Sub-editor at The Republic and author of ‘Health Versus Capitalism: Is Capitalism Making Us Sicker?’, Charles Ebikeme, believes humanity has not arrived at a proper way of valuing good health. ‘Every cost benefit analysis in health is biased, simply because we cannot effectively assign a benefit to, say, a child not getting malaria. We know there is a benefit in some general sense, in some altruistic sense. But there is a limit to our comprehension of that benefit.’
First Draft is our interview column, featuring authors and other prominent figures on books, reading, and writing.
Our questions are italicized.
What books or kinds of books did you read growing up?
I suppose some of my earliest memories with books were with reading comic books and trying to replicate them. I read a lot of comics growing up and I always tried to draw my own versions. I remember drawing my version of a Charlie Brown comic strip. My version involved Snoopy and Charlie Brown playing baseball. I cannot recall the punchline, but at that time the images were more important to me.
DC comics were also a strong preference for me. To this day, I am still a big Superman fan. We don’t talk enough about Superman being a part of the diaspora. As a British-Nigerian, there are some types of books that seem to be a staple of the commonwealth diaspora reading diet—Agatha Christie, Enid Blyton, Roald Dahl—even Beano comics were all aggressively consumed. Calvin and Hobbes, in its simplicity and intellect. I still remember the dark fantasy imagery of The Deptford Mice read at school.
If your life so far was a series of texts, which text (fiction or non-fiction) represents you at this moment?
Does sheet music count as text?
I have an immense amount of respect for people that write music. Real music, like on sheets of paper with notes and indentations and all that entails. Perhaps because it is so foreign to me, but I imagine they hear the entire piece of music in their head. That music exists simultaneously as text on paper and then, once performed, as notes in the air.
I’m not sure if that makes complete sense, but there is something about visualizing ideas in many different forms that appeals to me.
What is a recent book/text you disagreed with, and why?
Every single piece of academic text I read I disagree with. Not for what is contained within, but mainly for the way it is presented to me. There is a joke that academics use words the same way a drunk uses a lamp post—not for illumination but for support. Academic writing is so incredibly dense and, at a certain level, built to be impenetrable. Jargon is just one example. But sometimes we assume complex things cannot be rendered simple. We conflate academic rigour with inaccessibility.
And I understand that it’s written for a different audience. It’s written for other academics to consume.
But one of the unspoken secrets of academic writing is that it is in fact written for an audience of one—the reviewer. Everything is written to pass peer review. And look, peer review—like democracy—is the best system we have come up with up until now. But there are so many aspects in the way academics do business that makes what they write challenging to read.
What’s the last thing you read that changed your mind about something?
The Purpose of Power by Alicia Garza—one of the founders of the Black Lives Matter movement. It is all there in the title.
One of the unspoken secrets of academic writing is that it is in fact written for an audience of one—the reviewer. Everything is written to pass peer review.
What makes a text powerful: the subject or how it’s written?
The reader brings so much to the table that I think that is the missing key ingredient. Much of great literature really depends on the mind of the reader. I read Chinua Achebe’s Things Fall Apart while I was doing my doctorate. It was eye-opening. It is one of the few texts you can describe as big ‘L’ literature. I am convinced that there was no other point in time where I could have read that piece of work and it would have left the same impression on me.
Similarly, I read Stephen Clarke’s A Year in the Merde in my first few months after moving to France. It was a recommendation from a French friend from grad school when he learnt I would be moving to France. I could only have understood that book after spending some time among the French. The book I can only describe as an anthropological dissection of French society in the funniest way possible. I could not have appreciated it if I had read it before moving to France or even after being in France for many years.
I read Teju Cole during a long summer in New York and immediately understood. There is a sweet spot with some books. And they stay with you for years afterwards. To this day, before I start to write anything, or when I am struggling to write, I read Primo Levi’s The Periodic Table—mainly the last chapter titled ‘Carbon’. It is such a beautiful book, but I read mostly that chapter because it reinforces my faith in what writing can do. In the ‘Carbon’ chapter, Levi recounts the life of a carbon atom and simultaneously describes something which is fiction but at the same time something that is an inevitability in the grand scheme of things.
I read that Steven Spielberg, before starting any new film, watches Citizen Kane and a John Ford film, perhaps The Searchers. Not that I am comparing myself to Steven Spielberg, but I understand the process of trying to imitate greatness.
You work on health research and policy in Africa. What’s one common misconception about healthcare in Africa?
The misconception is that there is no expertise on the continent. We’ve seen it exemplified with this COVID-19 pandemic, and I am not the only person to have written about this. African countries did a lot of things right during the early months of the pandemic. While we saw some other countries, those some considered to be highly advanced economies with strong health systems and health policymaking systems, flail, falter, and struggle.
That expertise from African countries is there. The wealth of talent is there. We don’t need to invent or look for other reasons why African countries did well. Just pay them their dues, and let’s all try and learn from them.
What’s one thing you wish more African governments paid attention to when shaping and implementing healthcare policies?
Whether it is African governments or any other government the message is the same—health is an investment, not an expense. Ultimately, it is an investment in the population.
Nothing exists without health. We often take it for granted and I wish we wouldn’t so much.
Nothing exists without health. We often take it for granted and I wish we wouldn’t so much.
And what main healthcare policies would you implement if you had the power to do so?
This is a big question. Without avoiding the question, I would seek to reframe it and say, let’s take a step back for a moment—what are the actual health burdens that affect us as Africans? It is hard to answer that question without the burden on colonialism, philanthropic interests, and what we know as ‘aid’—the kind of aid made famous by Bono et al.
External interests, more than anything, drive health agendas on the continent. What would healthcare look like in Africa if that wasn’t the case? Difficult to say, but can we start by asking that question? Since time immemorial anything to do with health in Africa was given the title ‘tropical medicine’—so these are not easy things to disentangle, but I think we need to try and start.
What was your process for writing ‘Health Versus Capitalism: Is Capitalism Making Us Sicker?’
Like everything I write, there is the idea and, a long way down the line, there is the execution. Sometimes those things are quite close together—other times there is an ocean between them. For me, there are a lot of similarities between writing and cooking. And I often take this approach.
Ideas are ingredients, and they go into the pot on a low heat to simmer for a long time. Ingredients are stored in the Notes app on my phone, strewed across various PDFs of academic papers, in ‘save to pocket’ articles I come across online, and in Twitter discourses and threads. They all go into the pot in some sort of haphazard way. After a while, even on the lowest heat setting, it starts to overboil. That is the moment I have to commit the ideas to paper. That is when I have to start writing it.
For ‘Health versus Capitalism’, the idea was that capitalism, or the way capitalism operates in the general sense, is at odds with the goal of providing health for everyone. Again, these are ideas and concepts which are already out there in the ether. The ‘execution’ or the hard part is trying to say that in a way a reader can understand and in a way that actually matters to the reader.
What is the narrative? What am I actually trying to say? What needs to change? What can we do better? I would also add that having an editor for your writing is one of the unspoken secrets of writing. In between the idea and execution is a good editor to make your ideas better.
How would you recommend governments approach managing the tensions between access to quality and affordable healthcare and profit making?
Remove profit making from the equation.
Health is an investment. We are incredibly bad, as a species, at valuing things—especially the intangible things. Every cost benefit analysis in health is biased, simply because we cannot effectively assign a benefit to, say, a child not getting malaria. We know there is a benefit in some general sense, in some altruistic sense. But there is a limit to our comprehension of that benefit. We are seeing it now where it is literally too expensive for governments to vaccinate everyone against COVID-19.
Health is too expensive in the way we have conceptualized cost and benefit in our collective minds. Health, like education, is immeasurable because the benefits are equally immeasurable. And changing this mindset isn’t going to come from more and more data or evidence. It is going to come from imaginative and innovative ways we view the future we want to live in.
What is the most meaningful piece of writing advice you’ve ever received?
Having an editor for your writing is one of the unspoken secrets of writing. In between the idea and execution is a good editor to make your ideas better.
Who’s an author you wish you had discovered earlier?
Again, these things only arrive in their own time. The moment you step off the train or plane into Paris as a ‘Black’ person James Baldwin looms large. There is something about that Black experience of African Americans in Paris that we still return to today.
Who are the authors you’re most excited about today (and why?)
The pandemic did something to my reading habits that I have yet to recover from. Like long covid but for reading. I struggled to read during much of the pandemic, but I am slowly emerging from the fog. Pre-pandemic I read Lola Shoneyin’s The Secret Lives of Baba Segi’s Wives, a book I recommend to everyone.
Whether we want to call it Afrofuturism or African-futurism, Tade Thompson excites me. Ted Chiang’s fairy tales also excite me. In French, I read Maguerite Duras for no other reason than that her words are simple, and accessible for a non-native speaker like me.
Zadie Smith is a perennial obsession for the simple fact that we grew up in the same area in London—Willesden Green. When she writes about meeting an elder at the 98 bus stop, I feel seen. And then, I suppose, there are a whole host of authors I have yet to discover that will one day excite me.
What is your favourite topic to write or read about these days? (Please include the names of articles and books, if possible)
Food. I fell into food writing relatively recently. Food writing has traditionally been about food criticism. But there is a whole host of writers, found in non-descript Twitter threads, or in newsletters that arrive in your inbox, that make it feel different. As Nigerians we are very dogmatic about our food, I think. Or at least I am. But food evolves.
What fascinates me is how and why food evolves. The staples of today were once the taboos of yesterday. Wherever you find plantain or akara, you find a common history of some sort. Food, expressed as a fundamental human endeavour, and as the product of the movement of human peoples, and as the sum of the changing structure of human populations all of a sudden makes sense.
We are incredibly bad, as a species, at valuing things – especially the intangible things. Every cost benefit analysis in health is biased simply because we cannot effectively assign a benefit to, say, a child not getting malaria.
What are you currently working on?
No joke, I am developing a screenplay on Trofim Lysenko (so if anyone from Netflix is reading this, you know how to contact me). Trofim Lysenko was a Soviet scientist, who believed that he had discovered the secret to generating crops that could withstand the harsh Russian winters. He convinced the entire Soviet state of his discovery.
Except his discovery was not true. It led to a famine that killed millions of people. Trofim Lysenko probably killed more human beings than any individual scientist in history. Before there was fake news, misinformation, or entities that used questionable scientific evidence to their advantage, there was Lysenkoism. It is a fascinating story if only because we seem to be living through the same thing again with the pandemic—whether it is the politicisation of mask usage or antivaxxers. History repeats itself.
It is a story I have struggled to find a way to tell. It is historical fact and I had struggled writing it as non-fiction. As a screenplay, as a film, it is only really the fiction that can bring something as unbelievable as that to life.
I have also just completed a short fiction story for the Science Museum in London. It is going to go into an anthology book of short stories with other writers. I enjoyed working on that project not just because I got to visit the museum archives. Not sure how much I can go into on that project as it is scheduled to be launched by the end of the year.
What fascinates me is how and why food evolves. The staples of today were once the taboos of yesterday.
Question from Leena Koni Hoffman: What keeps you up at night?
Not having enough time.
Bonus: Please suggest a question for a future author’s First Draft
Where do ideas come from?⎈
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