This chapter provides information on viral zoonotic infections in humans, transmitted from animals, caused by rabiesvirus, influenzaviruses, HEV, poxviruses, hantavirus, Lassa fever virus, ebola, SARS-CoV, MERS-CoV, SARS-CoV-2, nipahvirus, zikavirus. It details which animal hosts are associated with which viruses, modes of spread and strategies for control.

This chapter details the epidemiology, route of spread, prevalence, animal hosts relating to viral haemorrhagic fever (Lassa fever, Marburg disease, Ebola, Crimean-Congo haemorrhagic fever, dengue haemorrhagic fever, HFRS, hantaviruses). It gives information on symptoms, laboratory diagnosis, treatment and infection control.

Health and science diplomacy is the activity of deploying international cooperation in the service of science and public health, and using global health and science efforts to achieve foreign-policy goals. As a bridge between the scientific community and decision-makers in government, a science or health diplomat must understand the work of both and, ideally, how they think. Scientists see a pattern or anomaly in nature and try to gather data and evidence to explain it. They publish their findings in peer-reviewed scientific journals. But those findings also have to be packaged and communicated to nonscientists, because the data rarely speaks for itself. This is where science diplomats come in. They need to understand the evidence and incorporate it into persuasive arguments that can influence policymakers to elevate the potential threat as a priority and take action.

Social media consist of tools that enable open exchange of information through conversation and interaction. Over half of the global population are active social media users. However, several countries that are among the most vulnerable to emergencies, incidents, disasters, and disease outbreaks (EIDD) have relatively low social media uptake rates. This chapter explores and identifies the range of social media usage before, during, and after crises such as disasters and disease outbreaks. It focuses on three serious illnesses – influenza, Ebola virus disease (Ebola), and COVID-19. The research related to the three diseases shows that social media are mainly used by authorities in risk communication and crisis communication. It highlights numerous other uses that can be helpful to emergency managers and health service providers. The chapter concludes with an identification of principles derived from the research and a brief assessment of the short-term and long-term impacts of social media use.

The outbreaks of Ebola in West Africa and the worldwide COVID-19 pandemic are used as exemplars to consider the management of the outbreaks and the application, or not, of the lessons identified. The need for a robust public health system supported by sound coordination and collaboration structures for response across the world is identified as a means of recognising the inter-dependence of the global community. This is seen as being critical to preparing for and managing epidemics, pandemics, and other crises in the future.

About 40 million people travel from abroad to the United States per annum; many international travelers arrive in urban centers, and those who are ill will seek care there. Clinicians working in urban hospitals or near points of international arrival must be familiar with diseases commonly acquired abroad as well as uncommon but potentially serious conditions such as emerging and re-emerging infectious diseases. The assessment of the ill international traveler begins with a thorough history including the patient’s itinerary, activities, and risk factors. A familiarity with conditions endemic to the region of travel, timing of exposure, and knowledge of incubation period will allow the clinician to form a focused differential diagnosis. Knowledge of the specific diseases for which the patient is at risk, their potential complications, and the patient’s clinical status will determine need for diagnostic testing, empiric treatment, and ultimate disposition.

As vaccines are complex technologies that interact with the human body, their development is overseen by regulators in the administrative state. Countries structure the review of pharmaceutical products according to domestic rules and institutional design. As such, vaccines are reviewed as biologic products by regulatory authorities at the domestic level, such as the Therapeutic Goods Administration in Australia or the Pharmaceutical and Medical Devices Agency in Japan. The national basis of vaccine regulation inevitably leads to country-specific processes and timelines and may in some cases lead to different decisions.

Given the strong public health, societal, and economic benefits associated with the availability and widespread use of vaccines, an ideal scenario would dictate that vaccines needed to prevent and mitigate public health crises be treated as R&D priorities. Both domestic and international innovation policies would prioritize their development, and there would be mechanisms in place to ensure an equitable distribution of these vaccines. In practice, that is not the case.

Efforts to govern health globally have broadened considerably since the 1850s in terms of the subjects, goals, participants, and instruments of governance efforts. Originating in a thin, limited set of rules formally agreed by states, the contemporary global health system has evolved into a complex, dense, yet fragmented network involving governance processes both within and outside the health sector, engaging hundreds of state and non-state actors across all countries. Broader global trends shaped health governance, but key features of the current system also owe much to the particularities of specific events: the HIV/AIDS pandemic, West African Ebola crisis, and most recently Covid-19. Can contemporary networked governance processes can add up to a coherent, functional system for protecting global public health, or is more hierarchy needed? The World Health Organization is a central convenor, legitimator, adviser, and political arena in a fragmented system, but has not yet been empowered to assume the role of a directive coordinator. The extent to which major powers will construct a more hierarchical system is an open question in a world that is not yet post-Westphalian nor truly multipolar.

Chapter 1 starts by describing how, shortly after HIV was identified as the cause of AIDS, it became increasingly clear that the virus originated in Africa. Tests of archival blood samples, retrospective confirmation of early cases of AIDS and comparison of the genetic diversity of HIV in different parts of the world all pointed to central Africa, and especially the two Congos, as the probable location for the beginning of HIV’s journey. Studies of HIV subtypes provide the foundation for reconstructing the complex routes followed by the virus across the world. The example of Cuba illustrates how geopolitical events influenced the spread of HIV. The first epidemic of Ebola fever in a bush hospital in the Congo, as well as recent epidemics in the same country and in West Africa, are used to explain the peculiar characteristics of HIV that enabled it to cause a pandemic.

Africa has seen progress and setbacks with regard to the economic and socio-economic development after decolonization until ca. 2000. These are linked to historical and structural challenges, including the economic infrastructure the colonial powers left behind and the unfavourable geography of vast parts of the continent. In the post-colonial phase there has been much economic and trade dependence on the former colonial powers – giving rise to the dependency theory and the notion of neo-colonialism. There was often an unwillingness of the post-colonial leadership to set the course for the economies of their countries. And rentier states developed. Several initiatives – from Africa and beyond – have been proposed to deal with the economic misery, with those of the World Bank and the International Monetary Fund being the dominant ones, pushing African initiatives aside.

The Epilogue does not summarize the already condensed version of African history and politics but offers some wider questions for reflection and asks the readers to engage with African affairs.

This concluding chapter maintains that Liberia’s battle to eradicate Ebola from 2014 to 2016 represented an interface wherein state-, nation-, and peace-building objectives converged. Whereas counterparts across Africa had waged nationalist struggles decades before against European colonialism, Liberian domestic and diasporic actors for the first time collaborated to fight a common enemy, Ebola, outside of themselves. As a direct response to deeply embedded inequalities in primary care, non-government Liberian actors at home and abroad embodied active citizenship by engaging in public health measures that reshaped how we envisage public authority in conflict-affected states. Their relatively successful struggles against an existential threat illuminated how the political economy of belonging to Liberia could be made manifest. This chapter demonstrates further that the 2020 referendum proposition based on Liberia’s Dual Citizen and Nationality Act of 2019 would be moot without reconciling disputes over the meaning and practice of Liberian citizenship amongst actors of divergent social locations and life-worlds. It contends that a Liberian citizenship triad—which frames citizenship as identity (passive), practice (active), and a set of relations (interactive)—could be used as a model for theorising citizenship generally since it moves citizenship from the abstract and Eurocentric to the concrete and Afrocentric.

This chapter traces the imperial history of racial and environmental medical research, the economic drivers behind public health initiatives, and the legacies of colonialism in medical research and public health interventions in Africa. Examining this history of African encounters with development interventions around health provides much-needed context for breaking down misconceptions about African resistance to or ignorance of Western biomedical aid. The development episteme has perpetuated the idea that Africa is a place of disease and that Africans are resistant to treatments and cures. The nineteenth-century ad hoc campaigns to protect Europeans and segregate the sick from the healthy grew into state-sponsored public health programs during the interwar period. By World War II colonial development discourses on African health had shifted from the “white man’s grave” to biopower as states harnessed healthy bodies for productive purposes. Medical studies on declining populations, outbreaks of sleeping sickness or tuberculosis, STIs, and maternity and childcare sought healthcare solutions that would increase the productivity of labor. New hospitals, maternity centers, child welfare centers, and dispensaries brought some people relief and others terror. Scientists and officials used public health interventions and biomedical research to bolster the norms of the development episteme.