Along with the spread of the COVID-19 virus (or “coronavirus”) has been the misguided belief that closed societies and other non-democratic regimes are capable of, or in some instances, better equipped at containing the contagion and others like it. Dr. Tedros Adhanom Ghebreyesus of Ethiopia, the current director-general of the World Health Organization, is a prime example. Dr. Tedros has gone to extensive lengths to “congratulate” China – one of the world’s most oppressive dictatorships – for its response to the pathogen. To be fair, the Chinese Communist Party has taken some positive steps in line with best practices, including publishing the full genome online within a few weeks, quarantining cities, and building rapid treatment facilities. Nevertheless, reports have since shown that the government’s opacity, and its hostility to dissent, actually helped the outbreak spread. Meanwhile, Dr. Tedros and other WHO officials have continued to laud Beijing’s response.
This type of solidarity is understandable.
First, seasoned public health professionals may reasonably argue that it isn’t helpful to criticize or to condemn leaders during an immediate health emergency, even in light of apparent missteps and mistakes. At the same time, however, a growing chorus of public health experts have questioned whether the WHO has been too deferential to China in its handling of the outbreak.
Second, recall that Dr. Tedros himself is the product of a deeply authoritarian regime. In the first few months of 2017 when he emerged as a front-runner to assume the WHO’s top position, many Ethiopians – and alarmed global citizens – raised concerns about his role in both helping to construct and later maintain a highly repressive surveillance state in which a lack of government transparency was a hallmark. As Ethiopia’s Minister of Health, Dr. Tedros was also blamed for allegedly covering up the country’s successive cholera epidemics – in 2006, 2009 and again in 2011 – which ultimately led to the deaths of hundreds of people.
It is not entirely clear why Dr. Tedros or why General Secretary Xi Jinping in China let these crises, including the COVID-19 virus, spin seemingly out of control. One potential possibility is that both did not know the true scope of the problem. It is indeed nearly impossible to gather direct evidence, and act on the facts accordingly, from inherently secretive states – ones that simultaneously criminalize dissent, persecute journalists and outlaw an independent press. A similar situation arose late last year, in increasingly repressive Tanzania, when state authorities failed to provide information about possible Ebola virus infections.
Thus, herein lies the problem: dictatorships are bad for public health, both inside their borders and globally.
Democracies, on the other hand, are much better equipped to both prevent and mitigate emergent health crises. Data in fact shows that democracies experience lower mortality rates for epidemic diseases than their non-democratic counterparts. Importantly, this fact holds true for any given level of income, according to a recent study conducted by The Economist, which analyzed all recorded epidemics since 1960 using data from the International Disaster Database. It’s also important to note here that democratic nations, as opposed to their illiberal counterparts, are more likely to increase their own spending on health and preventive care in the long-term; this is largely because democracies — established and further strengthened by means of free and fair elections — have the requisite checks on power that non-democracies innately lack.
At first glance, highly centralized, top-down regimes may appear to be better equipped to mobilize quickly during an epidemic. However, due to the climate of fear that they impose, tyrannies end up stifling innovation and treating even well-intentioned criticism as a crime against the state. In Sub Saharan Africa, for example, it is no surprise that the region’s top jailers of journalists — Eritrea, Cameroon and Rwanda — are also home to several of the world’s longest-ruling dictators.
Put simply, public health concerns and their solutions demand the free flow of information, democratic accountability, and open dialogue between citizens and their rulers, as well as cooperation among global counterparts. That these integral relationships are strained at best, or altogether absent, in non-democratic countries makes it nearly impossible to respond in a timely or effective manner, costing lives and untold misery in the process.
To be sure, ideas play as important a role as policies in our world. One of the most dangerous ideas today is the persistently misguided belief in the “developmental autocrat” or the “benevolent dictator” – a misnomer if there ever was one – a leader who will daringly sacrifice human rights in order to keep their citizens safe and healthy while spurring economic growth. The available data, and the lived experiences of millions of citizens worldwide, demonstrate that this is utter nonsense. A healthy democracy has in fact proven to be essential for both maintaining and boosting a country’s development outcomes.
The ongoing – and now worsening – COVID-19 outbreak has verified yet again that we cannot, in good faith, fully entrust our lives nor our health to the world’s dictators, despots and their enablers.
Jeffrey Smith is the Founding Director of Vanguard Africa and the Vanguard Africa Foundation