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This case study will focus on the political and economic factors that influence the feasibility and effectiveness of vaccine deployment during outbreaks, using Sierra Leone as a case study. In 2014-2016 Sierra Leone, along with neighbouring Guinea and Liberia, experienced an unprecedented outbreak of Ebola Virus Disease (EVD).The epidemic caught an already under-resourced and under-staffed healthcare system underprepared resulting in over 14,000 recorded cases and almost 4,000 deaths in the space of two years.

The outbreak set in motion a significant international response, including the fast-tracked development of vaccines and the establishment of various prevention and treatment trials in the country under emergency conditions. During this time, anthropologists mobilised to support all aspects of the international response, highlighting the importance of taking into account the social, political and economic factors that shaped communities’ acceptance of new technologies including therapeutics and vaccines. For vaccine trials, this drew in particular on existing work on vaccine hesitancy, determinants of public confidence in vaccination campaigns and on ethical considerations of carrying out

research in resource-poor countries.

In order to inform future emergency preparedness planning, this focus on social perceptions and

acceptability needs to be complemented by an appreciation of the macro-level factors that shape effective deployment. Indeed, whilst the EVD outbreak made clear that international and national communities of experts were unprepared to respond rapidly and effectively to contain the epidemic, the policy-level political and economic barriers and facilitators remain under explored. To address this, we propose to look systematically at various levels of policy-making and implementation, including studying the implications for vaccine deployment of national regulatory environments, financial capacity, relations between donors and recipients, and political considerations at global, national and local levels.


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