Nicki Minaj and Ne-Yo Take the Stage in Controversial Africa Performances: Where Do We Draw the Line?

Nicki Minaj recently performed in Angola despite pleas against it given ties to the country's corrupt leadership, a dictatorial head, and finances stained by a murky oil trade that makes up one of the country's greatest sources of income. Minaj, however, is not alone in her recent endeavors for a high-stakes performance on the continent that left a lingering, bitter aftertaste. Ne-yo has also taken the stage in Africa to perform in concert to a crowd that was bursting at the seams with a reported 30,000 attendants. This might be seen at face value as an exciting venture for Ne-yo, possibly as a nod to his openness to international fans located in more destitute locations, and maybe even a noble excursion to share much appreciated Western culture and music that has traversed international airwaves and is enjoyed as much here as it is even in remote places across the globe, like Uganda. However, this veneer of altruism and positivity is too thin for some of us that work in global public health not to note some of the more sinister notes of this tour.

Bell, Uganda's leading lager, wholly sponsored this concert and allegedly spent around 1.2 million USD on the investment. According to AllAfrica magazine, "Ne-Yo's concert in Kampala was to launch Bell Lager's new pack." In fact, they made a killing because the vast majority of tickets were not in fact sold, but obtained by sending in "10 bottle caps of Bell... lager..." to get one. One 12 oz bottle of Bell lager is around $2.00, and there were more attendants than Arthur Ashe Stadium can hold at a Serena Williams match. You can do the math. A large amount of financial returns went back to Bell with exponentially more to gain based on the promotion of their product based on this new association with the American idol, one that competitors would probably kill for.

So what does it matter that Bell sponsored a major U.S. pop star to entertain residents of a small East African Country? Everybody gets what they wanted out of it: entertainment, a colorful fun-filled night, and money. But this problem runs deeper than one single pop star's show, this has actually been a recurrent problem in the industry for decades, particularly in Western countries with branding of such products by hard-hitters like Diddy, Angelina Jolie and Brad Pitt, Justin Timberlake, and David Beckham, to name a few. The repercussions of advertising and such endorsements by celebrities and other popular figures are particularly felt in increased prevalence of underage drinking, binge drinking and dangers associated with these. The physical effects of this are an increase in disease and death rates related to traffic accidents, cancer, heart disease, and depression. Furthermore, long term alcohol use, has downstream effects of addiction and significant social issues associated with that.

The Ugandan story hit close to home because when I stumbled upon the Ne-yo concert advertisements, I was on a team of global health doctors working on a USAID mission that addresses hunger and poverty. "Bell" was strewn in large letters across billboard sign after billboard sign, clearly the centerpiece of the advertisement, posted along the main streets of the capital city, Kampala, advertising the arrival of this top forty god and woman-magnet, with his renowned star-studded grin in the foreground. I was studying the effects of noncommunicable diseases on poverty that include diabetes, heart disease, and cancer, in Uganda. The WHO has outlined high-impact targets or "best buys" to reduce the burden of noncommunicable diseases which are - tobacco use, unhealthy diet, physical inactivity, and harmful use of alcohol.

So whose responsibility is it anyway to fight this scourge of the harmful alcohol use problem that's fostered by public trend-setters, private companies and other business that have economic gain from pushing forward their agendas at the blatant (and sometimes careless) cost of the masses, and particularly in settings where the under-privileged are even more vulnerable to the appeal of such novelties? Are these crimes committed because the beneficiaries are a vulnerable population? Should governments play a role in facilitating or barring such easy preys on capital that have longstanding ill effects on their communities? Is there a wider body needed to bring such individuals, businesses or organizations to accountability?

The International Center for Alcohol Policies released a report for the WHO addressing avoiding targeting alcohol advertising at the youth, but naturally this one guideline is barringly difficult to accomplish, and marketers know this. Additionally, advertising guidelines are only voluntary in nature for companies, which makes the implications of such rules child's play at best. Several organizations spearhead efforts to address this issue such as the UK Centre for Tobacco and Alcohol Studies, Institute of Alcohol Studies, and Center for Science in the Public Interest. However, there remains a lack of strict international enforcement placing meaningful restriction on alcohol promotion à la movement for tobacco control that has saved nearly 8 million lives since the documentation of an association between smoking and lung cancer was published in the 1950s. These are easily preventable deaths. Seeing these efforts compromised with a disheartening show of disregard dampened my appreciation for Ne-Yo and his music. As these endorsements contribute to millions for the celebrity and the associated businesses, they contribute to deaths by the millions too. A question on the price of a life is just as real as that, my argument is for no show.

Christine Ngaruiya, MD, MSc, DTM&H is faculty in the section of Global Health and International Emergency Medicine in the Department of Emergency Medicine at Yale New Haven Hospitals and a Public Voices Fellow with The OpEd Project.