What can be learned about pandemic preparedness from greater attention to perspectives of people who live in regions labelled as ‘hotspots’ for disease outbreaks? And how might such attention require us to reconfigure science, policy, and practice – as part of a broader shifting of power in pandemics? These are the questions that motivate and are explored through the papers in this special issue on pandemic preparedness, for which this paper serves as Introduction. All the contributions to this special issue present perspectives, experiences, and reflections from African settings, drawing on research co-designed and conducted in close engagement with local communities or in dialogue with African scientists and public health actors. They approach biosocial questions from the concerns of the disciplinary fields of social, medical, and political anthropology, of engaged interdisciplinary social science, and, crucially, of embedded, ‘grassroots’ fieldwork by researchers who have grown up with the communities they are studying. The team bringing these complementary areas of expertise came together for a collaborative programme on ‘Pandemic preparedness: local and global concepts and practices in tackling disease threats in Africa’ supported by a collaborative award from the Wellcome Trust during 2018–2023. This special issue thus forms part of wider advocacy for rethinking pandemic preparedness and for the value of anthropology in informing its meanings and practices, now more than ever.