Rebel Cooperation with Vaccination Drives in Sub-Saharan Africa: The ‘Stationary’ v. ‘Roving’ Distinction and Health Security

In zones of armed conflict there is an elevated risk of the outbreak of communicable diseases. Vaccination drives are key to disease prevention but may be significantly impeded by fighting, undermining health security on a regional scale – or even beyond that, as the COVID-19 pandemic illustrated. To better understand the relationship between insurgency and gaps in vaccination coverage, this article revisits the “stationary v. roving” distinction, often employed in characterizing insurgencies. It seeks to verify if it is truly the stationary nature of rebel groups that determines a readiness to cooperate, to refine our understanding of conflict’s impact on the latter. To this end, the article compiles a comprehensive list of instances of insurgent organizations’ meaningful cooperation with vaccination efforts from a review of (i) academic literature and other sources; (ii) the VAXXPAX dataset, and (iii) documents retrieved from the World Health Organisaton’s IRIS online repository. The emerging case-set is evaluated to see – in a “soft test” – if the theory inherent to the “stationary v. roving” distinction holds up in the Sub-Saharan African context, where it is expected to do well. Some indirect supporting evidence is found, but this is, in the ensuing discussion, revaluated, identifying key challenges to assessing causality behind the assumed “insurgent behavior → vaccination coverage” relationship, with implications for a normative assessment of the issue of who may be suitable partners to cooperate with.