownership and control of Sierra Leone's vast natural resources – including gold, diamonds, bauxite and iron ore – in the state, particularly the executive. Mining, regulated by the National Minerals Agency, has been a key economic pillar, accounting for more than 26% of gross domestic product in 2014 and contributing significantly to public revenue and export earnings between 2012 and 2014 before Ebola and Covid-19 disruptions. Furthermore, the private sector relies on state-led public works and procurement. The government controls licences, permits and access to credit guarantees, making proximity to political elites a determinant of economic success. The public service, accounting for 39% of formal employment in 2018, remains a major employer. These factors reinforce state dominance over economic life and render access to political office a gateway to wealth accumulation, while exclusion often translates into economic marginalisation. Both major parties have accused each other of corruption and discriminatory economic practices. Between 2007 and 2018, SLPP leaders, including then-opposition figure Bio, accused the APC government of tribalism, patronage and nepotism, claiming government contracts were awarded primarily to ruling elite loyalists and associates. On assuming office in 2018, the Bio administration released a report alleging grand corruption and ethnic favouritism under former president Ernest Bai Koroma. At least 25% of citizens in the south and east claimed their ethnic groups were being treated unfairly. The APC has similarly accused the SLPP of state capture, citing, for example, the alleged misappropriation of public funds by First Lady Fatima Maada Bio. In its northern stronghold, where 26% of the Temne population reported experiencing ethnic discrimination by the state, grievances over rising living costs and limited access to basic services triggered deadly anti-government protests in August 2022. These developments echo the causes of the civil war, as identified by the truth and reconciliation commission in its 2004 final report. It found that '[t]he provinces had almost been totally sidelined through the centralisation of political and economic power in Freetown' and regions and ethnic groups were polarised by contrasting treatment. Successive governments, the commission concluded, had systematically favoured 'certain ethnic groups in appointments across the cabinet, the civil service and army'. Despite the 2023 agreement, political tensions intensified when Koroma was placed under house arrest and charged with treason between December 2023 and January 2024 regarding an alleged attempted coup. This followed attacks on military installations and prisons, which left 20 dead and enabled more than 2,000 prisoners to escape. The government claimed that Koroma's security personnel largely orchestrated these attacks. Moreover, the executive wields significant control over state institutions despite constitutional provisions for the separation of powers. Presidential appointments to key government positions – including in the judiciary, security sector and public administration – concentrate power in the executive and turn public institutions into vehicles for patronage, including through the allocation of public contracts and jobs. Transitions of power between the SLPP and APC have frequently resulted in widespread replacement of state personnel. Institute for Security Studies (ISS) interviews with political and civil society actors in June 2024 highlighted concerns over the politicisation of public appointments and deployment of state institutions against political opponents. The trial of APC's 2023 presidential candidate and former foreign minister Samura Karama for alleged corruption was cited as an example. Promoting sustainable national cohesion and ensuring stability during elections will require more than externally brokered political settlements. The deal was brokered by the African Union (AU), the Economic Community of West African States (Ecowas), the Commonwealth and the Independent Commission for Peace and National Cohesion. Structural reforms aimed at decentralising power and resource control must be prioritised through constitutional and legal reforms. The AU, Ecowas, and other international partners must go beyond crisis response and work to accelerate inclusive development and expand economic opportunities for all, irrespective of ethnicity or region. DM
Yahoo
26-03-2025
- Health
- Yahoo
He's Best Known for The Fault in Our Stars. That His Latest Book Is About the World's Deadliest Disease Actually Makes Perfect Sense.
Sign up for the Slatest to get the most insightful analysis, criticism, and advice out there, delivered to your inbox daily. Henry Reider talks like his words can't keep up his thoughts. It makes sense. English is his third language after Krio and Mende—all of which are spoken in his native Sierra Leone. Reider is also a creative, whose mind dances between anything from his university studies to his YouTube channel, or to whatever it is he's talking about at the time. While he speaks to me from his home in Sierra Leone, a rooster crows in the background, punctuating his sentences like a barnyard hype man. Rather than distract from what he's saying, though, it makes it seem all the more important. He's excited and passionate. He speaks quickly, as if he might not ever get the chance to say the words again. If I didn't know any better, I would never have guessed that, just a few years ago, Henry Reider nearly died being choked to death by his own lungs. 'People should understand that tuberculosis is not just a disease of the past,' Reider told me. 'It is still affecting millions of people today, but it is preventable, treatable, and also curable.' Reider's journey of how he contracted and (spoilers) ultimately recovered from multidrug-resistant TB is told in Everything Is Tuberculosis: The History and Persistence of Our Deadliest Infection by John Green. The book, which was published last week, tells the story of the disease and how it molded—and continues to shape—human history. The book might seem, at first blush, like a departure for Green, who's best known for his bestselling young adult novels, such as The Fault in Our Stars and Looking for Alaska along with his cleverly packaged memoir The Anthropocene Reviewed. But Everything Is Tuberculosis is, in many ways, a quintessential John Green book: one that grapples with the issue of mortality and our conflicting desires to both help and hurt one another, all within the backdrop of the coming of age of a young man, Reider. Reider met Green when he was 17 years old at the Lakka Government Hospital in Freetown, Sierra Leone. The author was there to learn about the country's maternal care system as part of his support for the global health nonprofit Partners in Health. Reider, now 25, acts as the book's heart and hero, giving the reader a view into his life that's both intimate and, often, unbearable to witness. We must witness it, though, the book insists. We must witness the pain, and the fleeting but precious moments of joy. We must witness Reider's struggles to find medicine and keep his torturous hunger at bay, and his near-superhuman ability to maintain hope throughout it all. While his story is the frame, the book also dives into the scientific and cultural history of tuberculosis, told with the intelligence, wit, and tragedy that have become hallmarks of the author's work. In this book, Green acts as a kind of exasperated Ms. Frizzle, if Ms. Frizzle lived in Indianapolis and seemed to only wanted to talk about TB. The approach works, letting the reader learn about the disease in fun ways ('Did you know tuberculosis gave us the cowboy hat?') but also underscoring the horrific unfathomability of TB ('Still, over a million people died of tuberculosis in 2023. That year, in fact, more people died of TB than died of malaria, typhoid, and war combined.'). Above all else, though, the book is an attempt to make the case for TB's relevance today. Despite the fact that many believe that the infection is a thing of the past—think cowboy Arthur Morgan coughing in Red Dead Redemption 2 or Fantine wasting away in Les Misérables—tuberculosis is still very much with us. In 2023, 10.8 million people worldwide were infected by the disease, according to the World Health Organization. In the same year, a total of 1.25 million people died as a result, making it the world's deadliest disease. From 2020 through 2022, it was second only to COVID-19. Everything Is Tuberculosis doesn't so much tell you the story of tuberculosis, as much as it gently holds your hand and parts the curtains into one of the darkest, most bizarre, and frustrating series of decisions in world history with the other. After all, Green often reminds us, that's what tuberculosis is: a decision. Even with drug-resistant TB, the disease is highly treatable—so it's a decision to let people die when we know how to cure their infection. It's a decision to allow the disease to spread and flourish when we cut funding. It's a decision to let TB feed and grow on human lives and communities, the way a fire might devour a forest. It's a decision to let people go untreated when pharmaceutical companies charge exorbitant premiums for lifesaving medicine for the sake of the bottom line. And it was a decision to let Henry Reider nearly die of tuberculosis. Tuberculosis kills you in different ways. Contracted via airborne particles, it can cause respiratory failure, damaging and scarring your lungs to the point where breathing can be like trying to suck air through a plastic coffee stirrer. It can also cause major bleeding in your lungs to the point where you cough up and, eventually, drown to death in your own blood. It takes a while for the disease to get to this point. In fact, some become infected with TB for years before they start developing symptoms. The standard treatment is intensive, requiring patients to take a regimen of around six to nine pills a day (sometimes more) for about six months. However, it's very effective, with success rates ranging around 90 percent. Of course, it can be expensive, with treatments costing upwards of $20,000 for a full course. International aid programs like USAID often provide the medicine free of charge, but those efforts aren't enough. Tuberculosis can develop quickly and viciously with the right conditions like those most often faced in communities throughout the 'Global South' such as poverty, malnutrition, and lack of access to medicine—conditions that Reider was and is regularly exposed to. This causes a domino effect, one that can exacerbate and worsen an already nightmarish situation. 'If the drugs are not available to those people who need them, it can lead to death,' Reider explained. 'People won't be able to handle it when funding is cut off. When you are funding something, and you cut off that funding, it can lead to unnecessary death.' In the book, Green talks about the concept of a 'good death,' noting that our concept of good and bad ways of dying have constantly shifted over the years. In the past, Western society romanticized tuberculosis (colloquially known as 'consumption'). It was the way great poets, artists, and philosophers died. People thought it even made you more beautiful the way it made one's skin glow with fever and the body waifish and willowy as it starved. Today, we would never consider dying of TB to be a 'good death.' The reality is it's painful and exhausting. Often, in places like Sierra Leone, there's so much stigma attached to TB that those infected are treated as social outcasts by even their family members. As such, patients often die alone in underfunded and under-resourced hospitals like the one Reider was in when Green met him. Yet every day we allow people like him to die of tuberculosis even though countries like the U.S. have nearly unfettered access to lifesaving treatments and vaccines. 'When the resources are available for treatment, it can prevent everything,' Reider said. 'It can also lead to awareness. More people will understand that the disease is dangerous, and that treatment is available.' It's a terrible bind: TB isn't hard to treat; we decide to let it go untreated. When I call John Green, he talks like words just aren't enough anymore—which is ironic for a man who has made his living writing novels. Sitting in the basement of his Indianapolis home in the room where he films the majority of his videos for his and his brother Hank Green's popular and long-running YouTube channel Vlogbrothers, he looks and sounds like the embodiment of the phrase 'I'm getting too old for this shit.' 'I am discouraged,' is what he tells me when I ask him how he's doing. Reider, he says, 'loves to use the words 'encouraged' and 'discouraged,' and the way that he uses them reminds me that courage is a verb. Courage is something we rouse ourselves and each other into, or courage is something that we pull away from. And right now, I feel pretty discouraged.' Green has plenty of reasons to feel discouraged—the U.S. government seems outright hostile to any efforts to support global health. President Donald Trump, along with his unelected billionaire hatchet man Elon Musk, has announced they would shut down USAID, which is also the largest bilateral donor in the fight against tuberculosis. On March 10, U.S. Secretary of State Marco Rubio—who is also the acting director of the agency—announced that the White House cut 83 percent of programs under USAID. Musk also took an ax to the Centers for Disease Control and Prevention. His Department of Government Efficiency team has fired roughly 1,300 employees at the agency (or 10 percent of the CDC overall), including 135 members of the Epidemic Intelligence Service. As many as 1,500 employees at the National Institutes of Health were also laid off by DOGE in February. Meanwhile, tuberculosis is spreading in America. After 30 years of decline, TB infections in the U.S. have risen every year since the pandemic. This is not a coincidence. As Green notes in his book, TB is a crisis that flourishes when there are other crises, including malnutrition, poor health care infrastructure, stigma surrounding the disease, poverty, and other infectious diseases such as HIV, Ebola, or COVID-19. A recent outbreak of the disease in Kansas City, Kansas, resulted in the deaths of two people with 67 being treated for active infections and 79 people with latent infections. For good and ill, all of these reasons have made Everything Is Tuberculosis perhaps the most relevant of the nine books Green has written or co-written—a fact that doesn't escape him. 'The defunding of USAID and other human health programs by the United States government in such a chaotic way has been absolutely devastating to human health,' Green said. 'The choices that are being made right now are going to send us backwards as a species, and that's devastating.' He added, 'The story of humanity should be a slow but persistent march toward more just and equitable human-built systems, and right now we're making the opposite choice.' Everything Is Tuberculosis is his way of grappling with this choice, and what happens when we do not, collectively, make the correct choice. A passage early on in the book sums it up well: 'But we cannot save those we love from suffering. This is the story of human history as I understand it—the story of an organism that can do so much, but cannot do what it most wants.' We as humans are organisms helpless against our worst qualities. That's part of what Green wants most out of this book: to bring awareness to something that society has ignored for reasons that are all at once human and frustrating. If there's anything that we've learned from the COVID-19 pandemic and the way that people brush it aside and ignore it even though it's still happening, it's that we don't like to think about disease. 'I think we solve the problems we pay attention to, and for too long we haven't paid attention to the global tuberculosis crisis,' Green said. 'That's the reason we haven't solved it.' Henry Reider talks like someone who escaped death. He spent nearly all of his formative years in hospital beds throughout Sierra Leone before finally being treated and cured. Now, having escaped his death, he's determined to live a full, rich, and good life. That means completing his university studies, growing his YouTube channel, and taking care of his mom. He told me he wants to become a 'great journalist and philanthropist' so he too can tell stories and change lives the way that Green did for him. 'I want to advocate,' Reider said. 'My connection with my friend John has created an atmosphere for me to advocate for those who have been in the same situation as me but have much less connections or support. So, I want to advocate for and motivate any individual who's sick and needs help out there, because I know when someone is in that same situation, they need support.' As I read Everything Is Tuberculosis, a line from another book kept echoing in my head: 'So we beat on, boats against the current, borne back ceaselessly into the past.' Humanity has a boundless capacity for so much joy and pain. Yet we nearly always find ourselves repeating the mistakes of our past over and over again. This is the story of us. This is the story of our relationship with this disease. Tuberculosis has been with humans for at least 9,000 years. We have an older relationship with TB microbes than we do with writing, horses, and the Great Pyramids of Egypt. We only learned how to cure the disease much more recently, in 1943, but in 2023 we still allowed 1.25 million people to die of it. Green notes in the book, it would take $25 billion dollars on comprehensive care a year to 'drive tuberculosis toward elimination.' This is money easily accessible and available to some people in the United States. There is zero excuse to allow people to die the same way today that they have for 9,000 years. And yet, no matter how hard we row the boat, we can't escape the past. We get dragged back into it, endlessly and ceaselessly. But we keep going. We wake up. We eat. We take care of our parents. We go to school. We make YouTube videos about our lives and dream of becoming journalists and advocates. We meet wonderful and interesting people, and we write books about them. We get sick. We get better. We fight to make sure that others don't get sick ever again, even if the very country we live in is working against us. We do everything we can—because we believe that people deserve nothing less than everything we have.
