Have Global Witness and Enough Brought Kwashiorkor to Central Africa?

Wikipedia Photo of Children
suffering from Kwahsiorkor

Imagine that your stated goal is to advocate for patients suffering from a terrible, debilitating disease, and that a new drug comes along that promises to alleviate many of the worst symptoms of this disease. Now imagine that the expense and difficulty of producing the drug, coupled with the fact that the disease itself is rare and little known, make it hard to get anyone interested in manufacturing the drug and putting it in the FDA pipeline. Imagine, nevertheless, that you find a company willing to risk producing the drug and succeed in persuading the relevant decision-makers to put it on the fast track for approval.

Now imagine that reports start filtering in from clinics where patients are being treated experimentally with the drug. The reports, at best, are mixed. At worst, they suggest that the drug may be truly harmful.

What do you do?

Do you redouble your efforts to get the drug approved? Mobilize the public to lobby elected officials by emphasizing the horrors of the disease and demanding that the government take action? Blame sensationalist media for playing up negative reports? Dismiss accounts of the drug's ill-effects as "temporary setbacks" or "inevitable side-effects"? Do you hold conferences in prestigious venues where only one side of the issue gets discussed? Plant stories in friendly media casting dissenting voices as shills rather than patient-advocates? Cherry pick a couple of patients to act as spokesmen? And if all else fails, do you rely on that old rhetorical standby, that the drug was never meant to be a "panacea"?

Or do you take a step back and revisit the research? Do you spend a little bit of the money you have on hand to make sure that you've got it right? Do you hire a few of the top specialists to conduct an independent evaluation? Do you make sure that you aren't breaking the physician's first commandment--to do no harm?

The analogy to the conflict minerals campaign isn't perfect of course. There is no accepted methodology for evaluating human rights advocacy. Nor is there any independent agency tasked with evaluating human rights policy initiatives. Nor, finally, is there any established forum for bringing the voices of those affected by the policy into the discussion. On all of these matters, we rely, traditionally, on the wisdom and good sense of advocacy groups, and trust that they speak for the people whose interests they claim to represent. And precisely for that reason, advocates should act with an abundance of caution, making sure that the work they do meets with the approval and support of the local population, Above all, advocates should cause as little harm as possible, and no more than is absolutely necessary.

Which is why I've been so astonished and saddened by the reaction of Global Witness and the Enough Project to news that their campaign is causing severe unintended harm to the people of eastern Congo. Many of the most important questions about the benefits and harms of the conflict minerals campaign are wholly empirical. I've outlined them here. Answers can be gathered by a small team of qualified social scientists in a matter of weeks, not months, at an expense that ranges in the tens and not the hundreds of thousands of dollars. But even as one after another independent scholar or human rights group comes out with a report alleging that the campaign has caused people irremediable harm, the advocacy groups have chosen to respond as if the truth of the matter could be settled by winning a public relations campaign.

I write on Christmas Day with real anger. I have just received independent confirmation that children in two mining communities are suffering from the protein malnutrition disease kwashiorkor as a direct result of the embargo on Congolese minerals brought about by the conflict minerals campaign. This must be a historic first: Never in the history of human rights advocacy have advocacy groups, with nothing but the best of intentions, brought so much predictable suffering to the people they purport to defend. And never before have they then blithely denied that anything had gone awry, despite mounting evidence to the contrary.

So Merry Christmas Global Witness! Merry Christmas, Enough Project! Congratulations on all your good works. And may you spare an idle thought, this holiday season, for the people whose lives you have so carelessly smashed up.