Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jun;18(1):115-128.

Biosocial Approaches to the 2013-2016 Ebola Pandemic

Eugene T Richardson  1 , Mohamed Bailor Barrie  2 , J Daniel Kelly  3 , Yusupha Dibba  4 , Songor Koedoyoma  5 , Paul E Farmer  6
Affiliations

Biosocial Approaches to the 2013-2016 Ebola Pandemic

Eugene T Richardson et al. Health Hum Rights. 2016 Jun.

Abstract

Despite more than 25 documented outbreaks of Ebola since 1976, our understanding of the disease is limited, in particular the social, political, ecological, and economic forces that promote (or limit) its spread. In the following study, we seek to provide new ways of understanding the 2013-2016 Ebola pandemic. We use the term, 'pandemic,' instead of 'epidemic,' so as not to elide the global forces that shape every localized outbreak of infectious disease. By situating life histories via a biosocial approach, the forces promoting or retarding Ebola transmission come into sharper focus. We conclude that biomedical and culturalist claims of causality have helped obscure the role of human rights failings (colonial legacies, structural adjustment, exploitative mining companies, enabled civil war, rural poverty, and the near absence of quality health care, to name but a few) in the genesis of the 2013-16 pandemic. From early 20th century smallpox and influenza outbreaks to 21st century Ebola, transnational relations of inequality continue to be embodied as viral disease in West Africa, resulting in the preventable deaths of hundreds of thousands of people.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1.
Figure 1.
Sierra Leone and surrounds. Kono District in red. Source: Centers for Disease Control and Prevention
Figure 2.
Figure 2.
Billboard at Koidu Government Hospital. Photo credit: ET Richardson
Figure 3.
Figure 3.
Diamond (kimberlite) mine as viewed from UN helicopter. Photo credit: ET Richardson
Figure 4.
Figure 4.
Bushmeat billboard, Liberia. Photo credit: P. E. Farmer.
See this image and copyright information in PMC

References

    1. Piot P., Muyembe J-J., Edmunds W. J. “Ebola in west Africa: From disease outbreak to humanitarian crisis,”. Lancet Infectious Diseases. 2014;14(11):1034–1035. - PubMed
    2. World Health Organization. Ebola situation report— 16 December 2015. Geneva: WHO; 2015. http://apps.who.int/ebola/current-situation/ebola-situation-reports Available at.
    1. Chan M. “Ebola virus disease in west Africa — No early end to the outbreak,”. New England Journal of Medicine. 2014;371(13):1183–1185. - PubMed
    2. Pigott D. M., Golding N., Mylne A., et al. “Mapping the zoonotic niche of Ebola virus disease in Africa,”. Elife. 2014;3:e04395. - PMC - PubMed
    3. Robinson J. A. Governance and political economy constraints to World Bank CAS priorities in Sierra Leone. Washington, DC: World Bank; Oct, 2008.
    4. Richards P., Amara J., Ferme M. C., et al. “Social pathways for Ebola virus disease in rural Sierra Leone, and some implications for containment,”. PLOS Neglected Tropical Diseases. 2015;9(4):e0003567. - PMC - PubMed
    5. Farmer P. E. “Diary,”. London Review of Books. 2014;36(20):38–39.
    1. Rodney W. How Europe underdeveloped Africa. London: Bogle-L’Ouverture; 1972.
    2. Abdullah I., editor. Between democracy and terror: The Sierra Leone civil war. Dakar: Codesria; 2000.
    3. Wilkinson A., Leach M. “Briefing: Ebola-myths, realities, and structural violence,”. African Affairs. 2014;114:136–148.
    4. Martin-Moreno J. “Ebola, or the messy cocktail of public health and globalisation in post-colonial Africa,”. Lancet Global Health Blog. 2014 http://globalhealth.thelancet.com/2014/09/04/ebola-or-messy-cocktail-pub... Available at.
    5. Philpott S., Schüklenk U. Garrison: Hastings Center; 2010. “A study that should not have been done,”.http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=4626#ixzz3i... Available at.
    6. Farmer P. E. Pathologies of power: Health, human rights, and the new war on the poor. Berkeley: University of California Press; 2004. “New malaise: Medical ethics and social rights in the global era,”; pp. 196–212.
    7. Ezeome E. R., Simon C. “Ethical problems in conducting research in acute epidemics: the Pfizer meningitis study in Nigeria as an illustration,”. Developing World Bioethics. 2010;10(1):1–10. - PubMed
    1. Centers for Disease Control and Prevention. Outbreaks chronology: Ebola hemorrhagic fever. Atlanta: CDC; 2014. http://www.cdc.gov/vhf/ebola/resources/outbreak-table.html Available at.
    2. Ebola Response Anthropology Platform. http://www.ebola-anthropology.net Available at.
    1. Vaughan M. Curing their ills: Colonial power and African illness. Redwood City: Stanford University Press; 1991.
    2. Akyeampong E. K. “Disease in West African history,”. In: Akyeampong E. K., editor. Themes in West African History. Oxford: James Currey; 2006.
    3. Farmer P. E. AIDS and accusation: Haiti and the geography of blame. Berkeley: University of California Press; 1992.
    4. Lock M., Nguyen V-K. An anthropology of biomedicine. Chichester: Wiley-Blackwell; 2010.

MeSH terms

LinkOut - more resources