Luisa Enria

Power, fairness and trust: understanding and engaging with vaccine trial participants and communities in the setting up the EBOVAC-Salone vaccine trial in Sierra Leone.

BackgroundThis paper discusses the establishment of a clinical trial of an Ebola vaccine candidate in Kambia District, Northern Sierra Leone during the epidemic, and analyses the role of social science research in ensuring that lessons from the socio-political context, the recent experience of the Ebola outbreak, and learning from previous clinical trials were incorporated in the development of community engagement strategies. The paper aims to provide a case study of an integrated social science and communications system in the start-up phase of the clinical trial.MethodsThe paper is based on qualitative research methods including ethnographic observation, interviews with trial participants and key stakeholder interviews.ResultsThrough the case study of EBOVAC Salone, the paper suggests ways in which research can be used to inform communication strategies before and during the setting up of the trial. It explores notions of power, fairness and trust emerging from analysis of the Sierra Leonean context and through ethnographic research, to reflect on three situations in which social scientists and community liaison officers worked together to ensure successful community engagement. Firstly, a section on “power” considers the pitfalls of considering communities as homogeneous and shows the importance of understanding intra-community power dynamics when engaging communities. Secondly, a section on “fairness” shows how local understandings of what is fair can help inform the design of volunteer recruitment strategies. Finally, a section on “trust” highlights how historically rooted rumours can be effectively addressed through active dialogue rather than through an approach focused on correcting misinformation.ConclusionThe paper firstly emphasises the value of social science in the setting up of clinical trials, in terms of providing an in depth understanding of context and social dynamics. Secondly, the paper suggests the importance of a close collaboration between research and community engagement to effectively confront political and social dynamics, especially in the context of an epidemic.

Co-producing knowledge through participatory theatre: reflections on ethnography, empathy and power

This article is based on methodological reflections from a participatory theatre project with economically marginal youth in Sierra Leone’s capital, Freetown. It offers empirical considerations on the application of participatory methods in reference to three concerns of feminist research: the situated nature of knowledge; the wish to create non-hierarchical knowledge; and the orientation towards emancipatory action. In discussing the potential for meaningful participation to create inclusive research spaces, the paper suggests the importance of acknowledging the necessarily indeterminate and imperfect nature of our efforts to mitigate power imbalances and the challenge of intersubjective understanding in our research encounters.

EBOVAC-Salone: Lessons learned from implementing an Ebola vaccine trial in an Ebola-affected country:

Background/aims During the 2014–2016 West African Ebola epidemic, clinical trials were fast-tracked in order to identify prophylactic vaccines and experimental treatments that might be useful in preventing or treating Ebola. These trials included the ongoing EBOVAC-Salone study, which was established and implemented in Sierra Leone to assess the safety and immunogenicity of the Ad26.ZEBOV/MVA-BN-Filo prime-boost Ebola vaccine regimen. Methods This article describes the experiences of the EBOVAC-Salone research team in setting up and implementing the trial, and provides recommendations for research teams aiming to conduct clinical trials in future outbreak situations. Results Establishing a clinical trial during an outbreak brought some unique challenges, including those related to trial design and the regulatory environment, operational issues, and community engagement. The situation was further complicated by the weak infrastructure and limited experience of clinical trials in Sierra Leone. However, operating in an outbreak context also brought some benefits to the research team, including strong stakeholder support. The EBOVAC-Salone study recruited participants both during and after the outbreak, leading to additional challenges to trial implementation during the post-outbreak transition. Conclusion Many lessons have been learned about setting up and implementing a clinical trial during a devastating Ebola epidemic, and some of the experiences of the EBOVAC-Salone team were mirrored by those of other researchers operating in the region. Common to several of these research groups is a recommendation that research should be more closely incorporated into outbreak response planning, which could expedite the establishment of timely and appropriate research projects. We recommend that the lessons learned by researchers during the West African Ebola epidemic are built into programmes and strategies to improve the responses to future epidemics, wherever they occur.

[REVIEW] Ebola: how a people's science helped end an epidemic

Review of: Ebola: how a peoples science helped end an epidemic , by Richards Paul. London: Zed Books, 2016. xii + 180 pp. £20.00 (paperback). ISBN 978 1 78360 858 4

Ebola: How a people's science helped end an epidemic [review]

Review of: Ebola: how a peoples science helped end an epidemic , by Richards Paul. London: Zed Books, 2016. xii + 180 pp. £20.00 (paperback). ISBN 978 1 78360 858 4

Ebola: How a people's science helped end an epidemic

Review of: Ebola: how a peoples science helped end an epidemic , by Richards Paul. London: Zed Books, 2016. xii + 180 pp. £20.00 (paperback). ISBN 978 1 78360 858 4