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This rapid literature review aims to provide initial insights into emerging lessons on pandemic preparedness in the wake of the Covid-19 pandemic. It pays special attention to research generated by the Covid Collective research partners, contextualising it within the perspectives and lessons from the broader literature and debates on preparedness. The report especially considers evidence which indicates how future approaches to pandemic preparedness (based on what we have learned from our research) can really serve the interests of those in different societies who experience the greatest levels of vulnerability, exclusion, and marginalisation.

Os surtos de cólera têm vindo a aumentar na Região da África Oriental e Austral (AOA) desde Janeiro de 2023, com uma transmissão generalizada e alargada no Malawi e em Moçambique e surtos registados na Tanzânia, na África do Sul, no Zimbabué, no Burundi e na Zâmbia.1 Existe o risco de uma maior propagação causada pelos efeitos do ciclone Freddy, que atingiu Madagáscar, o Malawi e Moçambique em Março de 2023. Continuam a registar-se surtos na Somália, na Etiópia, no Quénia e no Sudão do Sul, onde os países estão a atravessar uma situação de seca após sucessivas estações chuvosas deficitárias.1 O contexto de resposta na AOA é complexo. Isto deve-se à escassez de recursos de saúde pública, incluindo a insuficiência de vacinas orais contra a cólera, e às múltiplas emergências de saúde pública e humanitárias simultâneas, incluindo a reemergência do poliovírus selvagem. O envolvimento da comunidade nas respostas ao surto de cólera é essencial, especialmente enquanto o impacto da COVID-19 ainda se faz presente na região, sobretudo no que tange à confiança na saúde pública e nos esforços de vacinação.2,3 O objectivo do presente guia de orientação é apoiar os Ministérios da Saúde, a UNICEF e outros parceiros de resposta na concepção e implementação de um envolvimento comunitário eficaz, centrado na comunidade e baseado em dados, para a resposta ao surto de cólera. Este guia de orientação foi redigido em abril de 2023 por Megan Schmidt-Sane e Tabitha Hrynick (IDS), com a colaboração de Stellar Murumba (Internews), Ngonidzashe Macdonald Nyambawaro (FICV), Eva Niederberger (Anthrologica), Santiago Ripoll (IDS), Nadine Beckmann (LSHTM), Mariana Palavra (UNICEF) e Rachel James (UNICEF). Este guia de orientação tem por base o trabalho anterior sobre a cólera da Social Science in Humanitarian Action Platform (SSHAP).

Les flambées épidémiques de choléra s’intensifient dans la région Afrique de l’Est et australe (ESAR) depuis janvier 2023, avec une transmission généralisée et étendue au Malawi et au Mozambique, ainsi que des flambées épidémiques signalées en Tanzanie, en Afrique du Sud, au Zimbabwe, au Burundi et en Zambie.1 Il existe un risque de propagation accrue causée par les effets du cyclone Freddy, qui a frappé Madagascar, le Malawi et le Mozambique en mars 2023. Les flambées épidémiques se poursuivent en Somalie, en Éthiopie, au Kenya et au Soudan du Sud, où les pays sont confrontés à la sécheresse suite à plusieurs saisons des pluies consécutives lors desquelles les précipitations n’ont pas été assez abondantes.1 Le contexte de riposte dans la région ESAR est complexe. Cela est dû aux ressources limitées en santé publique, y compris les pénuries de vaccins par voie orale contre le choléra, et aux nombreuses urgences sanitaires et humanitaires simultanées, y compris la réapparition du poliovirus sauvage. L’engagement communautaire dans les ripostes contre les flambées épidémiques de choléra est essentiel, en particulier lorsque l’impact de la COVID-19 continuent de se faire sentir dans la région, notamment en ce qui concerne la confiance dans la santé publique et les mesures liées à la vaccination.2,3 La présente note d’orientation a pour objectif d’aider les ministères de la Santé, l’UNICEF et d’autres partenaires de la riposte à concevoir et à mettre en œuvre un engagement communautaire efficace, axé sur la communauté et basé sur des données afin de répondre à la flambée épidémique de choléra. Cette note d’orientation a été rédigée en avril 2023 par Megan Schmidt-Sane et Tabitha Hrynick (IDS), avec la contribution de Stellar Murumba (Internews), Ngonidzashe Macdonald Nyambawaro (IFRC), Eva Niederberger (Anthrologica), Santiago Ripoll (IDS), Nadine Beckmann (LSHTM), Mariana Palavra (UNICEF), et Rachel James (UNICEF). Cette note d’orientation s’inspire de travaux antérieurs sur le choléra réalisés par la Plateforme Social Science in Humanitarian Action (SSHAP).

Global trade has shaped food systems over centuries, but modern trade agreements are hastening these changes and making them more complex, with implications for public health and nutrition transition. This study aimed to understand the impact of the 2018 Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP) on the policy space for public health nutrition in Vietnam. We conducted comparative document review and key informant interviews, and our analysis drew on a framework of policy space and the theory of advocacy coalitions. We identified 10 CPTPP sections with potential public health nutrition implications; and 50 Vietnamese policies relevant to nutrition having one or more tensions with one or more CPTPP sections. A majority of policy tensions were in sections of the CPTPP relating to technical barriers to trade and government procurement; most tensions related to protecting policy-making from vested interests. Different groups of policy actors hold different beliefs and interests on these issues, and therefore promote different framings and policy approaches. We identified two advocacy coalitions working very separately on issues affecting nutrition policy space: a trade coalition holding the policy position that free trade improves nutrition by default; and a nutrition coalition holding the policy position that nutrition should be explicitly considered in trade policy. The policy space for nutrition in Vietnam has important potential constraints through written policy, and the trade and nutrition coalitions will need to interact more regularly and constructively in order to foresee where these tensions will arise in practice, and create plans for their mitigation. This study adds to global evidence of free trade agreement impacts on nutrition policy space, and we extend previous work by explaining these actor groupings in the policy space through the theory of advocacy coalitions.

This special issue of Anthropology in Action presents a collection of articles that reflect on and analyse the role of social science in epidemic response. The COVID-19 pandemic has exposed deep social and economic inequalities within and across countries which produce unequal COVID-19 outcomes. Researchers have long noted the connections between socioeconomic inequalities and infections, and there is growing recognition that epidemics are also social and political events (Bardosh et al. 2020). Anthropological and other social science research has contributed to epidemic response, through attention to cultural and politico-economic context, reframing community ‘resistance’, bolstering community engagement in preparedness and response, and informing response activities, including risk communication (Abramowitz 2017; Bardosh et al. 2020). Despite this, much of the work has been ad hoc and not systematically integrated into the systems of epidemic response, with the exception of the Centres d’Analyses des Sciences Sociales (CASS) in the Democratic Republic of Congo (DRC). This special issue is timely, in that it builds on foundational work in social science and epidemic response, draws on tensions and experience from recent epidemics including COVID-19 and Ebola, and charts a way forward at both a theoretical and a practical level.

In epidemic preparedness and response, it is now commonly accepted that insights from social science disciplines are important in shaping action. Unfortunately, the role of social science is often confined to risk communication and community engagement (RCCE) efforts. In this article, we propose an analytical framework that would allow researchers and practitioners from different disciplines to employ social science insights to enrich their understanding of epidemics and formulate more effective and sustainable responses. The framework goes beyond simply unpacking social, political, economic and cultural dimensions of context; it situates disease itself – as it is shaped by the contexts in which it circulates – and views it in dynamic relation to response. It also explores how different individuals, social groups and institutions shift their knowledge and practices during an epidemic through power-laden processes of dialogue and learning, or even through silencing and side-lining. It is our hope that this framework will enable responders to engage more deeply and systematically with the contexts of emergencies, so as to ensure activities are more adaptive to local dynamics.

Cholera outbreaks have been on the rise in the East and Southern Africa Region (ESAR) since January 2023, with widespread and extended transmission in Malawi and Mozambique and outbreaks reported in Tanzania, South Africa, Zimbabwe, Burundi, and Zambia.1 There is risk of further spread caused by the effects of Cyclone Freddy, which hit Madagascar, Malawi, and Mozambique in March 2023. Outbreaks are continuing in Somalia, Ethiopia, Kenya, and South Sudan, where countries are experiencing drought after multiple failed rainy seasons.1 The response context in ESAR is complex. This is due to the strained public health resources, including shortages of oral cholera vaccines, and the multiple concurrent public health and humanitarian emergencies, including the re-emergence of wild poliovirus. Community engagement in cholera outbreak responses is essential, especially while the impact of COVID-19 continues to be felt in the region, particularly on trust in public health and vaccination efforts.2,3 The purpose of this guidance note is to support Ministries of Health, UNICEF, and other response partners to design and implement effective, community-centred, and data-driven community engagement for cholera outbreak response. This guidance note was written in April 2023 by Megan Schmidt-Sane and Tabitha Hrynick (IDS), with input from Stellar Murumba (Internews), Ngonidzashe Macdonald Nyambawaro (IFRC), Eva Niederberger (Anthrologica), Santiago Ripoll (IDS), Nadine Beckmann (LSHTM), Mariana Palavra (UNICEF), and Rachel James (UNICEF). This guidance note draws on the Social Science in Humanitarian Action Platform (SSHAP)'s past work on cholera.

Childhood obesity is a growing global challenge, and no country has yet reversed the upward trend in prevalence. The causes are multifaceted, spanning individual, societal, environmental, and political spheres. This makes finding solutions complex as traditional linear models of treatment and effect have proven only minimally successful or unfeasible at the population level. There is also a paucity of evidence of what works, and few examples of intervention that operate on a ‘whole systems’ level. The city of Brighton in the United Kingdom has experienced a downward trend in child obesity rates compared to national figures. The aim of this study was to explore what has led to successful change in the city. This was done through a review of local data, policy and programs, and thirteen key informant interviews with key stakeholders involved in the local food and healthy weight agenda. Our findings highlight key mechanisms that have plausibly contributed to a supportive environment for obesity reduction in Brighton according to key local policy and civil society actors. These mechanisms include; a commitment to early years intervention such as breastfeeding promotion; a supportive local political context; the ability to tailor interventions to community needs; governance structures and capacity that enable cross-sectoral collaboration; and a citywide framing of obesity solutions in the context of a ‘whole system’ approach. However, substantial inequalities persist in the city. Engaging families in areas of high deprivation and operating in an increasingly difficult context of national austerity are persistent challenges. This case study sheds light on some mechanisms of what a whole systems approach to obesity looks like in practice in a local context. This is of relevance to both policymakers and healthy weight practitioners across a spectrum of sectors who need to be engaged to tackle child obesity.

The cost of the Covid-19 pandemic remains unknown. Lives directly lost to the disease continue to mount, while related health, livelihood and wellbeing impacts are still being felt, and the wider ramifications across society, politics and the economy are yet to fully materialise. What is known about these costs though, is that they have been unequally distributed both within and between countries. Preparedness plans proved inadequate in many settings – especially when it came to protecting those most vulnerable, including those marginalised by geography, poverty, or exclusion along the lines of religion, ethnicity or gender. The top-down, surge-style, biomedically dominated and technologically driven preparedness approach that has dominated global health thinking and which was propelled into action with Covid-19 was found wanting not only on the grounds of effectiveness, but also of social justice. This presents both a challenge and an opportunity for a convergence of the preparedness and development agendas. Drawing on a growing body of social science evidence, this report contends that securing health in the face of today’s uncertain disease threats in often unpredictable settings means making social, economic and political priorities as core to the preparedness agenda as biological and technological ones. We present here a framework for a vision of pandemic preparedness for the real world – one that accepts that context is paramount, embraces inclusivity and justice, shifts power centres and rejects simplistic, one-size-fits-all solutions.

Si l’on s’en tient aux chiffres de la vaccination contre la COVID-19 dans les pays du G7, la campagne apparaît comme un véritable succès tant au niveau global qu’au niveau national. En effet, à ce jour, 79,4 % de la population totale des pays du G7 a reçu une première dose, 72,9 % une seconde, et 45,4 % une dose de rappel (données du 28 avril 2022) 1 En France, c’est 80,6 % de la population totale qui a reçu une première dose, 78,2 % qui a reçu deux doses, et 55,4 % qui a reçu un rappel (données du 28 avril 2022).2 Au Royaume-Uni, 79,3 % de la population totale a reçu une première dose, 74,1 % une seconde, et 58,5 % un rappel.1 Enfin, en Italie, 85,2 % de la population totale a reçu une première dose, 80,4 % a reçu deux doses et 66,5 % a reçu leurs rappels (données du 28 avril 2022). Ces taux de vaccination élevés masquent pourtant des disparités importantes à l’intérieur de chaque pays. Ainsi, à Marseille, deuxième ville de France, moins de 50 % des habitants des quartiers nord de la ville étaient vaccinés à la fin de l’année 2021, alors que plus de 70 % des habitants des quartiers sud l’étaient au même moment.3 Dans le quartier populaire de Ealing, situé au nord-ouest de Londres, 70 % de la population admissible avait reçu une première dose, soit près de 10 % de moins que la moyenne nationale. 4 (Données du 4 avril 2022). Des disparités similaires ont été observées dans d’autres métropoles urbaines des pays du G7. Ce document examine ces disparités au prisme de la notion d’« (in)égalité vaccinale ». En s’appuyant sur des recherches qualitatives menées pendant la campagne de vaccination de la COVID-19 dans les quartiers nord de Marseille, le quartier de Ealing à Londres (Nord-ouest) et dans la région de l'Émilie-Romagne et à Rome, en Italie, il montre comment les autorités locales peuvent agir pour atténuer ces inégalités. Mieux comprendre les inégalités en matière de vaccins fut primordial lors de la pandémie de la COVID-19 en ce sens que les populations sous-vaccinées étaient la plupart du temps des minorités ethniques ou culturelles, vivant dans des zones défavorisées, ou sans-papiers, donc plus susceptibles de contracter la COVID-19, et d’en subir les conséquences les plus dramatiques. 5 6 7 8 Ainsi, à Ealing, quatre mois après la campagne de vaccination, seulement 57,6% des personnes dans le décile de pauvreté le plus bas avaient reçu une dose, contre 81% des personnes dans le décile le plus aisé. 9 En outre, 89,2 % des résidents britanniques blancs de Ealing étaient vaccinés, contre 64 % des Pakistanais et 49,3 % des habitants issus des Caraïbes.9 À Rome, comme c’est le cas dans d’autres métropoles urbaines des pays du G7, nos données révèlent des disparités particulières importantes entre le recours aux vaccins des populations sans papiers et celui des citoyens établis. Les facteurs d’inégalité vaccinale dans ces environnements urbains sont complexes et liés à l’interaction de nombreux phénomènes tels que les inégalités économiques, le racisme structurel, l'inégalité d'accès aux soins de santé, la méfiance envers les professionnels de santé, les représentants de l'État, et plus encore. Les collectivités locales tout comme les professionnels de la santé, les groupes communautaires et les résidents jouent un rôle clé dans la manière dont s’exprime l’(in)égalité vaccinale. Pour autant, peu de leçons ont été systématiquement tirées des efforts menés en matière d’ «engagement vaccinal » au niveau local. Dans ce document, nous proposons d’expliquer comment l’expérience des inégalités structurelles se recoupe avec celle des habitants, et comment ces expériences ont été prises en compte ou au contraire ignorées dans la promotion et l’administration des vaccins contre la COVID-19 par les collectivités locales. Nous adressons également un ensemble de recommandations qui s’appliquent aux programmes de « vaccination de rattrapage » contre la COVID-19 (visant à atteindre les personnes qui n’ont pas encore reçu leur schéma vaccinal complet), mais elles concernent également les programmes de vaccination d'urgence à venir. Ce document repose sur des recherches menées entre octobre et décembre 2021 à Marseille et sur des échanges réguliers avec les autorités du Borough de Ealing initiés dès mai 2021. Il identifie comment les gouvernements locaux, les acteurs de la santé, les groupes communautaires et les résidents jouent un rôle clé dans la production d’(in)égalités vaccinales. Ce document a été élaboré pour la SSHAP par Santiago Ripoll (IDS), Tavitha Hrynick (IDS), Ashley Ouvrier (LaSSA), Megan Schmidt-Sane (IDS), Federico Federici (UCL) et Elizabeth Storer (LSE). Il a été revu par Eloisa Franchi (Université de Pavie) et Ellen Schwartz (Conseil de santé publique de Hackney). La recherche a été financée par la British Academy COVID-19 Recovery : Fonds G7 (COVG7210038). Les recherches ont été menées à l’Institut d’études du développement (IDS), à l’Université de Sussex et au Laboratoire des sciences sociales appliquées (LaSSA). La SSHAP en assume la responsabilité.

On 20 September 2022, an outbreak of the Sudan strain of Ebola Virus Disease – SVD – was announced as the first laboratory-confirmed patient was identified in a village in Mubende District in central Uganda. Uganda’s Ministry of Health (MoH) activated the National Task Force and developed and deployed a National Response Plan, which includes the activation of District Task Forces. The target areas include the epicentre (Mubende and Kassanda districts) and surrounding areas, as well as Masaka, Jinja and Kampala cities. This is of great concern, as Kampala is the capital city with a high population and linkages to neighbouring districts and international locations (via Entebbe Airport). It is also a serious matter given that there has been no outbreak of Ebola before in the city. This brief details how Risk Communication and Community Engagement (RCCE) activities and approaches can be adapted to reach people living in Greater Kampala to increase adoption of preventive behaviours and practices, early recognition of symptoms, care seeking and case reporting. The intended audiences include the National Task Force and District Task Forces in Kampala, Mukono, and Wakiso Districts, and other city-level RCCE practitioners and responders. The insights in this brief were collected from emergent on-the-ground observations from the current outbreak by embedded researchers, consultations with stakeholders, and a rapid review of relevant published and grey literature. This brief, requested by UNICEF Uganda, draws from the authors’ experience conducting social science research on Ebola preparedness and response in Uganda. It was written by David Kaawa-Mafigiri (Makerere University), Megan Schmidt-Sane (Institute of Development Studies (IDS)), and Tabitha Hrynick (IDS), with contributions from the MoH, UNICEF, the Center for Health, Human Rights and Development (CEHURD), the Uganda Harm Reduction Network (UHRN), Population Council and CLEAR Global/Translators without Borders. It includes some material from a SSHAP brief developed by Anthrologica and the London School of Economics. It was reviewed by the Uganda MoH, University of Waterloo, Anthrologica, IDS and the RCCE Collective Service. This brief is the responsibility of SSHAP.

SSHAP convened and hosted a virtual roundtable discussion with partners engaged at the regional level response of the health and food insecurity crisis in the Greater Horn of Africa region. The objective was to discuss the critical needs for the response to the Horn of Africa crisis. The priorities under consideration were organised under the themes of health, community engagement and data management. Broader matters of strengthening coordination of the response were also discussed. This report offers a summary of the main discussion points and a list of resources shared during the discussion, it was compiled by Tabitha Hrynick (IDS) and Olivia Tulloch (Anthrologica). The views expressed here are a summary of those presented and do not necessarily represent a consensus of the individual participant agencies. This brief is the responsibility of SSHAP. There will be future roundtables focused either at the national level for affected countries or thematically focused.

Despite progress in COVID-19 vaccination rates overall in the US and UK, vaccine inequity persists as young people from minoritised and/or deprived communities are often less likely to be vaccinated. COVID-19 ‘vaccine hesitancy’ is not just an issue of misinformation or lack of information. ‘Vaccine hesitancy’ among young people is reflective of wider issues such as mistrust in the state or the medical establishment and negative experiences during the pandemic. This report is based on case study research conducted among young people (ages 12-18) in Cleveland, Ohio, US and the London borough of Ealing, UK. Whilst public discourse may label young people as ‘vaccine hesitant,’ we found that there were differences based on social location and place and this labelling may portray young people as ‘ignorant.’ We found the greatest vaccine hesitancy among older youth (15+ years old), particularly those from minoritised and deprived communities. Unvaccinated youth were also more likely to be from families and friend groups that were unvaccinated. While some expressed distrust of the vaccines, others reported that COVID-19 prevention was not a priority in their lives, but instead concerns over food security, livelihood, and education take precedence. Minoritised youth were more likely to report negative experiences with authorities, including teachers at their schools and police in their communities. Our findings demonstrate that COVID-19 vaccine hesitancy is embedded in a context that drives relationships of mistrust between minoritised and deprived communities and the state, with implications for COVID-19 vaccine uptake. Young people’s attitudes toward vaccines are further patterned by experiences within their community, school, family, and friend groups.

Despite overall progress in COVID-19 vaccination rates in Cleveland, vaccine inequity persists as young people from minority communities are often less likely to be vaccinated. COVID-19 vaccine hesitancy is not just an issue of misinformation or lack of information. Vaccine hesitancy among young people is reflective of wider issues such as mistrust in the state or the medical establishment and negative experiences during the pandemic. This report is based on case study research conducted among minority youth (ages 12-18) in Cleveland, Ohio. While public discourse may label young people as “vaccine hesitant,” we found that there were hesitation differences based on social location and place. We found the greatest vaccine hesitancy among older youth (15+ years old), particularly those from minoritized communities. Unvaccinated youth were also more likely to be from families and friend groups that were unvaccinated. While some expressed distrust of the vaccines, others reported that COVID-19 prevention was not a priority in their lives. Instead, concerns over food security, livelihood, and education take precedence. Minority youth were more likely to report negative experiences with authorities, including teachers at their schools and police in their communities. Our findings demonstrate that COVID-19 vaccine hesitancy is embedded in a context that drives relationships of mistrust between minority communities and authorities, with implications for COVID-19 vaccine uptake. Young people’s attitudes toward vaccines are further patterned by experiences within their community, school, family, and friend groups.

This brief explains youth perceptions of COVID-19 vaccination and outlines key considerations for engaging with and building trust among young people living in Ealing, London. Within the category of ‘young people,’ there are differences in vaccination based on age and ethnicity. This brief is based on research, including a review of the literature and in-depth interviews and focus groups with 62 youth across Ealing to contextualise youth perspectives of COVID-19 vaccination and highlight themes of trust/distrust. We contribute ethnographic and participatory evidence to quantitative evaluations of vaccine roll-out. Key considerations for addressing youth distrust regarding the COVID-19 vaccine are presented, followed by additional regional context. This work builds on a previous SSHAP brief on vaccine equity in Ealing. This brief was produced by SSHAP in collaboration with partners in Ealing. It was authored by Megan Schmidt-Sane (IDS), Tabitha Hrynick (IDS), Jillian Schulte (Case Western Reserve University), Charlie Forgacz-Cooper (Youth Advisory Board), and Santiago Ripoll (IDS), in collaboration with Steve Curtis (Ealing Council), Hena Gooroochurn (Ealing Council), Bollo Brook Youth Centre, and Janpal Basran (Southall Community Alliance), and reviews by Helen Castledine (Ealing Public Health), Elizabeth Storer (LSE) and Annie Wilkinson (IDS). The research was funded through the British Academy COVID-19 Recovery: USA and UK fund (CRUSA210022). Research was based at the Institute of Development Studies. This brief is the responsibility of SSHAP.

This brief explains youth perceptions of COVID-19 vaccination and outlines key considerations for engaging with and building trust among young people living in Ealing, London. Within the category of ‘young people,’ there are differences in vaccination based on age and ethnicity. This brief is based on research, including a review of the literature and in-depth interviews and focus groups with 62 youth across Ealing to contextualise youth perspectives of COVID-19 vaccination and highlight themes of trust/distrust. We contribute ethnographic and participatory evidence to quantitative evaluations of vaccine roll-out. Key considerations for addressing youth distrust regarding the COVID-19 vaccine are presented, followed by additional regional context. This work builds on a previous SSHAP brief on vaccine equity in Ealing. This brief was produced by SSHAP in collaboration with partners in Ealing. It was authored by Megan Schmidt-Sane (IDS), Tabitha Hrynick (IDS), Jillian Schulte (Case Western Reserve University), Charlie Forgacz-Cooper (Youth Advisory Board), and Santiago Ripoll (IDS), in collaboration with Steve Curtis (Ealing Council), Hena Gooroochurn (Ealing Council), Bollo Brook Youth Centre, and Janpal Basran (Southall Community Alliance), and reviews by Helen Castledine (Ealing Public Health), Elizabeth Storer (LSE) and Annie Wilkinson (IDS). The research was funded through the British Academy COVID-19 Recovery: USA and UK fund (CRUSA210022). Research was based at the Institute of Development Studies. This brief is the responsibility of SSHAP.

Despite progress in COVID-19 vaccination rates overall in Cleveland, vaccine inequity persists as young people from minoritised communities are often less likely to be vaccinated. Despite being over-represented in COVID-19 case counts and fatalities, Black residents were under-represented in COVID-19 vaccination during the first year and half of the pandemic. In Ohio, while roughly 60% of Cuyahoga County residents are fully vaccinated, just 45% of Cleveland residents are fully vaccinated. Lower-income, majority Black, east side neighbourhoods have markedly lower vaccination rates compared to higher-income, mostly white neighbourhoods. Young people ages 16-40 became eligible for the COVID-19 vaccine on March 29th, 2021, and individuals aged 12 and above were able to get vaccinated from May 2021 onward. However, large disparities exist based age, race, and zip code. This brief illustrates underlying reasons shaping COVID-19 vaccine attitudes among minority (especially Black and Latinx) youth (ages 12-18) and offers key considerations for how young people can be better engaged within Cleveland, Ohio. This brief is based on research, including in-depth interviews and focus group discussions with 61 young people across 16 neighbourhoods through a Youth Participatory Action Research (YPAR) approach in Cleveland to contextualise youth perspectives of COVID-19 vaccination and highlight areas of hesitancy and confidence. In this brief, we share findings from the study and key considerations for addressing youth ‘vaccine hesitancy’ around the COVID-19 vaccine are presented. This brief was authored by Jillian Schulte (Case Western Reserve University), Megan Schmidt-Sane (IDS), Elizabeth Benninger (Cleveland State University), Tabitha Hrynick (IDS), and Santiago Ripoll (IDS), and includes contributions from Elizabeth Davies (Cleveland State University), Diane Mastnardo, Brenda Pryor (MyCom), Brinda Athreya (Case Western Reserve University), Ivis Maldonado (MyCom) and reviews from Elizabeth Storer (LSE) and Annie Wilkinson (IDS). The research was funded through the British Academy COVID-19 Recovery: USA and UK fund (CRUSA210022). Research was based at the Institute of Development Studies. This brief is the responsibility of SSHAP.

At national and aggregate levels, COVID-19 vaccination across G7 countries appears successful. To date, 79.4% of the total population of G7 countries have received a first dose, 72.9% a second, and 45.4% a booster shot (28th April 2022 data). In France, 80.6% of the total population has had a first dose, 78.2 % have had two doses, and 55.4% have had their booster jabs (28th of April 2022 data). In the UK, 79.3% of the total population has received one dose, 74.1% a second one, and 58.5% have received a booster. In Italy, 85.2% of the total population has had a first dose, 80.4% have had two doses, and 66.5% have had their booster jabs (28th of April 2022 data). These figures indicate enthusiasm across G7 countries for COVID-19 vaccines. Yet high overall vaccination rates at the national level, disguise significant in-country disparities. For example, by the end of 2021, less than 50% of residents of the Northern Districts of Marseille were vaccinated, compared with over 70% in wealthier neighbourhoods. In the Ealing borough of Northwest London, 70% of the eligible population has had a first dose – which is almost 10% percent below the national average (4th of April 2022 data). Disparities are also seen in other urban metropolises across the G7. This brief investigates these disparities through the lens of “vaccine (in)equity”, focusing on the role of local actors. It builds on ethnographic and qualitative research carried out in the Northern Districts of Marseille and ongoing research engagement around vaccine equity in Ealing (Northwest London), as well as qualitative research carried out in Italy among networks of healthcare providers, intercultural mediators, and civil society organizations that collaborated during the COVID-19 campaign in the Emilia Romagna region and in Rome. This brief is based on research conducted between October and December 2021 in Marseille and ongoing engagement in Ealing which started in May 2021. It identified how local governments, health actors, community groups and residents play key roles in shaping vaccine (in)equity. This brief was developed for SSHAP by Santiago Ripoll (IDS), Tabitha Hrynick (IDS), Ashley Ouvrier (LaSSA), Megan Schmidt-Sane (IDS), Federico Federici (UCL) and Elizabeth Storer (LSE). It was reviewed by Eloisa Franchi (Università degli Studi di Pavia) and Ellen Schwartz (Hackney Council Public Health). The research was funded through the British Academy COVID-19 Recovery: G7 Fund (COVG7210038). Research was based at the Institute of Development Studies (IDS), University of Susssex, and the Laboratoire de Sciences Sociales Appliquées (LaSSA). The brief is the responsibility of SSHAP.

Embedded within the COVID-19 pandemic is the spread of a new pandemic of information – some accurate, some not – that can challenge the public health response. This has been termed an ‘infodemic’ and infodemic management is now a major feature of the World Health Organization’s work on health emergencies. This commentary highlights political, social, and economic aspects of infodemics and posits social science as critical to mitigating the current infodemic and preventing future ones. Infodemic managers should address the wider context of infodemics if we are to understand narratives, help to craft positive ones, and confront the root causes of misinformation rather than just the symptoms.

On 25 November 2021, the CORE Knowledge Translation Services team at the Institute of Development Studies, UK, hosted an online clinic session to facilitate the sharing of experiences and mutual learning on how CORE projects have or can adapt their research activities in the context of the Covid-19 pandemic. The clinic was attended by 22 CORE members from 12 projects and featured contributions from two CORE projects: The Youth Question in Africa: Impact, Response and Protection Measures in the IGAD Region and A New Digital Deal for an Inclusive Post-Covid-19 Social Compact: Developing Digital Strategies for Social and Economic Reconstruction. This learning guide captures the practical insights and advice from the event, to help inform the practice of participants and other projects across the portfolio.

This brief illustrates how COVID-19 vaccine (in)equity has played out on the ground and offers key considerations for how it can be improved in the North West London (NWL) borough of Ealing. We conducted a review of literature and several informal consultations with local actors involved in COVID-19 vaccination efforts in statutory bodies (local authorities and the NHS) and the community in order to build a picture of and contextualise COVID-19 vaccine uptake in Ealing. Key considerations and lessons for achieving greater vaccine and health equity are presented, followed by additional context of interest to responders within statutory authorities and the community. This brief was produced by SSHAP in collaboration with partners in Ealing Council. It was authored by Tabitha Hrynick and Santiago Ripoll and is the responsibility of SSHAP.

This review sets out key considerations for improving vaccine equity – as well as broader health equity – in the North West London (NWL) borough of Ealing. It foregrounds the political, economic and social dynamics which have perpetuated health inequalities during and prior to COVID-19, and how they have manifested to shape COVID-19 vaccine accessibility and uptake among different social groups. It also highlights how local actors have sought to address these inequalities. By bringing together data and insights from existing social science research and consultations with people involved in local COVID-19 vaccination efforts (in local authorities, the NHS and community groups), we point to ways local authorities and healthcare providers, in collaboration with local people and organisations, can support vaccine equity – and health equity more broadly – now, and into the future. Critical to this are further efforts to integrate sensitivity to context, sustain collaborative working, build trust and meaningfully engage citizens (especially vulnerable groups), and support a robust civil society. The review begins with summary key considerations for operational actors. This review was produced by SSHAP in collaboration with Ealing Council. It was authored by Tabitha Hrynick and Santiago Ripoll, and reviewed by Maddy Gupta-Wright, Ellen Schwartz, and Nikita Simpson. It is the responsibility of SSHAP

Zambians in all walks of life are affected by malnutrition, and working through human rights is one key way to address this injustice. Based on research aiming to understand how a ‘right to nutrition’ is perceived by different actors globally and in Zambia, this brief presents a clear framework for a rights-based approach to nutrition in Zambia. This framework identifies rhetorical, legal and practical functions of human rights, and offers a way to think through clearly how different actors might work on the different aspects of rights. Addressing these three aspects of a right to nutrition all together – instead of by very separate constituencies as happens now – is fundamental to a coherent rights-based approach to nutrition. This brief outlines which actors need to come together – from law and policy, activism and communities, across global, national and local levels – and suggests how to start. It lays out the Zambian policy, legal and practical environment as it stands, and suggests actions to move forward in each of these areas in ways that are consistent with the different aspects of rights. Through these steps, Zambia can become known as a hub of action on a right to nutrition, to join with others in using human rights to address the injustice of malnutrition.

‘Vertical’ responses focused primarily on preventing and containing COVID-19 have been implemented in countries around the world with negative consequences for other health services, people’s access to and use of them, and associated health outcomes, especially in low-income and middle-income countries (LMICs). ‘Lockdowns’ and restrictive measures, especially, have complicated service provision and access, and disrupted key supply chains. Such interventions, alongside more traditional public health measures, interact with baseline health, health system, and social and economic vulnerabilities in LMICs to compound negative impacts. This analysis, based on a rapid evidence assessment by the Social Science in Humanitarian Action Platform in mid-2020, highlights the drivers and evidence of these impacts, emphasises the additional vulnerabilities experienced by marginalised social groups, and provides insight for governments, agencies, organisations and communities to implement more proportionate, appropriate, comprehensive and socially just responses that address COVID-19 in the context of and alongside other disease burdens. In the short term, there is an urgent need to monitor and mitigate impacts of pandemic responses on health service provision, access and use, including through embedding COVID-19 response within integrated health systems approaches. These efforts should also feed into longer-term strategies to strengthen health systems, expand universal healthcare coverage and attend to the social determinants of health—commitments, both existing and new—which governments, donors and international agencies must make and be held accountable to. Crucially, affected communities must be empowered to play a central role in identifying health priorities, allocating resources, and designing and delivering services.

The COVID-19 pandemic has exposed long-standing social inequalities and vulnerabilities, with the most disadvantaged and marginalised groups bearing the greatest health, social, and economic burdens. Beyond documenting these vulnerabilities, there is a need to mitigate them and support the resilience of marginalised communities. ‘Community resilience’ can bolster community capacity to cope with the pressures of various shocks; this brief explores how its concepts can be applied to epidemics. It reviews the grey and academic literature on different approaches to community resilience. It covers 1) terminology, 2) lessons from practice, 3) the context of community resilience, 4) a systems approach, and 5) key human and social capacities. Social justice, inequality, equity, and fairness are highlighted as themes in need of further development for resilience as it relates to epidemic preparedness and response. This brief was developed for SSHAP by IDS (led by Megan Schmidt-Sane with Tabitha Hrynick) with Anthrologica (Eva Niederberger).

في ضوء استمرار استشراء جائحة فيروس كورونا المستجد، ثمة حاجة إلى تقديم الدعم القوي للمجتمعات الأكثر تأثرا بالأزمات وتعزيز المرونة المجتمعية. نهج "المرونة المجتمعية" يعني الشراكة مع المجتمعات المحلية وتعزيز قدراتها بهدف التخفيف من تداعيات الجائحة، ومن ضمنها التداعيات الاجتماعية والاقتصادية. 1–3 لذا لا مجال للعودة إلى الوضع الذي كان سائداً قبل الجائحة، بل لا بد من إحداث تغيير جذري يتطرق لأوجه عدم المساواة ويعمل على تحسين الظروف الاجتماعية والاقتصادية. وفي حين أن النهج القائم على تعزيز قدرة المجتمع على الصمود لا يزال جديد نسبيًا فيما يتعلق بالتأهب لمواجهة الأوبئة والتصدي لها، فإنه يضع إطاراً للتعامل مع الصدمات الوبائية بطريقة شاملة ومن خلال إتباع نهج يشمل نظاما كاملا. 4–6 وبينما تركز الاستجابة للوباء والتصدي له على التخفيف من أوجه الضّعف، يمكن اللجوء إلى النهج القائم على تعزيز الصمود لبناء القدرات الحالية بهدف إدارة الآثار الصحية والاجتماعية والنفسية والاقتصادية الناتجة عن الوباء. وهذا يعزز من إضفاء الطابع المحلي على هذا النهج ومن قدرته على التكيف والاستدامة على المدى الطويل، ما يمثل المبادئ الأساسية للاستجابة للوباء وفقا للعلوم الاجتماعية. 7–9 يناقش هذا الموجز الاعتبارات المتعلقة بكيفية تقديم العاملين في القطاع الصحي والإنساني الدعم للمجتمعات من أجل الاستجابة والتعافي من فيروس كورونا المستجد باستخدام نهج المرونة المجتمعية. تم تطوير هذا الموجز لـصالح منصة العلوم الاجتماعية في العمل الإنساني من قبل معهد دراسات التنمية (تحت إشراف ميغان شميدت- ساين وتابيثا هرينيك بالتعاون مع أنثرولوجيكا (إيفا نايدربيرغر) وهو يقع ضمن مسؤولية منصة العلوم الاجتماعية في العمل الإنساني.

As the unequal impact of the COVID-19 pandemic continues, there is a need to robustly support vulnerable communities and bolster ‘community resilience.’ A community resilience approach means to work in partnership with communities and strengthen their capacities to mitigate the impact of the pandemic, including its social and economic fallout. However, this is not resilience which returns the status quo. This moment demands transformative change in which inequalities are tackled and socioeconomic conditions are improved. While a community resilience approach is relatively new to epidemic preparedness and response, it frames epidemic shocks more holistically and from the perspective of a whole system. While epidemic response often focuses on mitigating vulnerabilities, there is an opportunity to use a resilience framework to build existing capacities to manage health, social, psychosocial, and economic impacts of an epidemic. This makes a resilience approach more localised, adaptable, and sustainable in the long-term, which are key tenets of an epidemic response informed by social science. This brief presents considerations for how health and humanitarian practitioners can support communities to respond to and recover from COVID-19 using a community resilience approach. This brief was developed for SSHAP by IDS (led by Megan Schmidt-Sane with Tabitha Hrynick) with Anthrologica (Eva Niederberger).

أظهرت جائحة فيروس كورونا المستجد عدم المساواة وأوجه الضعف المترسخَين منذ فترة طويلة في المجتمع، حيث أن الفئات المجتمعية الأكثر حرمانًا وتهميشًا تتكبّد أثقل الأعباء الصحية والاجتماعية والاقتصادية1. لذا، والى جانب توثيق أوجه الضعف، هناك حاجة للتخفيف عن هذه الفئات المهمشة ودعم قدرتها على الصمود. يمكن أن تعزز " المرونة المجتمعية " قدرة المجتمع على التكيف مع الضغوط الناتجة عن الصدمات المختلفة. يبحث هذا الموجز كيفية تطبيق مفاهيم المرونة المجتمعية على الأوبئة ويستعرض المصادر الرمادية (المنشورات غير الرسمية) والأكاديمية حول المقاربات المختلفة للصمود المجتمعي. ويشمل ذلك 1) المصطلحات، 2) الدروس المستفادة من الممارسة، 3) سياق المرونة المجتمعية، 4) نهج النظم، 5) القدرات البشرية والاجتماعية الأساسية. يتم التطرق أيضًا إلى العدالة الاجتماعية وعدم المساواة والإنصاف والعدالة كمواضيع تحتاج إلى مزيد من التطوير للوصول إلى الصمود، باعتبارها ترتبط مباشرة بالتأهب للأوبئة والاستجابة لها. تم إعداد هذا الموجز لـصالح منصة العلوم الاجتماعية في العمل الإنساني \ معهد دراسات التنمية (تحت اشراف كل من ميغان شميدت-ساين وتابيثا هرينيك) بالتعاون مع أنثرولوجيكا (إيفا نايدربيرغر). هذا الموجز يقع ضمن مسؤولية منصة العلوم الاجتماعية في العمل الإنساني

As one of the poorest countries in the world, Niger is highly vulnerable to epidemics and faces considerable operational challenges for preparedness and response. Key overarching summary points and implications are presented below.

The heterogeneous epidemiological picture for COVID-19 in Africa continues to generate debate. Modelling projections raise speculation about the phases and trends of SARS-CoV-2 outbreaks across the continent and how these differ from outbreaks elsewhere.[1–4][1] Continental efforts drew praise in

Urbanisation is associated with changes in consumption patterns and food production processes. These patterns and processes can increase or decrease the risks of outbreaks of foodborne diseases and are generally accompanied by changes in food safety policies and regulations about food handling. This affects consumers, as well as people economically engaged in the food value chain. This study looks at Tanzania&rsquo, s red meat value chain&mdash, which in its totality involves about one third of the population&mdash, and focuses on the knowledge, attitudes and reported practices of operators of butcheries and eateries with regards to meat safety in an urban and in a rural environment. We interviewed 64 operators about their experiences with foodborne diseases and their explanations and expectations around meat safety, with a particular emphasis on how they understood their own actions regarding food safety risks vis-&agrave, vis regulations. We found operators of eateries emphasising their own agency in keeping meat safe, whereas operators of butcheries&mdash, whose products are more closely inspected&mdash, relied more on official inspections. Looking towards meat safety in the future, interviewees in rural areas were, relative to their urban counterparts, more optimistic, which we attribute to rural operators&rsquo, shorter and relatively unmediated value chains.

This research was funded by the Biotechnology and Biological Sciences Research Council, the Department for International Development, the Economic and Social Research Council, the Medical Research Council, the Natural Environment Research Council, and the Defence Science and Technology Laboratory, under the UK Zoonoses and Emerging Livestock Systems Initiative (BB/L017679/1 and BB/L018926/1). BACKGROUND: With increasing demand for red meat in Tanzania comes heightened potential for zoonotic infections in animals and humans that disproportionately affect poor communities. A range of frontline government employees work to protect public health, providing services for people engaged in animal-based livelihoods (livestock owners and butchers), and enforcing meat safety and food premises standards. In contrast to literature which emphasises the inadequacy of extension support and food safety policy implementation in low- and middle-income countries, this paper foregrounds the 'street-level diplomacy' deployed by frontline actors operating in challenging contexts. METHODS: This research is based on semi-structured interviews with 61 government employees, including livestock extension officers/meat inspectors and health officers, across 10 randomly-selected rural and urban wards. RESULTS: Frontline actors combined formal and informal strategies including the leveraging of formal policy texts and relationships with other state employees, remaining flexible and recognising that poverty constrained people's ability to comply with health regulations. They emphasised the need to work with livestock keepers and butchers to build their knowledge to self-regulate and to work collaboratively to ensure meat safety. Remaining adaptive and being hesitant to act punitively unless absolutely necessary cultivated trust and positive relations, making those engaged in animal-based livelihoods more open to learning from and cooperating with extension officers and inspectors. This may result in higher levels of meat safety than might be the case if frontline actors stringently enforced regulations. CONCLUSION: The current tendency to view frontline actors' partial enforcement of meat safety regulations as a failure obscures the creative and proactive ways in which they seek to ensure meat safety in a context of limited resources. Their application of 'street-level diplomacy' enables them to be sensitive to local socio-economic realities, to respect local social norms and expectations and to build support for health safety interventions when necessary. More explicitly acknowledging the role of trust and positive state-society relations and the diplomatic skills deployed by frontline actors as a formal part of their inspection duties offers new perspectives and enhanced understandings on the complicated nature of their work and what might be done to support them. Publisher PDF