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‘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.

This working paper explores the challenges that emerge when public health measures to mitigate the risk of infection during an epidemic infringe on the rights of religious communities to say a final farewell to their loved ones according to their custom. The paper aims to answer these questions: how does epidemic response in the context of death and burials frame and impact religious minority rights? And in turn, how do sectarian dynamics reposition themselves in the context of epidemic response?

In recent years, fears about infectious diseases with pandemic potential have led to global initiatives to predict, prepare and respond to outbreaks. Practices that are focused on prediction and control centre on turning uncertainties into ‘risk’, through surveillance, modelling and scenario planning. We argue that, alongside scientific uncertainties, a further source of uncertainty has come into view for science-policy communities: the behaviour of affected populations and the social and political dynamics of disease ‘hotspots’. We contend that this has catalysed an increased recognition of social science perspectives, with new practices emerging, detected in approaches that aim to standardise risk communication and community engagement, or to synthesise social knowledge to make ‘context’ more discretely legible. We suggest that such initiatives can also be viewed as part of a broader suite of technologies to transform uncertainties into calculable risks. In this chapter, we seek to open up a richer dialogue about the different understandings of uncertainty, illustrating the potential contestation between the official response efforts of agencies, and alternative ways of knowing and responding to outbreaks in ‘communities’, grounded in local-level practice. In conclusion, we reflect on the limits in comprehending the ontological dimensions of uncertainty: for people living in these settings, it is not ‘context’ that is salient, but the ongoing flow – or text – of social and ecological life, where everyday uncertainties are constantly faced. We ask if alternative processes might be possible for formulating international planning frameworks, more attentive to views ‘from below’ that could reveal alternative priorities and ways of being-in-the-world.

This paper explores the contested notion of what constitutes a fair price in the context of grain exchanges in a subsistence farming village in the highlands of Matagalpa. Using ethnographic data, I show how Nicaraguan campesinos’ economic behavior plays out within a local moral universe of fairness: how much to produce and how much to sell in the market (or to give away); how prices and obligations vary depending on the social relation that binds the seller and the buyer (kinship, friendship, community, and so on); in what ways these notions of fair price are articulated and contested by different classes within a rural community; and lastly, what is expected of the State in terms of regulating food prices. Price emerges as the dialectic between the market in its abstract form and the specific social relationships and everyday politics that shape exchanges. What constitutes help (ayuda) and what constitutes exploitation in market exchanges and the determination of price is constantly contested, the moral economy is a discursive battlefield.