New Pandemics, Old Politics: two hundred years of war on disease and its alternatives. Cambridge: Polity (hb £50 – 978 1 5095 4779 1;pb £15.99 – 978 1 5095 4780 7). 2021, 296 pp

[...]faced with a world of disease hazards we have all helped to create, he proposes that our best hope may lie with activist engagement of the kind apparent in the HIV and AIDS response, where those most affected by the problem became adept at pushing both science and politics towards sustainable solutions. A high degree of integration between hierarchies of science and market institutions – the result, for example, of having a government scientific adviser with a background in private-sector pharmaceutical research – would be seen as a textbook example of the Williamson approach, effectively reducing transaction costs by coordinating policy demand and research supply. At the end, Alex de Waal excuses himself: ‘the policies and practices needed range far beyond the scope of this book’ (p. 230). [...]we must be patient and await the sequel, which promises to be as compelling reading as the present potent offering.

Keeping Ebola at bay: public authority and ceremonial competence in rural Sierra Leone

Ebola Virus Disease struck Sierra Leone in May 2014. An international response was instrumental in ending the epidemic by December 2015 and has been extensively documented. Less attention has been paid to local responses. Here, we focus on a case in which there was no infection despite high infection in neighbouring areas. This brings into focus the role of customary public authority in implementing successful controls. We pay particular attention to the activities of a chiefdom Ebola Task force committee chaired by the Paramount Chief. Meetings were characterised by protocol and ceremony, but ‘face time’ served to reinforce, in ritual terms, important messages about quarantine and social distancing. The committee's pronouncements had illocutionary force. Local volunteers translated this ceremonial message into practical action to block imported cases. The analysis of ceremonial competence, we conclude, opens a window into how public authority addresses developmental shocks in Africa.

Vaccine anxieties, vaccine preparedness: Perspectives from Africa in a Covid-19 era.

Global debates about vaccines as a key element of pandemic response and future preparedness in the era of Covid-19 currently focus on questions of supply, with attention to global injustice in vaccine distribution and African countries as rightful beneficiaries of international de-regulation and financing initiatives such as COVAX. At the same time, vaccine demand and uptake are seen to be threatened by hesitancy, often attributed to an increasingly globalised anti-vaxx movement and its propagation of misinformation and conspiracy, now reaching African populations through a social media 'infodemic'. Underplayed in these debates are the socio-political contexts through which vaccine technologies enter and are interpreted within African settings, and the crucial intersections between supply and demand. We explore these through a 'vaccine anxieties' framework attending to both desires for and worries about vaccines, as shaped by bodily, societal and wider political understandings and experiences. This provides an analytical lens to organise and interpret ethnographic and narrative accounts in local and national settings in Uganda and Sierra Leone, and their (dis)connections with global debates and geopolitics. In considering the socially-embedded reasons why people want or do not want Covid-19 vaccines, and how this intersects with the dynamics of vaccine supply, access and distribution in rapidly-unfolding epidemic situations, we bring new, expanded insights into debates about vaccine confidence and vaccine preparedness.

Negotiating Intersecting Precarities: COVID-19, Pandemic Preparedness and Response in Africa.

This article shares findings on COVID-19 in Africa across 2020 to examine concepts and practices of epidemic preparedness and response. Amidst uncertainties about the trajectory of COVID-19, the stages of emergency response emerge in practice as interconnected. We illustrate how complex dynamics manifest as diverse actors interpret and modify approaches according to contexts and experiences. We suggest that the concept of "intersecting precarities" best captures the temporalities at stake; that these precarities include the effects of epidemic control measures; and that people do not just accept but actively negotiate these intersections as they seek to sustain their lives and livelihoods.

At-Home Testing for Sexually Transmitted Infections During the COVID-19 Pandemic.

During the COVID-19 pandemic in New York City, NewYork-Presbyterian Hospital provided HIV prevention patients with gonorrhea/chlamydia testing kits at home. This report describes the program implementation to provide other sexual health clinics with a roadmap in adapting to a "new normal" in providing comprehensive sexual health care virtually to patients.

Ebola and COVID-19 in Sierra Leone: comparative lessons of epidemics for society

This case study focuses on two epidemic diseases in Sierra Leone. Ebola in 2014–15 drew international response, but was contained within the Upper West African region. COVID-19 reached Sierra Leone in April 2020 as part of a global pandemic. Local social knowledge has been an important factor in shaping responses to both diseases. In the case of Ebola, infection was concentrated in families, and responders needed a good knowledge of family interactional dynamics. COVID-19 is a more public disease. Responders have to assess risk factors in workplaces, markets, and places of worship. Comparing and contrasting the two cases also draws attention to different aspects of the historical context. Ebola response indexes Sierra Leone’s history as a humanitarian project associated with the abolition of the slave trade. The pandemic challenge of COVID-19 draws attention to Sierra Leone’s nodal position within a global diaspora rooted in Atlantic slavery and emancipation. Responders are forced to consider the ways in which the two infections articulate different aspects of calls for global social justice.

How villagers in central Sierra Leone understand infection risks under threat of Covid-19.

BACKGROUND: Concern has been expressed over how well Africa is prepared to cope with the pandemic of Covid-19. Will rural populations with low levels of education know how to apply community-based infection control? We undertook fieldwork in two villages in central Sierra Leone to gain insight into how rural people faced with Covid-19 assess epidemic infection risks. METHODS: Two communities were selected based on prior contrasted exposure to Ebola Virus Disease-one with substantial number of cases and the other having resisted infection through strong community sequestration measures. We assessed understanding of infection risks via an experimental game. This asked players to express a preference for one of two diseases, one resembling Ebola with lower risk of infection and the other resembling Covid-19 with lower risk of death. Players were not told the identity of the diseases. RESULTS: In total 107 adult villagers played the game (58% women). Half (52%) preferred the disease model with lower risk of infection, 29% preferred the model with lower risk of death, while 21% saw the combined risk of infection and death as being equivalent. Differences in reactions between the two locations were small despite different experiences of Ebola. Asked to explain their choices 48% of players cited information on infection risks modelled by the game and 31% stated that their choices reflected awareness of the need for personal action and respect for local regulations. We concluded that villagers thoughtfully assess disease risks and that some are good intuitive statisticians. CONCLUSIONS: Results suggest rural people in Sierra Leone retain the lessons of experience from the Ebola outbreak of 2014-15 and will be able to apply these lessons to a new infectious disease for which have no prior practical experience. Our expectation is that rural populations will understand Covid-19 control measures, thus reducing need for draconian enforcement.