Social studies of Lassa Fever have developed the concepts of ‘framing’ and ‘narratives’ of disease. These concepts allow us to explore how particular understandings of Lassa fever and related visions for international health response have shaped the amount of international attention that Lassa fever has received, and by extension the ways that resources are allocated for prevention and response. For example, post 9/11 and the US anthrax attacks, Lassa virus was categorised by US authorities as a 'category A' agent, the highest risk level for potential use in bioterrorism. Lassa fever was also included as a notifiable disease under the WHO’s revised International Health Regulations in 2005. These framings changed the way that Lassa fever was seen and the kinds of resources available for research and management. In particular, the framing of Lassa fever as a potential bioterrorist weapon led to an investment in laboratory research at times to the detriment of research on rodent control and clinical care.
Research on the politics of Lassa fever forms part of wider literature in the social sciences that seeks to understand the implications of the narrative of ‘biodefence’ for international health. Biosecurity is the idea that the security of the nation-state relies partly on keeping populations healthy, for example by preventing epidemics that would damage the social and economic fabric of society, or providing protection from terrorists who might seek to deliberately spread disease. These concerns have developed alongside fears sparked by the recent history of other pandemics, including Ebola, avian flu, and SARS. The experience of the global community in managing these diseases continues to shape responses to Lassa fever, particularly in the case of Ebola, given that the endemic area for Lassa fever in Sierra Leone, Guinea and Liberia maps on almost exactly to the areas that were affected in the 2014-2016 epidemic.
Social science work has also explored the effectiveness of interventions to manage Lassa fever within the contexts where these interventions are delivered. For example, researchers have studied settings where local governments are struggling with the legacies of colonialism and more recent structural adjustment programmes liberalising their economy and health sectors. Social science research underlines the impact of these political-economic factors on health care delivery and outcomes.
Policy relevant findings
- Calls for a shift from global scare stories to focused local responses in African settings, and then, to responses that integrate local people’s own system framings and knowledge
- Conventional policy responses to epidemics represent challenges of sustainability mainly in terms of stability. Addressing this involves acknowledging the power imbalance between differing pathways of disease response and prioritising social justice.