Alcohol and drugs in post-war Sierra Leone

The kind of social stress that a civil war expose the population to makes it easy to assume that an increased level of alcohol and drug abuse should be observable in post-war Sierra Leone. This is, however, not the case. As this study reveals, the pattern of alcohol and drug consumption in Sierra Leone. This is, however, not the case. As this study reveals, the pattern of alcohol and drug consumption in Sierra Leone is the same as we find in other African countries that has never experienced civil war. The majority of the population do not drink very much or use drugs at all, but there is a small minority that are frequent drinkers and use drugs. These findings are based on a survey in Sierra Leone and explore who the drinkers are, how many people drink and what characterises drug users in Sierra Leone

Power-sharing in Africa's war zones: how important is the local level?

Research on power-sharing in Africa remains silent on the effects of national peace agreements on the sub-national level. Conversely, most armed conflicts originate and are fought in (or over) specific areas. A plausible hypothesis would be that for power-sharing to have the desired pacifying effect throughout the national territory, it needs to be extended to the local level. Based on fieldwork in six former hotspots in Liberia, Burundi and the Democratic Republic of Congo (DRC) we find that there is hardly any local content, including local power-sharing, in national agreements. However, contrary to our hypothesis, neither local content (inclusion of actors or interest) nor local-power-sharing (either introducing a local power balance or monopoly) are indispensable to effectively bring about local peace, at least in the short-term. On the contrary, it might even endanger the peace process. The importance of the sub-national level is overestimated in some cases and romanticised in others. However, the history of spatial-political links, centralised policies, and the establishment of local balances or monopolies of power ultimately play an important role

Recommendations for respiratory syncytial virus surveillance at national level

Respiratory syncytial virus (RSV) is a common cause of acute lower respiratory tract infections and hospitalisations among young children and is globally responsible for many deaths in young children, especially in infants aged <6 months. Furthermore, RSV is a common cause of severe respiratory disease and hospitalisation among older adults. The development of new candidate vaccines and monoclonal antibodies highlights the need for reliable surveillance of RSV. In the European Union (EU), no up-to-date general recommendations on RSV surveillance are currently available. Based on outcomes of a workshop with 29 European experts in the field of RSV virology, epidemiology and public health, we provide recommendations for developing a feasible and sustainable national surveillance strategy for RSV that will enable harmonisation and data comparison at the European level. We discuss three surveillance components: active sentinel community surveillance, active sentinel hospital surveillance and passive laboratory surveillance, using the EU acute respiratory infection and World Health Organization (WHO) extended severe acute respiratory infection case definitions. Furthermore, we recommend the use of quantitative reverse transcriptase PCR-based assays as the standard detection method for RSV and virus genetic characterisation, if possible, to monitor genetic evolution. These guidelines provide a basis for good quality, feasible and affordable surveillance of RSV. Harmonisation of surveillance standards at the European and global level will contribute to the wider availability of national level RSV surveillance data for regional and global analysis, and for estimation of RSV burden and the impact of future immunisation programmes

Lessons from the Ebola Crisis in West Africa: Community engagement, crisis communication and countering rumours

What lessons can we draw from the 2014-2016 Ebola crisis in Guinea, Liberia, Sierra Leone? While both the outbreak itself and the context is different, there are enough similarities between the Ebola crisis and COVID-19 to extract useful lessons and best practices. In this research note, the focus is on three key lessons from the Ebola experience: community engagement, crisis communication and countering the rumour mill. In the world’s most fragile states, an uncontrolled outbreak of COVID-19 would have devastating consequences for the population. In a scenario where the spread of the coronavirus is under control in large parts of the world, the survival of COVID-19 in fragile states would also most certainly be a source for new waves of infections to the rest of the world. Not only do fragile states lack capacity to react adequately on their own, but their ability to utilise external support and assistance is limited due to low absorption capacity