Given the health, social, and economic upheavals of the COVID-19 pandemic, there is understandable anxiety about another virus, monkeypox, quickly emerging in many countries around the world. In West and Central Africa, where the disease has been endemic for several decades, monkeypox transmission in humans usually occurs in short, controllable chains of infection after contact with infected animal reservoirs. Recent monkeypox infections have been identified in non-endemic regions, with most occurring through longer chains of human-to-human spread in people without a history of contact with animals or travel to endemic regions. These seemingly different patterns of disease have prompted public health investigation. However, ending chains of monkeypox transmission requires a better understanding of the social, ecological and scientific interconnections between endemic and non-endemic areas. This brief is intended to be read in conjunction with the companion brief entitled ‘Social Considerations for Monkeypox Response’.1 In this set of briefs, we lay out social considerations from previous examples of disease emergence to reflect on 1) the range of response strategies available to control monkeypox, and 2) specific considerations for monkeypox risk communication and community engagement (RCCE). These briefs are intended to be used by public health practitioners and advisors involved in developing responses to the ongoing monkeypox outbreak, particularly in non-endemic countries. This brief on RCCE strategies for monkeypox response was written by Megan Schmidt-Sane (IDS), Syed Abbas (IDS), Soha Karam (Anthrologica), and Jennifer Palmer (LSHTM), with contributions from Hayley MacGregor (IDS), Olivia Tulloch (Anthrologica), and Annie Wilkinson (IDS). It was reviewed by Will Nutland (The Love Tank CIC/PrEPster) and was edited by Victoria Haldane (Anthrologica). This brief is the responsibility of SSHAP.

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Ebola Virus Disease in the Democratic Republic of Congo (DRC) was declared a public health emergency of international concern on July 17, 2019. The first case to cross the border into Uganda in June 2019 demonstrates the importance of better understanding border dynamics in a context of Ebola. This paper adopts a political economy approach to contextualize epidemic response programs conducted in moderate-and high-risk border districts in Uganda, through a qualitative study with 287 participants. To that end, our aim was to describe the historical underpinnings of the borderlands context; the role of livelihood strategies in constraining risk avoidance decisions; and the dynamics of trust in authority figures, including health workers. This paper reports that border communities are highly connected, for a variety of social and economic reasons. These daily realities are in direct opposition to guidance to limit travel during an active Ebola epidemic. We argue that an ability to limit movement is constrained by the economic need to seek livelihood strategies wherever that may be. Moreover, border regions are populated by communities with long-standing distrust in authority figures, particularly in fishing areas. This distrust spills over with consequences for Ebola prevention and control activities. This research indexes the importance of tailoring Ebola programming and policies to consider the political and economic dynamics of borderlands.

Our findings suggest that aspects of the neighborhood built environment, such as the presence of abandoned houses or the lack of recreational centers, can be stressors themselves and may also critically alter families' thresholds for navigating other everyday pressures. Conversely, aspects of the neighborhood built environment, such as housing density, may work to mitigate the risk of maltreatment, either by promoting social support or by increasing the likelihood that maltreatment is reported to authorities. Additional research, both qualitative and quantitative, is integral to building and testing models of these separate but related pathways by which the neighborhood built environment may link to child maltreatment.

Since February 2021, countless lives have been lost in India, which has compounded the social and economic devastation caused by the second wave of COVID-19. The sharp surge in cases across the country overwhelmed the health infrastructure, with people left scrambling for hospital beds, critical drugs, and oxygen. As of May 2021, infections began to come down in urban areas. However, the effects of the second wave continued to be felt in rural areas. This is the worst humanitarian and public health crisis the country has witnessed since independence; while the continued spread of COVID-19 variants will have regional and global implications. With a slow vaccine rollout and overwhelmed health infrastructure, there is a critical need to examine India's response and recommend measures to further arrest the current spread of infection and to prevent and prepare against future waves. This brief is a rapid social science review and analysis of the second wave of COVID-19 in India. It draws on emerging reports, literature, and regional social science expertise to examine reasons for the second wave, explain its impact, and highlight the systemic issues that hindered the response. This brief puts forth vital considerations for local and national government, civil society, and humanitarian actors at global and national levels, with implications for future waves of COVID-19 in low- and middle-income countries. This review is part of the Social Science in Humanitarian Action Platform (SSHAP) series on the COVID-19 response in India. It was developed for SSHAP by Mihir R. Bhatt (AIDMI), Shilpi Srivastava (IDS), Megan Schmidt-Sane (IDS), and Lyla Mehta (IDS) with input and reviews from Deepak Sanan (Former Civil Servant; Senior Visiting Fellow, Centre for Policy Research), Subir Sinha (SOAS), Murad Banaji (Middlesex University London), Delhi Rose Angom (Oxfam India), Olivia Tulloch (Anthrologica) and Santiago Ripoll (IDS). It is the responsibility of SSHAP.

Given the health, social, and economic upheavals of the COVID-19 pandemic, there is understandable anxiety about another virus, monkeypox, quickly emerging in many countries around the world. In West and Central Africa, where the disease has been endemic for several decades, monkeypox transmission in people usually happens in short, controllable chains of infection after contact with infected animal reservoirs. Recent monkeypox infections have been identified in non-endemic regions, with most occurring through longer chains of human-to-human spread in people without a history of contact with animals or travel to endemic regions. These seemingly different patterns of disease have prompted public health investigation. However, ending chains of monkeypox transmission requires a better understanding of the social, ecological and scientific interconnections between endemic and non-endemic areas. In this set of companion briefs, we lay out social considerations from previous examples of disease emergence to reflect on 1) the range of response strategies available to control monkeypox, and 2) specific considerations for monkeypox risk communication and community engagement (RCCE). We aim for these briefs to be used by public health practitioners and advisors involved in developing responses to the ongoing monkeypox outbreak, particularly in non-endemic countries. This brief on social considerations for monkeypox response was written by Syed Abbas (IDS), Soha Karam (Anthrologica), Megan Schmidt-Sane (IDS), and Jennifer Palmer (LSHTM), with contributions from Hayley MacGregor (IDS), Olivia Tulloch (Anthrologica), and Annie Wilkinson (IDS). The brief was reviewed by Boghuma Titanji (Emory University School of Medicine). This brief is the responsibility of SSHAP.

The Covid-19 pandemic is more than a health crisis. It has worse outcomes among individuals with co-morbidities, has exposed fault lines in our societies, and amplified existing inequalities. This article draws on emerging evidence from low- and middle-income contexts to highlight how Covid-19 becomes syndemic when it interacts with local vulnerabilities. A syndemic approach provides a frame for understanding how Covid-19 is amplified when clustered with other diseases and how this clustering is facilitated by contextual and social factors that create adverse conditions. Public health responses to Covid-19 have also exacerbated these adverse conditions as many face social and economic crises as a result of some policies. These multiple challenges generate major implications for both the public health response and for broader development action: first, one size does not fit all and we must attend to local vulnerabilities; second, short-term public health response and longer-term development approaches must be integrated for improved intersectoral coordination and synergy. A synergised public health and development response will allow us to better prepare for the next pandemic.

Research examining the sexual identities, behaviors, and experiences of bisexual men outside of Western contexts (including in India) is limited. Individuals who self-identify as bisexual due to their orientation towards partners of more than one gender face distinct psychosocial challenges relative to exclusively heterosexual, gay/lesbian or other individuals. We conducted four focus group discussions (n = 22) and in-depth interviews (n = 50) with self-identified bisexual men (age 18 years and older) who were recruited from the metropolitan area of Mumbai, India, between June and August 2013. We triangulated and analyzed focus group and interview data using standard qualitative research techniques. Findings from our study suggest that multiple factors influence the sexual experiences of self-identified bisexual men in Mumbai, including contexts of sexual interactions, sexual positioning, and the gender of sexual partners. Participants described cultural meaning systems and psychosocial dynamics that regulate bisexual identity development, disclosure, and sexual decision making with male, female, and other partners. Secrecy, discretion, and sexual pleasure also influenced sexual behaviors and relationships. Although Western sexual identity categories are not necessarily equivalent in the Indian context, it is interesting and important to note that a number of individuals in India continue to use the identity label of “bisexual.” Before developing interventions to meet unique sexual health needs of bisexual men, it is crucial to understand how these men perceive themselves, reconcile the ordinary aspects of their lives with their sexuality, and structure their relationships with partners.