Description du projet :
The 2009 H1N1 pandemic was the first global health crisis of the century to be monitored under the revised International Health Regulations. Since the early 1990s, the World Health Organization has striven to gain a leadership role in global health issues, in a context characterized by (re-)emerging risks and the multiplication of actors involved in health issues. The management of H1N1 took place in this complex environment of global health policy.
Since 2010, state agencies and international organizations have engaged in vast lessons learned experiences through published evaluation reports, aiming at better understanding the conditions under which the H1N1 pandemic was monitored worldwide. Lessons learned experiences are far from simple to conduct, as many organizational cultures are too often characterized by a blame culture when confronted with self-reported errors or dysfunctions. This is why the impetus given by international and national public health organizations, as well as parliamentary bodies in the aftermath of the pandemic, is a critical source of both academic analysis and policy assessment. Questions about risk management strategy from the vantage point of organizational processes, risk communication, and costs incurred have almost never been addressed in a multidisciplinary framework. Furthermore, these three aspects (organizing, communicating, and costing) were subject to harsh controversies during and after the pandemic. These issues are the backbone of this project. This project, analyzing the responses in three countries (Switzerland;' United-States and Japan) in relation to WHO frameworks, would like to demonstrate how organizational mitigation strategies, risk communication, and cost-benefit analysis are
closely intertwined. Planning and developing organizational responses during acute crises need to be articulated with a corresponding risk communication strategy that should not only avoid reporting on the intrinsic difficulties of planning, deciding, and organizing for such events but also mirror the organization that has been chosen. Similarly, it should attempt to propose an economic evaluation of the costs incurred and seek to look for large support in affected communities for these cost allocations. These are not three sequential moments:
1) planning and organizing,
2)communicating, and, finally,
3) paying the bills.
These are not three independent segments of a global response. We consider 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. We will test the following hypothesis for H1N1: in a context where organizational issues, risk communication strategies, and cost-benefit evaluations have not been integrated from the beginning in a single comprehensive global response, controversies ' which by nature are inevitable ' have had the potential to develop and undermine efforts to achieve transparency and mobilization throughout the course of the pandemic.
Many decisions, taken at the local and national level during the pandemic have not been thoroughly understood. Making sense of what happened, the degree to which precursors, rehearsed plans, intense preparedness, past sanitary crisis, hostile publics and public controversies led public health officials and front-line actors to decide on certain courses of action and not on others has yet to be investigated. This is in this context that this research proposal should be understood.
Research team within HES-SO:
Brender Nathalie, Maradan David
Durée du projet:
22.10.2013 - 31.12.2017
Montant global du projet: 197'376 CHF