Integrating the social sciences in epidemic preparedness and response: A strategic framework to strengthen capacities and improve Global Health security

Abstract

Background The importance of integrating the social sciences in epidemic preparedness and response has become a common feature of infectious disease policy and practice debates. However to date, this integration remains inadequate, fragmented and under-funded, with limited reach and small initial investments. Based on data collected prior to the COVID-19 pandemic, in this paper we analysed the variety of knowledge, infrastructure and funding gaps that hinder the full integration of the social sciences in epidemics and present a strategic framework for addressing them. Methods Senior social scientists with expertise in public health emergencies facilitated expert deliberations, and conducted 75 key informant interviews, a consultation with 20 expert social scientists from Africa, Asia and Europe, 2 focus groups and a literature review of 128 identified high-priority peer reviewed articles. We also analysed 56 interviews from the Ebola 100 project, collected just after the West African Ebola epidemic. Analysis was conducted on gaps and recommendations. These were inductively classified according to various themes during two group prioritization exercises. The project was conducted between February and May 2019. Findings from the report were used to inform strategic prioritization of global investments in social science capacities for health emergencies. Findings Our analysis consolidated 12 knowledge and infrastructure gaps and 38 recommendations from an initial list of 600 gaps and 220 recommendations. In developing our framework, we clustered these into three areas: 1) Recommendations to improve core social science response capacities, including investments in: human resources within response agencies; the creation of social science data analysis capacities at field and global level; mechanisms for operationalizing knowledge; and a set of rapid deployment infrastructures; 2) Recommendations to strengthen applied and basic social sciences, including the need to: better define the social science agenda and core competencies; support innovative interdisciplinary science; make concerted investments in developing field ready tools and building the evidence-base; and develop codes of conduct; and 3) Recommendations for a supportive social science ecosystem, including: the essential foundational investments in institutional development; training and capacity building; awareness-raising activities with allied disciplines; and lastly, support for a community of practice. Interpretation Comprehensively integrating social science into the epidemic preparedness and response architecture demands multifaceted investments on par with allied disciplines, such as epidemiology and virology. Building core capacities and competencies should occur at multiple levels, grounded in country-led capacity building. Social science should not be a parallel system, nor should it be “siloed” into risk communication and community engagement. Rather, it should be integrated across existing systems and networks, and deploy interdisciplinary knowledge “transversally” across all preparedness and response sectors and pillars. Future work should update this framework to account for the impact of the COVID-19 pandemic on the institutional landscape.

How Can Health Systems Better Prepare for the Next Pandemic? Lessons Learned From the Management of COVID-19 in Quebec (Canada)

“…Such a holistic analysis looked at the evolution of the first wave of the COVID-19 pandemic and at the Quebec HSSS's capacity to adapt and deploy effective interdependent measures to face the crisis. The implications of our findings are in line with other studies on the preparedness of health systems against outbreaks of infectious diseases and natural hazards (2,9,11,28,47,57,124,132,135,149,154,155). The key ingredients for managing sanitary crises have led the HSSS to: (1) maintain basic essential health services; (2) remove barriers to access emergency care and services; (3) provide rapid and flexible access to required financial resources; (4) deploy leadership through a clear and flexible chain of command; (5) ensure optimal collaboration and coordination among stakeholders inside and outside the HSSS; (6) modify and adapt standards and protocols of care; (7) nurture a skilled, trained and ready-to-act workforce; (8) obtain medical supplies and equipment; (9) implement protocols and train health care providers in infection prevention and control; and (10) strengthen post-crisis recovery plans (156).…”

“…There is also a strong need to develop new training that values interprofessional, interdisciplinary, and intersectoral collaborations to avoid perpetuating silos (e.g., reserved acts, professional jurisdictions). To promote greater interdisciplinarity and intersectorality, the social sciences and humanities need to be integrated into the curriculum of health professionals (135). Training based on a "One Heath" approach -which emphasizes the interdependence of humans, animals and the environment -is becoming essential (136,137).…”

Following the science? Views from scientists on government advisory boards during the COVID-19 pandemic: a qualitative interview study in five European countries

“…Epidemic preparedness and response as well as health systems strengthening initiatives are increasingly recognising epidemics as complex biosocial events. 17 The complex systems theory has been recently proposed as one way of shifting the traditional positivist paradigm, reflecting more complex and dynamic relationships in the real world which needs to be addressed by a variety of methods, 14 18 going beyond clinical trials. Others have also called for embracing the complementary insights achieved through diverse methods and diverse disciplines, sacrificing the need for a black and white picture of a problem for a more robust understanding of it.…”

Following the science? Views from scientists on government advisory boards during the COVID-19 pandemic: a qualitative interview study in five European countries

“…26 Looking for entry points where other disciplines can bring added value to some of the more clinical or biomedically oriented work can improve advisory boards’ preparedness to perform their expert roles during future crises. 27 As measures to tackle a pandemic touch every aspect of society, it is key to involve experts of a wide range of disciplines who have the skills to work in an interdisciplinary fashion. 4, 28 Secondly, this study has highlighted a need to better clarify the role of scientific advisors towards policy makers, media and the broad public.…”