THE REPRESENTATION OF AFRICA AS A GEOGRAPHY OF DISEASE: HOW THE GLOBAL NORTH MEDIA REPORTING OF THE MONKEYPOX VIRUS REINFORCE STEREOTYPES ABOUT AFRICA

This paper examines how the international media reporting on the monkeypox epidemic reinforces stereotypes about Africa and what this means for Africa in global power relations. How European and Western media depict Africa in their reporting of an epidemic creates and reinforces power dynamics and political bias along the lines of Africa being portrayed as a diseased-poor continent. The effect of these global inequalities is evident in the travel ban policies and the unequal distribution of vaccines. The concepts of hegemony, stigma, and labeling theory were used as theoretical approaches to analyze how foreign media hegemony creates and reinforces stereotypes about Africa through media reporting of an epidemic like the 2022 monkeypox virus. Online publications and tweets by Western and European media outlets were used as data to analyze foreign media hegemony while reporting the monkeypox outbreak in Europe and North America. As a counter-hegemony, African journalists reacted to foreign media agencies using African images to report disease outbreaks in the Global North. The conclusion and recommendation of this paper call for investment in African journalism to help Africa tell their own story and for African literature and researchers from Africa to contribute to global biomedical literature.


INTRODUCTION
The World Health Organization announced the 2022 monkeypox outbreak in non-endemic countries outside Africa in May (World Health Organization (WHO), 2022), and to report the news of the epidemic online, foreign media agencies used images of Black-skin Africans to announce the monkeypox outbreak at the time.Foreign media reporting reinforces stereotypes about Africa.This paper analyzes the representation of Africa by media agencies in developed countries, how this representation reinforces stereotypes about Africa and the global implications for Africa in the development discourse.The representation of Africa by foreign media represents the development ideology about Africa as a geography of disease and poverty (Escobar, 2011).Western media coverage of Africa mainly focuses on negative reporting, lacking "nuanced and in-depth media" coverage (Gathara, 2019).Coffey (2022) states that the image of Africa as portrayed by the press not only "reduces people and places to singular depictions," it also "impedes cross-cultural understanding and tends to "reinforce damaging power dynamics."How Western media report about Africa reinforces Africa's global power dynamics as a Third World country.Political power agenda connects to media contents and how international news media report events (Menéndez Alarcón, 2012).Power influences how people are portrayed through the decision of who tells the story, how the stories are told, and how they are described in ways that the story becomes their identity (Adichie, 2009).According to Escobar (2011), the images displayed by the Global North media in their reporting about Africa depict Africa as a Third World country.The media serve as agents of cultural transmission.Their reporting of events shapes the story and the audience's perception (Menéndez Alarcón, 2012).The foreign media's reporting about Africa strengthens the stereotype about Africa, which is depicted as a continent with people dying from poverty and endemic to AIDS and other diseases.
These media stereotypes on international relations create global social hierarchies and inform international/inter-group relations and foreign policies.This media disease stereotype and its implications are further discussed in this paper by analyzing the visual propaganda of the monkeypox epidemic, the global inequalities in the distribution of vaccines, and the travel ban policies.The Western and European media reporting on the monkeypox outbreak used images of African hands and bodies to announce the outbreak in non-endemic and foreign countries, strengthening the stereotypical view of Africa as a diseased continent.Portraying Africa as a geography of disease also creates unequal power relations where developed countries issue a travel ban on African countries.At the same time, vaccines are sent to wealthy and developed countries, and less attention is paid to African countries (Kuwonu, 2021).This paper calls for the need to have a good representation of African researchers to research epidemic outbreaks and author researchers done in Africa.Maye et al. (2019) argue that African authors are underrepresented in the biomedical literature despite Africa being seen as endemic to several infectious diseases.This study also aims to curb the challenges facing African media representation by improving the media coverage and reporting of African journalists through funding, support, and press freedom.

COLONIAL BACKGROUND
How Africa is portrayed by Western media today has its roots in colonial rule (Biney, 1997).Throughout the history of the Cold War and the economic revolutions in Europe, down to contemporary societies, one thing has remained constant, and that is the misrepresentation of Africa by Western and European press, scholars, and writers (Biney, 1997;Coffey, 2022;Conrad, 1995).This misrepresentation of Africa can be traced to the history of slavery and colonial rule (Biney, 1997).
The British Press played a significant role in the decolonization era in Africa by influencing public opinion (Coffey, 2022).British press reports in the era of decolonization depicted postcolonial Africa and her leaders in Congo, Ghana, Nyasaland, and Kenya as inadequate, unfit to rule, and violent (Coffey, 2022).The Western stereotypical representation of Africa in the media has its root in the history of colonialism.In the late 19th century, colonial administrators, European merchant explorers, and writers like Joseph Conrad, Henry Morton Stanley, and Ryder Haggard created and disseminated views and images about Africa.Africa was named "The Dark Continent" by Joseph Conrad.Ryder Haggard and Joseph Conrad wrote about Africa as a continent inhabited by uncivilized and barbaric savages with exotic resources that need to be explored and harnessed (Conrad, 1995).These early descriptions of Africa also influenced the Berlin Conference of 1884 and the scramble for Africa by European states.In the pre-colonial and colonial eras, colonial administrators, missionaries, European merchants, explorers, writers, and the print media created and disseminated information and ideas about Africa.While in contemporary society, the representation of Africa is being carried out by all the various forms of the media and the mass media (newspaper, television, social media, radio, and the internet) (Biney, 1997).
This paper poses the question; how does the Global North media reporting an epidemic reinforce stereotypes about Africa?This paper will contribute to the literature on Western and European media reporting on the recent monkeypox outbreak in non-endemic countries through the framework of media hegemony and the role of political and socioeconomic power in stigmatization and labeling, and also the consequences in international/intergroup relations.This paper looks at how media politics shapes government policies and what it means to Africa and for Africans in global relations.

Media Hegemony
This section reviews existing literature and research on media hegemonic theory and the representation of Africa by media agencies in the Global North.This theoretical concept is important in analyzing the media representation of Africa and its implications.Hegemony, as developed by Antonio Gramsci, is the dominant political, moral, or cultural ideology established by a dominant class with the consent and collective will of the people (Femia, 1987).Media hegemony is the socialization of Western journalists to reproduce the dominant ideology, which includes the negative reporting about Third World countries by foreign media (Altheide, 1984).The dominant ideology about Africa as a "Third World" country is the ideology of the Western media portrayed by their representation of Africa as a geography of disease.Referencing Gramsci's hegemony, Coban stated that media reporting is controlled by the capitalists who own and dominate "the means of mental production" (Coban, 2018).The media hegemony school of thought argues that foreign media report negative stereotypes about Third World countries to promote control through "information imperialism" (Dahlgren & Chakrapani, 1982).Altheide (1984) asserts that the media does not entirely have a hegemonic agenda and that it plays a role in social change by challenging the status quo.Stan (2015) argues that the media adopt sensationalism in their reporting, and because negative news sells, media capitalists take advantage of it.The media's primary goal is to make money and sell stories to the readers.Western media websites, newspapers, and networks sell biased news to get more readers and make money via advertising (Stan, 2015).Similarly, Michira (2002) states that Western media representation of Africa is because of the commercialization of news by the corporate media and that to make a profit, Western media publish stories about Africa that sell by engaging in "crisis-driven journalism" lacking in objective and balanced reporting (Michira, 2002).

Stigma and Labeling Theory
According to Goffman (1986), stigma is a social theory with the attributes of "spoiling identity."Stigma can demean individuals and their identity through labeling.Becker's (1963) labeling theory views stigma as attaching stigmatizing stereotypes to a group of people by labeling them as deviants.Stigma is a negative perception and stereotypical label attached to a group of people (Link & Phelan, 2001).The labeling of Africa is evident in how foreign media report the outbreak of epidemics.Negative labels and stereotypes are embedded in stigma.Power plays a role in stigmatization because stigma depends on political, economic, and social power (Link & Phelan, 2001).Power influences how people are portrayed through the decision of who tells the story, how the stories are told, and how they are described in ways that the stories become a group's identity (Adichie, 2009).Stigma creates social exclusion between groups by separating "us" from "them" through stereotypical attributes, and this has consequences (Link & Phelan, 2001).Farmer (2006) states that stigma and social inequalities create barriers to proper care.The use of Black skin images to accompany the stories about the monkeypox outbreak not only shapes the public view about the epidemic and the carriers but can also prevent proper awareness and care.People from non-endemic countries may not recognize their potentiality of contracting the virus and may dismiss a monkeypox rash (Haelle, 2022).The use of Black imagery from previous disease outbreaks to announce the outbreak of the monkeypox virus in foreign countries in 2022 is the Western media reinforcing the hegemonic ideology of Africa as the geography of disease and poverty.Escobar (2011) states that hegemonic ideology about poverty in Third World was created and reinforced to articulate the knowledge about Third World countries in the development discourse.
Adichie (2009) states that if people are shown as only one thing repeatedly, that is what there will become.The Black-skin images used by foreign media to report monkeypox significantly impact people's perception and behavior towards the virus.

METHOD AND ANALYSIS
This paper adopts a visual methodology to understand and interpret images used in qualitative research (Barbour, 2014;Glaw et al., 2017).Visual representation is used to understand media stereotypes by analyzing pictures used as illustrations by the media and their relationship to the text in the news article (Ash et al., 2022).This paper examined the images used by eight selected foreign media agencies to illustrate their online news publications on the 2022 monkeypox outbreak.Media agencies publish news articles on their websites and post news headlines and breaking news on their social media accounts.This study uses a qualitative content analysis of selected screenshots of controversial social media posts of foreign news agencies on Twitter and their websites during the monkeypox outbreak in May/June 2022.The first news of the 2022 monkeypox outbreak was announced online in May 2022.Monkeypox was confirmed in non-endemic countries, including the U.S., England, and Portugal.None of these countries were African countries, and while no cases were reported in Africa as of May 2022, the visuals used for the headline stories and the news articles by foreign media websites and their verified Twitter accounts are images of dark-skinned Africans.To report the news about the confirmed cases of monkeypox in North America and Europe, foreign media agencies like ABC News (Kekatos, 2022), Sky News, and Reuters Health all used an identical image of the hands of an African with monkeypox marks taken during an outbreak in the Democratic Republic of Congo from 1996 to 1997 (Centers for Disease Control and Prevention (CDC), 1997) to illustrate their headline news.

Figure 1. Screenshots of tweets from the verified Twitter accounts of ABC News, Sky News, and Reuters illustrate how foreign media use an identical image of the hands of an African with monkeypox marks to announce the outbreak of monkeypox outbreak in Western and European countries in 2022.
In Figure 1 above, on their verified Twitter account, the ABC News headline states that monkeypox was confirmed in Massachusetts, Sky News mentioned confirmed cases in the UK, and Reuters Health reported confirmed cases in Portugal.The image these foreign media used for illustration did not match the content of their text.According to the Centers for Disease Control and Prevention, images showing the arms and torso of patients with monkeypox marks were created by CDC/ Brian W.J. Mahy in 1997 during an investigation of a monkeypox outbreak in DR Congo (CDC, 1997).The use of these images created 26 years ago by these foreign news agencies to announce the 2022 monkeypox outbreak in Western and European countries portrays Africa as a geography of disease outbreaks.CNBC (The Associated Press, 2022), 7 News Miami (Browning, 2022), and BBC News (BBC News, 2022) all used the same image of a dark-skinned African torso in their online publications of the 2022 monkeypox outbreak in Western and European countries, as seen in Figure 2.

Figure 3. Screenshots of headlines gotten from the tweet and website publications of Reuters Africa, Evening Standard, and CNN on the 2022 monkeypox outbreak.
In Figure 3, Reuters Africa and Evening Standard (A UK-based media company) used identical images of the hands of an African taken in 1997 during a monkeypox investigation in DR Congo (CDC, 1997) to report outbreaks in Europe.On the other hand, CNN (Howard, 2022) used the image of an African to illustrate how monkeypox spread and the symptoms of monkeypox in a video dated 2008.The collective use of images and bodies of dark-skinned Africans to illustrate news headlines and publications about the monkeypox outbreak portrays a Western and European media hegemony, giving the 2022 monkeypox epidemic outbreak an African identity shows how foreign media reporting an epidemic misrepresent Africa as a geography of disease, and this reinforces stereotypes about Africa.
According to Herrera-Ulashkevich, referenced in The New York Times online publication, monkeypox was named in 1958 after it was first identified by researchers in a colony of laboratory monkeys in Denmark (Jacobs, 2022).In their research experiment, Parker and Buller (2012) argue that the monkeypox virus was discovered in an animal facility in Copenhagen, Denmark, in 1958, in a facility scientists used for polio vaccine research on animals obtained from Asian monkeys.
The first outbreak of the monkeypox virus outside Africa was reported in six states in the United States in 2003, and the outbreak was due to human contact with infected prairie dogs native to North America (Nsofor, 2022).
The Implications for Africa in International/Intergroup Relations Farmer (2006) states that health, illness, and stigma are socially constructed and have consequences.The Western press reported that AIDS came to the United States from Africa through Haiti -"Little Africa," and this bad press, which accused and presented Haiti as "the birthplace of AIDS," had political and economic implications in international relations (Farmer, 2006).Haitians, both at home and abroad, were stigmatized.Those in the U.S. experienced discrimination and violence, some were falsely accused of AIDS and fired from their jobs, and some were evicted from their rented apartments (Farmer, 2006).The AIDS accusation also affected the Haitian economy, and the stigma affected tourist visitation.Coffey (2022) states that the misrepresentation of Africa in Western media "reinforce damaging power dynamics."The articulation of knowledge of the "Third World" is rooted in colonial discourse and reproduced by the development discourse, which has political and economic implications (Escobar, 2011).According to Escobar (2011), the development discourse gave rise to the imaginative geographical division of countries into "First and Third World, North and South, Center and Periphery."Escobar (2011) argues that the "developmentalist representations" are articulated through the "media images of the Third World."The implication is that it creates global inequality resulting from dependency and modernity.
The implication of these endemic stereotypes articulated by the Global North media not only reinforces stereotypes about Africa and her global interactions but also influences foreign government policies.Quoting a Namibian Physician, Claassens (2021) wrote, "Travel bans are based on political agendas, not science, and certainly not on respect".When Omicron, a new SARS-CoV-2 variant, was detected in South Africa in November 2021, it did not take long for foreign countries to place a travel ban for Southern African countries by the government of the U.S., UK, Canada, Australia, Belgium, and Germany (Claassens, 2021).However, COVID-19 data comparisons show that these Southern African countries recorded lower death rates from COVID-19 (Claassens, 2021).The social hierarchies in global health and vaccine inequity reinforce the systemic global class system of First World and Third World.This global health inequality is evident in how African countries "scrambled" for the COVID-19 vaccines (Kuwonu, 2021) and, more recently, the monkeypox vaccine (Adepoju, 2022).While rich foreign countries with low epidemic cases had easy vaccine access, African countries are left behind.Professor Christian Happi, the Director of the African Centre of Excellence for Genomics of Infectious Diseases in Nigeria, states that "Our lives are not the same; their lives (the Global North) are worth more than ours."(Adepoju, 2022).The representation of Africa as a geography of disease also has economic implications for Africa.It can drive tourists and direct financial investors away from Africa.

Counter-Hegemony
African journalists condemned the use of Africa-related imagery to announce the monkeypox outbreak.The Foreign Press Association, Africa (FPAA) published a press statement condemning the Western media's use of Black-skin African images to report the monkeypox virus outside Africa.According to an excerpt from their press release statement: "As any other disease, it (monkeypox) can occur in any region in the world and afflict anyone, regardless of race and ethnicity.We condemn the perpetuation of this negative stereotype that assigns calamity to African race and privilege or immunity to other races."(Foreign Press Association, 2022) There were reactions on Twitter against using Black skin images by international media to illustrate the outbreak of the 2022 monkeypox virus in European and Western countries.Abang Mercy, a Nigeria Journalist; Dr. Madhu Pai, an epidemiology and global health professor; Samira Sawlan i, a journalist, and others reacted to the media reporting of the monkeypox outbreak on Twitter, as seen in Figure 4.These condemnations and awareness about the stigmatized announcement of the 2022 monkeypox outbreak prompted some foreign media agencies to delete their previous update, while some edited the Black-skin image to a microscopic image of the monkeypox virus.And to curtail racial stigma, the World Health Organization renamed the monkeypox virus to mpox virus (WHO, 2022).

Figure 4 .
Figure 4. Screenshots of reactions on Twitter to counter the use of Black skin images by the global North media in their online reporting of the 2022 monkeypox cases in Western and European countries.