Pandemic preparedness: local and global concepts and practices in tackling disease threats in Africa

Since the Ebola epidemic in West Africa in 2014-15, the notion of disease ‘preparedness’ has gained prominence in global health policy. Yet ‘preparedness’ remains ambiguous, inviting critical scrutiny. Who, or what, exactly, is being prepared for what, and by whom? We propose research to examine the concept of ‘preparedness’ by exploring diverse meanings and uses of the term from an anthropological perspective, with specific focus on any gap between preparedness as understood in global health, and ‘preparedness from below’ (how communities anticipate and deal with disease threats on a daily basis). Three key themes are addressed - risk and uncertainty, knowledge and information, and agency and responsibility. The meanings of ‘preparedness’ globally, and how the idea is mobilised in policy, research and implementation, will be examined. We also ask what concepts and practices of preparedness might be locally salient in two countries, Sierra Leone and Uganda, and how ideas ‘travel’ both upwards and downwards between local, national, regional and global levels. Examining different perspectives on pandemic preparedness via multi-sited ethnography, oral history, focus groups, interviews and participatory methods, we will identify pathways for connecting them, towards more effective preparedness and response approaches informed by a critical medical anthropology.