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Politics 

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.

Resources

Epidemics: Science, governance, and social justice

This book focuses on how different policy-makers, scientists, and local populations construct alternative narratives-accounts of the causes and appropriate responses to outbreaks- about epidemics at the global, national and local level. The contrast between emergency-oriented, top-down responses to what are perceived as potentially global outbreaks and longer-term approaches to diseases, such as AIDS, which may now be considered endemic, is highlighted.

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Culture and politics: The anthropology of an emerging disease

This book explores how indigenous people cope with the Ebola virus, addresses political, structural, psychological, and cultural factors, along with conventional intervention protocols as problematic to achieving medical objectives. It also aims to shed new light on a continuing debate about the motivation for human behavior by showing how local responses to epidemics are rooted both in culture and in human nature.

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Emerging disease or emerging diagnosis?: Lassa fever and Ebola in Sierra Leone

This article looks beyond Ebola in 2014 to the history of efforts to control VHFs in the Mano River and challenges the idea that there was a vacuum of knowledge. Highlighted instead are politics of knowledge which have run through global health and which have prioritized particular forms of knowledge and ways of dealing with disease. Ethnographic research on the emergence of Lassa and the subsequent emergence of Ebola in West Africa is presented, focusing on the development of technologies and institutions to detect and manage both viruses.

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Lassa fever: The politics of an emerging disease and the scope for One Health

As a rodent borne virus, Lassa fever is of particular interest from a One Health perspective. The interplay between security, public health and One Health approaches are explored through ethnographic and interview based research in Kenema, Sierra Leone, a long-term treatment and research hub. ‘Biodefence dollars’ have provided the majority of recent funding in Sierra Leone and have created opportunities for both local and international actors to address a neglected disease.

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Lassa fever in post-conflict Sierra Leone

This resource presents observations of case fatality rates of Lassa fever in Sierra Leone after the civil war and compared to studies completed prior to the conflict. Peak presentation of Lassa fever cases occurs in the dry season, which is consistent with previous studies. This paper's studies also confirmed reports conducted prior to the civil war that indicate that infants, children, young adults, and pregnant women are disproportionately impacted by Lassa fever.

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