Introduction :
This workshop is expected to take place towards the end of a three-year research project, funded by the Swiss National Fund for Scientific Research (2013-2016). This project entitled “Unraveling lessons learned from the A(H1N1) pandemic to the 2014 Ebola epidemic” involves sociologists from the Department of Sociology at the University of Geneva, and economists from the Geneva School of Business Administration (HEG), with research partners at WHO headquarters (Pandemic and Epidemic Diseases Department), in the United States (Graduate School of Public Health and Political Science Department, Berkeley University of California) and in Japan (Tohoku Medical School).
This on-going project is embedded in research exchanges with the above-cited institutions dating back from an earlier American national Foundation’s project (2008-2011) led by our Berkeley-based colleagues, which helped developing our current research options. Therefore, the workshop is expected to take stock of this fruitful collaboration, and aims at producing a collective book.
This project takes a comparative look at the 2009 A(H1N1) influenza pandemic and the ongoing Ebola (hereafter EVD) crisis in West Africa, from the point of view of the international and national emergency response systems. Both crises are very different but they both have had, and still have lasting impacts on national and international public health institutions and on other key societal sectors (trade; transport; education; media and communication to name a few).
It aims at analyzing how emergency systems come together differently according to the specificity of a given crisis. More specifically, the project attempts to clarify how organizational mitigation strategies, risk communication, and cost-benefit analyses interact, and how this regime of interaction helps explain the form and the problems of the response for a given threat.
To be even more precise, during the early days of the project we initially formulated the following hypothesis: in a global response, planning & organizing, communicating, and evaluating costs are three closely related segments. We argued that because these three aspects (organizing, communicating, and costing) are usually envisioned separately, social controversies have the necessary fuel to destabilize whatever “reasonable” (in the sense of reasonable buy-in) decisions were made earlier on these issues. In the context of A(H1N1) where organizational issues, risk communication strategies, and cost-benefit evaluations have not been integrated from the beginning in a single comprehensive global response, social controversies – which by nature are inevitable – have had the potential to undermine efforts to achieve transparency and mobilization throughout the course of the pandemic. But this line of argument proved to be even more critical and devastating for the EVD tragedy.
For the pandemic, in hindsight the apparent disproportion between the deployment of costly organizational strategies based on plans already available and the mildness of the virus contributed to the widespread perception of a failure of involved public health institutions to react adequately. Moreover, at WHO, this public outcry then resulted in the partial dismantling of emergency response capacities, a loss which would prove costly in the current EVD event.
This close relation invites us to analyze public health emergency response as an integrated whole, which needs to be analyzed in a de-compartmentalized, multidisciplinary approach, bringing social sciences to the forefront. The project will eventually provide important insights for future outbreak management and global health governance.
Our research evidence come from a mix of in-depth study of documentation at hand (pandemic plans; evaluation reports from various institutions, academic literature) and investigations (through interviews with experts and first line responders – more than 50 have been conducted so far. It is expected that around 100 persons will be included in our sample at the end of the project) at WHO headquarters, in the US, Swiss and Japanese organizations in charge of surveillance and responses to epidemics (local to national), and investigations in NGOs, such as MSF for the EVD. Thus, the workshop objectives are threefold:
1. To share and confront our findings with a multidisciplinary panel of specialists, both academics and experts, who will discuss them.
2. To widen our analytical scope by seeking original communications by specialists outside of our core research team.
3. To prepare a volume, out of the presented papers and discussions.