The current outbreak of a novel coronavirus in Wuhan, China has cast a spotlight once again on infectious disease epidemics as a vital global challenge. As evidence emerges that the virus – thought to have zoonotic origins in a food market – can transmit between people; as case numbers rise to above 400, and as fears of rapid spread intensify as crowds congregate and people travel to celebrate the Lunar New Year, an archetypical ‘outbreak narrative’ appears to be unfolding, reminiscent of SARS in 2003.
While the World Health Organisation debates whether to declare this officially a Public Health Emergency of International Concern, government and international agencies in China and around the world are already taking steps to control the outbreak to prevent it becoming a global pandemic through measures such as screening at airports and fast-track vaccine development. As headlines project the inevitable anxieties of a ‘mystery illness’, possible viral mutation, and concerns about transparency, scientific experts drawn in for media comment scramble to reassure that it is these strengthened surveillance systems and global institutional arrangements that are enabling the detection of such events and data sharing for a rapid response. An epidemic is a social thing.
A growing appreciation of social science
One key contrast with the SARS era of the early 2000s is the appreciation now given to social science in pandemic preparedness and response. Boosted by the experience of the West African Ebola outbreak of 2014-16, when the Ebola Response Anthropology platform and related networks contributed social science insights that informed a more sensitive and effective response, we have seen a flurry of supportive reviews, assessments, investments and new institutional arrangements. The report Towards People-Centred Epidemic Preparedness and Response commissioned in 2017 as part of the Global Research Collaboration for Infectious Disease Preparedness argues that ‘Social science has demonstrated its potential to help save lives, humanize epidemic response, and mitigate the disruptive socio-economic and psychosocial burdens associated with outbreaks, epidemics and pandemics’. It recommends a ‘strategic roadmap’ to address social science knowledge, infrastructure and funding gaps and accelerate capacity development and innovation. New and strengthened initiatives are emerging, such as the EU-supported Sonar-Global network and the IDS-hosted Social Science in Humanitarian Action Platform (SSHAP), to be expanded from March 2020 with support from the Wellcome Trust-DFID Joint Initiative on Epidemic Preparedness.
Meanwhile, the incoming CEO of the British Academy, Hetan Shah, cited the Ebola contributions as a lead example of why ‘global problems need social science’ more generally, in his article in Nature last week.
Limits – and possibilities for wider contributions
Despite this growing attention, the roles envisaged for social science in pandemic preparedness and response are often quite limited. Social science is too often confined to narrow policy and operational domains, such as ‘community engagement’ and ‘risk communication’. It is sometimes seen as a ‘magic bullet’ which can reveal ‘culture’ and ‘social context’, enabling negative aspects to be managed and controlled, and positive ones to be harnessed in instrumental solutions to reduce risk and dispel ‘ignorant’ beliefs. Public health and humanitarian agencies sometimes assume and perpetuate simplistic, homogenising views of ‘community’ and ‘authority’. This is the way anthropological contributions around burials in the context of Ebola are often portrayed for example – including in Shah’s Nature article.
Yet as a group of experienced researchers, policymakers and practitioners agreed in a Pandemics Workshop on January 20th on ‘Social sciences and humanities: taking the next steps’, supported by the British Academy and the Wellcome Trust, the potential contributions of the social sciences and humanities are much broader. While anthropology offers key insights, there are opportunities to involve a far wider range of social sciences and humanities – from history and political economy to ethics and the creative arts. These need to be engaged throughout the full cycle of an epidemic, from ‘peacetime’ interludes to the various pillars of preparedness and response operations, to mopping up the tail end of an epidemic and informing lessons for the future. A diverse range of social science insights helps elucidate the complexities of the contexts in which outbreaks occur, and the diverse forms of public authority and power at play, in social-ecological-political-epidemiological systems that are inherently dynamic, complex and uncertain. They help reveal the value of plural forms of knowledge, beyond the biomedical and beyond the ‘expert’, prefiguring a more democratic and socially just politics of pandemic knowledge.
Social science lenses can valuably be turned onto global and national actors and the framing of evidence and coordination of resources and response operations, as well as their diverse interactions with people in local settings. Indeed a focus centred on people – both those affected and ‘responders’ – might underscore points of conflict but also coalitions, and solidarities.
Historical approaches offer a great deal, from revealing how epidemic dynamics unfold over time, understanding public anxieties amidst wider political-economic events and citizen-state relations, and elucidating the interplay of technologies, ecologies, social and political processes. It can also contextualise and question dominant narratives about place, time and control, such as the trope of Western assistance offered to alleviate the suffering of others. Our discussions reflected on the power relations that mean lessons from past outbreaks are often neglected or wilfully ignored, and indeed the colonial assumptions embodied in the ‘lessons learned’ discourse itself. Perhaps the issue is not what can be learned from history, but what history can contribute, such as through revealing how the historical consciousness of epidemics shape anxieties and imaginaries in the present and how these might compare to the lived experience of outbreaks on the ground.
We debated the tensions and challenges that work against this more thoroughgoing integration of social sciences and humanities into policy and practice, from time and incentives, to the mismatch of academic and bureaucratic imperatives, to wider issues of power and legitimacy. We considered how new approaches to institutions and capacities, research, preparedness and response might seek to overcome such challenges – and create opportunities not only for the greater use of social and historical insights, but also for more inclusive and democratic processes for collecting evidence, and greater attention to how information is interpreted, by whom, and for what purposes.
These rich discussions, and the next steps they suggest, will be summarised in a forthcoming workshop report. More significantly, we hope elements of these conversations and interactions amongst social scientists and policymakers will help deepen and nuance their own initiatives and catalyse further engagement with an eye to identifying windows for further strategic advocacy going forward. We certainly want to build on them in the briefings, roundtables and capacity-strengthening planned for the new, expanded phase of SSHAP.
While these workshop discussions took place, several of our participants dropped in and out, called away to participate in emergency meetings and calls concerning the China coronavirus outbreak. This lent an immediacy and poignancy to our discussions – and underlined their significance. For this latest epidemic is definitely one requiring a broader social science lens, extending beyond narrow ‘community’ concerns to the geopolitics, complexities and uncertainties of a new disease in rapidly globalising China. More than ever, social scientists and health policy-makers will need to work well together to address this latest potential pandemic.