Towards People-Centered Epidemic Preparedness and Response: From Knowledge to Action

"Because of the dominance of biomedical approaches thus far, integrating social science techniques into the ecosystem of response will help orientate and mobilize more people-centred national, regional and global systems."

In the view of the Funders' Forum for Social Science Research (Funders' Forum), saving lives during a disruptive infectious disease epidemic requires the effective generation and use of contextual information and knowledge that can guide adaptive planning, decision-making, and intervention. This means making social science a permanent, core part of the preparedness and response architecture. To support this vision, the report provides 38 recommendations that articulate how global health funders, as well as multilateral agencies, governments, public health institutes, and universities, can improve epidemic preparedness and response systems through a concerted strategy of investment in social science capacity, infrastructure, tools, and durable systems.

During an epidemic, day-to-day decision-making takes place in a context of uncertainty, complexity, fear, and stress. An epidemic response of global concern typically involves an array of local and national government bodies supported by the United Nations (UN), humanitarian non-governmental agencies, donors and funders, civil society groups including the media, militaries, and other partners. These partners work together to address issues of: epidemiological surveillance; clinical care and management; water and sanitation; therapeutics and vaccination; laboratory diagnostics; social mobilisation; risk communication; community engagement; project management; and logistics. At the foundation of any response, the Funders' Forum observes, is the local affected population. The value-claim of social science is that its contribution extends beyond Risk Communication and Community Engagement (RCCE) to encompass the full spectrum of decision-making across the pillar system and incident management structure, and from community-level to global governance. In this context, social science can support the quality, course, and timeliness of key information flows and knowledge synthesis necessary for decision-making.

The first section of the report outlines a set of 17 priority recommendations, which are part the total list of 38 key recommendations organised across 3 domains:

1. Core social science response capacities - In brief, the call is for investments in: human resources within response agencies; the creation of social science data analysis capacities at field and global levels; and mechanisms for operationalising knowledge (guidance, standard operating procedures, or SOPs). For example: "Support a process of socializing national ethics boards in pre-approval processes, as well as norms of qualitative and ethnographic data collection."
2. Applied and basic science investments - Includes the need to: define better the social science agenda and core competencies; support innovative interdisciplinary science; make concerted investments in building the evidence base; and develop a code of conduct. For example: "Support a programme of work that pushes the boundaries of current theory and conceptual approaches, with specific focus on risk communication, community engagement and local and global preparedness and response governance. Support the translation of theory into practice."
3. The supportive social science ecosystem - Advocacy around foundational investments for: institutional development (e.g., support for a global social science coordination body); training and capacity building (e.g., an early career development scheme); awareness-raising activities with allied disciplines (e.g., short online courses); and support for a community of practice (e.g., an annual conference). For example: "Knowledge sharing platforms and networks are an important part of supporting the integration of epidemic social science and the growth of new knowledge and approaches. This includes a commitment to Open Access publishing, the centralization of resources on the web, an expert database and various face-to-face opportunities for social scientists to attend conferences, organize and strategize and share knowledge."

The 38 recommendations and domains are outlined in detail in the report after an introduction that describes the contribution, value, current status quo, and key considerations in better integrating the field of epidemic social science into the preparedness and response architecture.

Looking ahead, the vision is as follows: "Social science should not become a parallel system, nor should it be 'siloed' into risk communication and community engagement. Rather, it should be integrated within existing capacities and systems, develop interdisciplinary knowledge by working with allied scientific disciplines, and add value across all sectors and pillars of the preparedness and response architecture....If this is successful, there is no doubt that the widespread adoption of social science techniques, and integration of community knowledge and participation, will challenge the status quo of the existing humanitarian system, scientific and medical education and global and national governance regimes. It will challenge it in order to make it more people-centric and responsive to the needs and challenges of the 21st century - a century that is widely predicted to witness many more infectious disease epidemics."

Prepared by the Amsterdam Institute for Global Health and Development (AIGHD), this report was commissioned by the Wellcome Trust, the United Kingdom (UK) Department for International Development (DFID) Joint Initiative on Epidemic Preparedness, and the Canadian Institutes of Health Research on behalf of the Funders' Forum. Created in 2016 in response to the Ebola and Zika epidemics, the Funders' Forum is part of the Global Research Collaboration for Infectious Disease Preparedness (GloPID-R) network. The Funders' Forum includes the Canadian Institutes of Health Research, the European Commission, DFID, the South Africa Medical Research Council, and Wellcome Trust.