Cultural, Anthropological, Social and Economic Considerations During a Disease Outbreak

The recent EVD outbreak in West Africa has brought to the forefront the importance of cultural, anthropological and social issues in the prevention and control of deadly epidemic diseases. While a lot of attention and resources were channelled towards upgrading the local health infrastructure and strengthening the individual pillars of the health system (leadership and governance, financing, health workforce, medical products, vaccines and technologies, information and service delivery), relatively little attention and resources have been devoted to understanding the role of cultural, anthropological and social issues in the prevention and control of the epidemic at the beginning of the outbreak. The development of drugs and vaccines, for instance, is crucial towards curbing infectious diseases in Africa. Yet, this only constitutes a fraction of what needs to be done. Social, cultural, ethical and economic dynamics play significant roles in determining how effective these drugs and vaccines would be in the long run.

We cannot underestimate the role of the socio-cultural context in worsening/aggravating the spread of deadly infectious diseases at an epidemic scale. For health systems to be responsive, they must be built around the needs and expectations, as well as the socio-cultural outlook of the communities and patients they serve. This was arguably not the case in the early days of the EVD outbreak. Public health interventions aimed at curbing the spread of the disease did not adequately engage and involve affected local communities, thereby undermining infection prevention and control efforts. While the prevailing weak health systems in the affected countries were ill-prepared to manage the epidemic, ‘lack of trust in the authorities, probable virus infection during the preparation of “bushmeat” for human consumption, traditional funerary practices, and relatively free flow of goods and people between regions and across international borders also constituted important factors that facilitated the spread of the disease and hindered infection prevention and control efforts (Phua 2015)[1]. Moreover, a recent review of the challenges to the control of the EVD epidemic in West Africa reported eight main challenges of which five were linked to cultural, anthropological and social issues (Guadu and Tekle, 2015)[2]. As such, any effective strategy to manage a similar outbreak must integrate and incorporate these issues.

Going forward there is a lot to learn from anthropologists, sociologists and other social scientists to better engage communities in the event of a similar epidemic, and how health systems can better be responsive to the needs of the communities they serve and in rebuilding lost trust. If any key lesson was learned during the recent West EVD outbreak, it is the strong need for community engagement and involvement in any prevention and control programme. For the effectiveness of a health system in responding to the needs of communities depends on appropriate engagement and involvement.

Considering the above, the upcoming 3rd EID in Africa conference in Accra, Ghana, has considered it crucial to include a faculty devoted to Cultural, Ethical, Anthropological, Social and Economic issues. This faculty would broadly address varying issues around these broad areas as they bear on emergence, spread, control and prevention of future epidemics in Africa. It will ensure that the GET Consortium adopts a more comprehensive strategy towards addressing EIDs and Biosecurity in Africa.

Article Submitted by the Global Emerging Pathogens Treatment Consortium: Faculty on Cultural, Anthropological, Social and Economic Issues (CASE)

[1] Phua. Meeting the Challenge of Ebola Virus Disease in a Holistic Manner by Taking into Account Socioeconomic and Cultural Factors: The Experience of West Africa. Infectious Diseases: Research and Treatment 2015:8 39–44

[2] Tadesse Guadu and ZenebeTekle. Challenges to Control Ebola in West Africa: A Review. World Applied Sciences Journal 33 (6): 1000-1009, 2015


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