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Accepted Paper:
The political economy of vaccine deployment: reflections from an ‘insider ethnography’ approach in Sierra Leone
Luisa Enria
(LSHTM)
Abass S Kamara
(MOHS)
The article explores the potential for anthropological engagements with the political economy of vaccine deployment through 'insider ethnography', based on our reflections as a surveillance officer turned ethnographer and an anthropologist shadowing the surveillance team in Sierra Leone.
Paper long abstract:
Recent epidemics, from Ebola to Zika and COVID-19 have brough emergency vaccination to the forefront of policy and research engagements. Anthropologists’ contributions are increasingly recognised as central to these endeavours, however they have tended to focus primarily on the experiences and perspectives of those receiving vaccines, exploring for example the contextual nature of trust in immunisation programmes and the socio-political factors that may affect engagements with vaccines. Whilst these perspectives are crucial, anthropological insights also have much to contribute to an exploration of the ‘supply side’ of vaccination— studying the opportunities and challenges faced by healthcare workers and public health officials tasked with running emergency vaccination campaigns within communities. This article offers reflections on one effort to do this in Kambia District, Sierra Leone, by using ethnographic approaches. In particular, the article focuses on the experience of doing ethnography from the ‘inside’, as a surveillance officer turned ethnographer and as an anthropologist shadowing the surveillance team. Through a dialogue between the two authors from their different positionalities, the article highlights both the advantages of privileged access into vaccine deployment processes that such a methodological approach provides and the ethical, practical and political challenges that emerge from doing this work.