International Political Economy and the 2014 West African Ebola Outbreak

Benton, Adia; Dionne, Kim Yi

doi:10.1017/asr.2015.11

Cited by 108 publications

(79 citation statements)

References 26 publications

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“…The 2013–16 Ebola virus disease (EVD) pandemic was the longest and largest on record (World Health Organization, 2016), yet we are only beginning to parse the complex biosocial processes that eventuated in its surge across West Africa (Benton and Dionne, 2015; Brown and Kelly, 2014; Richardson et al, 2016a). Important questions remain, including the effects of clinical sequelae, loss of family and livelihood, and other psychosocial burdens on EVD survivors.…”

Section: Introductionmentioning

confidence: 99%

The symbolic violence of ‘outbreak’: A mixed-methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing

Richardson

Kelly

Sesay

et al. 2017

Social Science & Medicine

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Despite over 28,000 reported cases of Ebola virus disease (EVD) in the 2013–16 outbreak in West Africa, we are only beginning to trace the complex biosocial processes that have promoted its spread. Important questions remain, including the effects on survivors of clinical sequelae, loss of family and livelihood, and other psychological and social trauma. Another poorly understood question is what effect social protection and job creation programs have had on survivors’ wellbeing. Several clinical and social protection programs have been developed to respond to the needs of EVD survivors; however, little in the way of impact evaluation has taken place. We enrolled 200 randomly selected EVD survivors from Port Loko, Kenema, and Kailahun districts in Sierra Leone and stratified them based on the amount of instrumental social protection received post-discharge from an Ebola treatment unit. We then conducted a survey and in-depth interviews to assess participants’ wellbeing and food security. Social protection categories II-IV (moderate to extensive) were each significantly associated with ~15–22% higher wellbeing scores compared to minimal social protection (p<0.001). Only social protection category IV (extensive) was significantly associated with being food secure (adjusted odds ratio 6.11; 95% confidence interval, 2.85–13.10) when compared to minimal social protection. Qualitative themes included having a sense of purpose during the crisis (work and fellowship helped survivors cope); using cash transfers to invest in business; the value of literacy and life-skills classes; loss of breadwinners (survivors with jobs were able to take over that role); and combating the consequences of stigma. We conclude that, for EVD survivors, short-term social protection during the vulnerable period post-discharge can pay dividends two years later. Based on the empiric evidence presented, we discuss how terms such as “outbreak” and “epidemic” do symbolic violence by creating the illusion that social suffering ends when transmission of a pathogen ceases.

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Section: Introductionmentioning

confidence: 99%

The symbolic violence of ‘outbreak’: A mixed-methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing

Richardson

Kelly

Sesay

et al. 2017

Social Science & Medicine

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“…Interestingly, the first Ebola case was reported in March 2014, just 6 months before the registration of several Ebola clinical trials. This is a relatively short time from the recognition of a need for clinical research, securing funding for that research, and initiation of the clinical trial [25]. A similar trend was observed with Zika trials, which also were registered only in 2015 and 2016, corresponding to the onset of that outbreak [26].…”

Section: Discussionmentioning

confidence: 71%

“…Influenza vaccine trials exhibited a distinct spike in the number of clinical trials in study years 2008 and 2009, corresponding to the H1N1 swine influenza epidemic worldwide [24]. Hemorrhagic virus trials had a distinct spike in 2014-2015, corresponding to the 2014-2016 Ebola hemorrhagic fever epidemic in Western Africa [25]. Interestingly, the first Ebola case was reported in March 2014, just 6 months before the registration of several Ebola clinical trials.…”

Section: Discussionmentioning

confidence: 99%

A Decade On: Systematic Review of ClinicalTrials.gov Infectious Disease Trials, 2007–2017

Jaffe

Chiswell

Tsalik

2019

Open Forum Infectious Diseases

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Background Registration of interventional trials of Food and Drug Administration–regulated drug and biological products and devices became a legal requirement in 2007; the vast majority of these trials are registered in ClinicalTrials.gov. An analysis of ClinicalTrials.gov offers an opportunity to define the clinical research landscape; here we analyze 10 years of infectious disease (ID) clinical trial research. Methods Beginning with 166 415 interventional trials registered in ClinicalTrials.gov from 2007–2017, ID trials were selected by study conditions and interventions. Relevance to ID was confirmed through manual review, resulting in 13 707 ID trials and 152 708 non-ID trials. Results ID-related trials represented 6.9%–9.9% of all trials with no significant trend over time. ID trials tended to be more focused on treatment and prevention, with a focus on testing drugs, biologics, and vaccines. ID trials tended to be large, randomized, and nonblinded with a greater degree of international enrollment. Industry was the primary funding source for 45.2% of ID trials. Compared with the global burden of disease, human immunodeficiency virus/AIDS and hepatitis C trials were overrepresented, and lower respiratory tract infection trials were underrepresented. Hepatitis C trials fluctuated, keeping with a wave of new drug development. Influenza vaccine trials peaked during the 2009 H1N1 swine influenza outbreak. Conclusions This study presents the most comprehensive characterization of ID clinical trials over the past decade. These results help define how clinical research aligns with clinical need. Temporal trends reflect changes in disease epidemiology and the impact of scientific discovery and market forces. Periodic review of ID clinical trials can help identify gaps and serve as a mechanism to realign resources.

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“…No published studies of foreign government responses to 2014 Ebola were identified during this research. Public health experts' individual reasons for joining 2014 Ebola response missions have been evaluated (Rexroth et al, ), as have affected countries' own responses (Benton and Dionne, ) and WHO's response capabilities (Gronke, ; Osterholm, Moore, and Gostin, ; Siedner et al, ; van de Pas and van Belle, ). But the logics of donor countries' medical resource deployments also warrant exploration, given their importance to halting severe infectious disease epidemics.…”

Section: Five Political Perspectives On Hcw Deployment In Internationmentioning

confidence: 99%

Political drivers of epidemic response: foreign healthcare workers and the 2014 Ebola outbreak

Nohrstedt

Bækkeskov

2017

Disasters

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International Political Economy and the 2014 West African Ebola Outbreak

Cited by 108 publications

References 26 publications

The symbolic violence of ‘outbreak’: A mixed-methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing

The symbolic violence of ‘outbreak’: A mixed-methods, quasi-experimental impact evaluation of social protection on Ebola survivor wellbeing

A Decade On: Systematic Review of ClinicalTrials.gov Infectious Disease Trials, 2007–2017

Political drivers of epidemic response: foreign healthcare workers and the 2014 Ebola outbreak

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