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Political Dynamics of Slow-Onset Disasters: Contrasting Antimicrobial Resistance (AMR) and Ebola Responses

Periodic Reporting for period 1 - SlowDisasters (Political Dynamics of Slow-Onset Disasters: Contrasting Antimicrobial Resistance (AMR) and Ebola Responses)

Berichtszeitraum: 2021-01-01 bis 2022-12-31

The overall grand objective of SlowDisasters was to provide us with a better understanding of how emergencies with a slower onset differ from emergencies characterized by more of a rapid onset. The project focused on this notion of onset, which refers specifically to the speed at which an emergency develops, or manifests, so to speak.

As a whole, the project represents a comprehensive inquiry into this original aim. As a proposal written in 2019 about epidemic disease outbreaks and their political dynamics, it was naturally necessary to expand the scope of the project to capture the emerging insights that the COVID-19 pandemic taught us and continues to teach us. However, I was aware of the risks associated with studying developing events. I therefore stuck with my original research plan in order to avoid reaching conclusions that would be too colored by COVID-19. The scholarly work was not interrupted by the lockdowns because I did not rely on collecting primary data. All in all, the work has been carried out in a relatively consistent manner with little to no interruptions. Changes made to the project are thus not because of interruptions to the research process but because of the need to also include lessons from COVID-19 in my pursuit of the project objectives. As a training project, this was also very important for my career as it greatly enhanced the relevance and publishability of my work

The main analytical changes to the project, partially due to the COVID-19 pandemic, include the following:
•Rather than a strict focus on antimicrobial resistance (AMR) and Ebola, the study has considered public health emergencies more generally, including COVID-19 and some potential but currently only anticipared health emergencies like the risk of an Avian influenza outbreak. Considering more cases has enriched the project but also meant a shift towards a greater career specialization on my part towards a focus on Public Health Emergencies of International Concern (PHEIC) and the International Health Regulations (IHR) frameworks withint the World Health Organization. I believe this was very timely as we in fact saw three PHEIC events happen after the proposal was submitted to the EU: an Ebola outbreak in Congo, the COVID-19 pandemic, and monkeypox, all declared a PHEIC after early 2019 and all with a great deal of controversy.
•Insights from the project and related readings have also led to a few COVID-19 specific publications, to capitalize on the urgency of the topic. Great care has been taken not to present analytical insights prematurely that would not stand the test of time as the pandemic evolved.
•Insights from the project led to one conceptual paper that addresses the overall objective of the project more specifically, discussing the notion of “slow-onset disasters” without reference to public health emergencies.

The project has been very productive and has delivered on its core commitments while also going into new and unexpected directions as part of the work.

The broad objective of the project was to give us a better understanding of how emergencies with a slower onset differ from emergencies characterized by more of a rapid onset. More specifically, the project had five specific objectives:

O1. Understand the policy dynamics shaping global and EU-level AMR initiatives
O2. Understand the policy dynamics shaping global and EU-level Ebola pandemic responses
O3. Explain differences among AMR and Ebola response initiatives in relation to traits
O4. Explain the policy dynamics of AMR and Ebola initiatives in relation to timing
O5. Expand the knowledge base on political aspects of slow-onset disaster response

I approached these objectives through three complimentary and more specific research questions (RQs):
RQ1. How do the records of decisions (or policy trajectories) on AMR and Ebola differ? [O1,O2]
RQ2. How can differences between AMR and Ebola initiatives be explained in relation to their hazard dynamics? [O3,O5]
RQ3. Why do response initiatives for AMR and Ebola occur when they do – and what do their timing-aspects imply for slow-onset disaster response in general? [O4, O5]

The project has largely achieved its objectives and generated new knowlesge on the RQs. The project has also expanded beyond its intended focus on AMR and Ebola responses towards a focus on Public Health Emergency of International Concern response dynamics more generally, to reflect the controversies surrounding also the COVID-19 and monkeypox emergency deliberations at the WHO-level.
The project has been successful with over 12 research outputs, two op-eds, as well as an international workshop hosted in Copenhagen as part of the NEEDS2022 conference. Insights from the project were successfully disseminated to a wide audience at policy platforms such as the Global Platform for Disaster Risk Reduction as well as mixed-audience conferences such as NEEDS2022. Overall, the project has mainly reached a scientific audience and policymaker audience, although society at large has also been reached through op-eds and social media. Several on-site dissemination opportunities were limited due to pandemic lockdowns, but these have not affected the scientific productivity of the project as such.
The scientific contribution of the project has gone in different directions. It has provided nuance and forwarded thinking on slow-onset emergencies as a concept and a policy problem. My focus has been on contributing to an understanding of their political dynamics with a health sector lens. New collaborations have also arisen spontaneously. In last phase of the MSCA-IF I have specialized more into the politics surrounding the International Health Regulations at the WHO level, with a particular focus on the Public Health Emergency of International Concern declarations. Some political research already existed on this, but I have taken it into a new direction currently not existing in this field by connecting it to crisis and disaster research and existing research on crisis politics, which has not been well integrated into global health research. I would say this is the main scientific contribution of the project as a whole.

The project has had an immense impact on my career and reputation in the wider field. I was already a tenured associate professor when I was granted the project. I was given a 2-year leave and have remained an inspiration for other Arctic researchers. In my proposal I mentioned that my ambition with the IF was to position myself as a leading scholar in research on slow-onset emergencies and their distinct political dynamics. I feel that I have come much closer to this goal and that I now have a strong name in the field.
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