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BRICS and global health: the case of the Ebola response

By Guanyang Zou
on May 14, 2015

Together, the BRICS countries Brazil, Russia, India, China and South Africa constitute 25 percent of the world’s GNI, 40 percent of the world’s population and 40 percent of the global burden of disease. BRICS  countries play an increasing role in global health, both by improving health outcomes in their own countries and by engaging in mutual ( “win-win”) cooperation in LMICs. The Ebola crisis in West-Africa and beyond was a (rather rude) wake-up call for many governments in the world including BRICS governments. Although the worst seems over now, Ebola still remains an international public health emergency, and it would be unwise to doze off again on the issue of global health security, post-2015. As Ebola has threatened global peace and security last year, the crisis provides a good opportunity to critically examine BRICS contributions to international humanitarian emergencies, also with a view on pandemics that may emerge in the future and even seem very likely, according to people “in the know” (including Bill Gates). In this short reflection, we explore whether and to what extent the BRICS have supported Ebola affected countries in their efforts to contain the Ebola epidemic. Data are a bit patchy, but we give it a try anyhow.

As you know, BRICS’ economic engagement with African nations has been substantial in recent years, including in the region badly hit by Ebola. With many BRICS workers in the Ebola affected regions, BRICS countries quickly understood the risk of the virus for their own countries, in light of the increased migration and with booming economies. BRICS thus responded positively—but unfortunately also largely separately, not as a joint BRICS effort —to the Ebola outbreak in West Africa, even if some of the former colonial powers from the West took the lead in the global response (albeit belatedly). BRICS countries contributed bilaterally, via regional channels but also through multilateral institutions, especially UNMEER, the UN Mission for Ebola Emergency Response, and WHO.

Of the BRICS countries, China’s contribution has no doubt been the most significant, even if the epidemic also revealed certain problems in Sino-African relations, according to Ian Taylor.  China delivered four rounds of emergency funding up to 129 million dollars, building treatment centers, increasing the number of Chinese medical and military medical staff and building mobile laboratories. The Ebola situation was the first time that China extended humanitarian aid to countries facing a public health emergency.  China has donated approximately 13.9  million USD to  multi-lateral agencies like the World Food Program (WFP), WHO and the UN Multi-Partner trust Fund (MPTF) under UNMEER, and nearly 30.7 million USD in the form of in kind aid for laboratories, food, disease prevention materials, and medical response teams in Liberia, Guinea and Sierra Leone. The latter funds have also contributed to containment efforts in ten neighboring countries and within the African Union.

The South African Cabinet committed close to $3 million to support the containment of the virus through mobile laboratory services and training healthcare personnel. Till now, South Africa has donated almost 325,000 USD to the WHO for Ebola relief efforts. The country also sent some health professionals to deal with the epidemic. The  Ebola Response Fund, a joint initiative of the South African government and the private sector also raised 1 million USD in cash and resources.

Although their bilateral links to West Africa are less strong, other BRICS countries also provided direct support to Ebola affected countries. For example, Brazil’s Health Ministry donated a number of medical kits to affected countries, and donated   nearly 7.3 million USD in bilateral aid and contributions to the WFP, WHO and the MPTF under UNMEER, to affected countries. India gave 2 million dollars for the purchase of protective gear for health workers in the affected regions,  10 million USD to MPTF/UNMEER, and nearly 0.6 million USD to support WHO efforts to prevent the spread of the Ebola virus. The Russian Federation has provided nearly 0.5 million USD to the WFP and 20 million USD in bilateral aid to the governments of affected countries. Russia has also pledged nearly 8 million USD to various other UN agencies. BRICS countries also help develop affordable Ebola drugs and vaccines, with the Chinese increasingly playing  an important role in this respect.

In addition to providing direct financial support to other UN agencies than UNMEER & WHO (see for example quite a substantial contribution from China to the World Food Program activities in affected areas), BRICS  also sent peace-keeping task forces. In addition to the national governments, several BRICS companies operating in West Africa also contributed to the Ebola response. For instance, China Kingho Group, a leading exploration and mining company in Sierra Leone, donated about $90,000 to the government and people of Sierra Leone. The Russian mining company Rusal  constructed and opened a treatment and research center in the city of Kindia in Guinea at a cost of $10 million.


An assessment

As we already mentioned, information on BRICS’ aid to West Africa (not just Ebola related assistance) is fragmented. Although development assistance for health from BRICS countries is increasing, their support has not often been recorded in the OECD-DAC report. Figures in different Ebola response resource trackers do not always correspond, and there’s also sometimes a difference between amounts pledged and money actually delivered (like for other countries). Nevertheless, let us try to come up with some key messages anyway, even if based on patchy data and a ‘quick & dirty’ search.

Despite widespread criticism of WHO’s handling of the Ebola response at the early stages, BRICS countries have firmly supported the UN and WHO in coordinating efforts to contain Ebola throughout the epidemic. The 4th BRICS health ministers’ meeting in Brasilia, December 5 2014,  supported the efforts taken at all levels and confirmed support for the strategic objectives of UNMEER to contain the outbreak, treat the infected, ensure essential services, and preserve stability.

Despite several large scale efforts of health cooperation among BRICs countries in recent years, it is fair to say that the BRICS responses related to Ebola control in West Africa have been relatively fragmented. BRICS countries prioritized global health strategies mainly through (their own) bilateral cooperation with West-African countries, and by contributing to the global multilateral response. Although the BRICS share many common health interests, different foreign policy interests may have prevented them from developing common positions or a coordinated response in this particular international public health emergency.  That is definitely not a first, BRICS countries are, like other countries, quite flexible in seeking coalitions in other (for example development) agendas.

In comparison to former colonial powerhouses such as the US and the UK, BRICS countries have  played a constructive but secondary role in responding to Ebola emergency. Among the BRICS countries, China seems to have made the most significant contribution, which is easy to understand as China, among the BRICS countries, has the longest history of supporting health and economic development in Africa. It is likely that China will also play a key role in the recovery stage of countries (and their health systems) in the post-Ebola stage, in line with its new aid focus on UHC in Africa.

Finally, BRICS countries will no doubt have their say in the – likely – thorough revamp of the global health architecture in the coming months and years, after this rather nasty surprise. Global health security is also a key concern for them, not just for wealthy nations in the North. No doubt that will already become clear at next week’s World Health Assembly in Geneva.




Correspondence to: Guanyang Zou (

About Guanyang Zou

Guanyang Zou (China Program, COMDIS Health Services Delivery Research Consortium, University of Leeds, Shenzhen, China & Institute for International Health and Development, Queen Margaret University, Edinburgh, UK  ) wrote this blog together with Kristof Decoster (ITM), Swati Srivastava (PHFI, India), Bhaskhar Purohit (PHFI, India & Indian Institute of Public Health Gandhinagar (IIPHG)), Shakira Choonara (University of the Witwatersrand) and Daniel Eduardo Henao Nieto (Fundación Universitaria Autónoma de las Américas, Pereira, Colombia). 

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