On 27 April 2023, this webinar, featuring a panel of experts, will draw on new evidence from research on Mpox in Nigeria, as well as wider research on national, regional and global perspectives on epidemic preparedness and response, to explore questions such as how can global efforts interconnect more effectively with national and regional preparedness, taking account of varying priorities and perspectives? And what can be done to strengthen community-level efforts for outbreak detection and care provision?
This Practical Approaches brief highlights key considerations for taking a psychosocial approach to working in the context of an epidemic. Public health emergencies can cultivate fear, anger and grief, and deeply impact the wider social fabric. Exposure to disease is frightening to many.
When people are frightened, they may avoid or flee treatment facilities and distrust those responding to the epidemic. They are also more difficult to ‘engage’ through traditional mechanisms. Furthermore, people in affected areas may misattribute signs of worry (headaches, stomach-ache, etc.) as symptoms of the disease, which can increase suffering and overwhelm health services.
Trust is an essential component of successful cooperative endeavours. The global health response to the 2014–2016 West Africa Ebola outbreak confronted historically tenuous regional relationships of trust. Challenging sociopolitical contexts and initially inappropriate communication strategies impeded trustworthy relationships between communities and responders during the epidemic. Social scientists affiliated with the Ebola 100-Institut Pasteur project interviewed approximately 160 local, national and international responders holding a wide variety of roles during the epidemic. Focusing on responder’s experiences of communities’ trust during the epidemic, this qualitative study identifies and explores social techniques for effective emergency response. The response required individuals with diverse knowledges and experiences.
Responders’ included on-the-ground social mobilisers, health workers and clinicians, government officials, ambulance drivers, contact tracers and many more. We find that trust was fostered through open, transparent and reflexive communication that was adaptive and accountable to community-led response efforts and to real-time priorities.
This paper by Anoko J. N., reports on the success of a communication programme among 26 rebellious villages in Forest Guinea during fieldwork in June-July 2014.
The Ebola outbreak currently affecting West Africa is the most serious trans-national medical emergency in modern times. It has the potential to become a global health crisis. Many of the countries affected already have weak health systems, which are now stretched to breaking point. The health authorities have a limited capacity to respond and in a context of widespread fear and misunderstanding about the nature of the disease and how to prevent it.
Alongside addressing human resourcing, health system and pharmaceutical challenges, social mobilisation is increasingly recognised as a key component of any strategy that aims to bring the Ebola outbreak under control. This helpdesk seeks to establish what lessons have been learnt from the current and previous Ebola outbreaks. It recommends good practice and makes suggestions based on the evidence for good practice and preparedness to reduce transmission and prevent further risk and exposure in affected countries.
Diseases such as Ebola highlight the importance of a holistic focus on health systems, as opposed to assuming that health is the preserve and concern of health professionals alone. This was the lesson Uganda learnt very quickly in managing the Ebola outbreak in 2001.
Until the current epidemic in West Africa, Uganda held the unfortunate record for the greatest number of infections, with 425 recorded cases of Ebola, of which 224 people sadly died.
The spread of Ebola in West Africa centres on a region with a shared recent history of transnational civil war and internationally led post-conflict reconstruction efforts. This legacy of conflict and shortcomings in the reconstruction efforts are key to understanding how the virus has spread. The dynamics of warfare tied into and accentuated the state’s remoteness from many people. Ebola has simply unmasked persisting deep public suspicion and mistrust of the state, laying bare the limits of post-conflict reconstruction to transform state-society relations.
The reconstruction emphasis on rehabilitating pre-existing governance structures – such as the paramount chieftancy in Sierra Leone – did not redress deeply rooted social inequalities, with the result that many people have been marginalised. Ebola’s impacts threaten to undo some of the advances made since the wars ended in Sierra Leone and Liberia, yet there are critical lessons to learn about how to better support societies shaped by violence and war.
Over the last decade, the avian influenza virus, H5N1, has spread across most of Asia and Europe and parts of Africa. In some countries – including Indonesia, China, Vietnam, Bangladesh, Nigeria and Egypt – the avian disease has probably become endemic. There has, as yet, been no human pandemic, although 245 deaths have been reported since 2003. A major international response has been launched, backed by over $2 billion of public money. Huge numbers of poultry have been culled, vaccination campaigns have been implemented and markets have been restructured. These efforts have affected the livelihoods and businesses of millions. In addition, substantial efforts have been invested in improving human and animal health systems, combined with major investments in drug and vaccine development.
Detailed contingency and preparedness plans have been devised in case a pandemic occurs. This paper asks: what lessons can we learn from this experience,
Current global health policy is dominated by a preoccupation with infectious diseases and in particular with emerging or re-emerging infectious diseases that threaten to ‘break out’ of established patterns of prevalence or virulence into new areas and new victims. This paper seeks to link a set of dominant narratives about epidemics and infectious disease with what is often called the architecture, or organizational landscape, of global health policy. A series of dichotomies helps to distinguish and valorise epidemics policies. Fast- versus slow-twitch models of disease, global versus local models of culture, and official versus unofficial models of knowledge provide categories according to which policies can be evaluated, designed and implemented. As a result, policy on the global scale has tended to be oriented towards addressing highly time-focussed outbreaks that threaten to cross international boundaries rather than longer-term endemic problems the affect the most vulnerable people.
