Communicating Risk in Public Health Emergencies

Recent public health emergencies, such as the Ebola virus disease outbreak in West Africa (2014–2015), the emergence of the Zika virus syndrome in 2015–2016 and multi-country yellow fever outbreaks in Africa in 2016, have highlighted major challenges and gaps in how risk is communicated during epidemics and other health emergencies.The challenges include the rapid transformation in communications technology, including the near-universal penetration of mobile telephones, the widespread use and increasingly powerful influence of digital media which has had an impact on 'traditional' media (newspapers, radio and television), and major changes in how people access and trust health information.Important gaps include considerations of context – the social, economic, political and cultural factors influencing people's perception of risk and their risk-reduction behaviours. Finally, guidance is needed on the best approaches for strengthening emergency risk communication (ERC) capacity and sustaining them for potential health emergencies.The recommendations in these guidelines provide overarching, evidence-based guidance on how risk communication should be practised in an emergency. The recommendations also guide countries on building capacity for communicating risk during health emergencies

Comparative analysis of spring flood risk reduction measures in Alaska, United States and the Sakha Republic, Russia

Thesis (Ph.D.) University of Alaska Fairbanks, 2017River ice thaw and breakup are an annual springtime phenomena in the North. Depending on regional weather patterns and river morphology, breakups can result in catastrophic floods in exposed and vulnerable communities. Breakup flood risk is especially high in rural and remote northern communities, where flood relief and recovery are complicated by unique geographical and climatological features, and limited physical and communication infrastructure. Proactive spring flood management would significantly minimize the adverse impacts of spring floods. Proactive flood management entails flood risk reduction through advances in ice jam and flood prevention, forecasting and mitigation, and community preparedness. With the goal to identify best practices in spring flood risk reduction, I conducted a comparative case study between two flood-prone communities, Galena in Alaska, United States and Edeytsy in the Sakha Republic, Russia. Within a week from each other, Galena and Edeytsy sustained major floods in May 2013. Methods included focus groups with the representatives from flood managing agencies, surveys of families impacted by the 2013 floods, observations on site, and archival review. Comparative parameters of the study included natural and human causes of spring floods, effectiveness of spring flood mitigation and preparedness strategies, and the role of interagency communication and cooperation in flood risk reduction. The analysis revealed that spring flood risk in Galena and Edeytsy results from complex interactions among a series of natural processes and human actions that generate conditions of hazard, exposure, and vulnerability. Therefore, flood risk in Galena and Edeytsy can be reduced by managing conditions of ice-jam floods, and decreasing exposure and vulnerability of the at-risk populations. Implementing the Pressure and Release model to analyze the vulnerability progression of Edeytsy and Galena points to common root causes at the two research sites, including colonial heritage, unequal distribution of resources and power, top-down governance, and limited inclusion of local communities in the decision-making process. To construct an appropriate flood risk reduction framework it is important to establish a dialogue among the diverse stakeholders on potential solutions, arriving at a range of top-down and bottom-up initiatives and in conjunction selecting the appropriate strategies. Both communities have progressed in terms of greater awareness of the hazard, reduction in vulnerabilities, and a shift to more reliance on shelter-in-place. However, in neither community have needed improvements in levee protection been completed. Dialogue between outside authorities and the community begins earlier and is more intensive for Edeytsy, perhaps accounting for Edeytsy's more favorable rating of risk management and response than Galena's

Trust and Public Health Emergency Events:A Mixed-Methods Systematic Review

The systematic review examined the phenomenon of trust during public health emergency events. The literature reviewed was field studies done with people directly affected or likely to be affected by such events and included quantitative, qualitative, mixed-method, and case study primary studies in English (N = 38) as well as Arabic, Chinese, French, Russian, and Spanish (all non-English N = 30). Studies were mostly from high-and middle-income countries, and the event most covered was infectious disease. Findings from individual studies were first synthesized within methods and evaluated for certainty/confidence, and then synthesized across methods. The final set of 11 findings synthesized across methods identified a set of activities for enhancing trust and showed that it is a multi-faceted and dynamic concept

Informal Disaster Governance in Longyearbyen and South Dominica

Scholars and practitioners are increasingly questioning formal disaster governance (FDG) approaches as being too rigid, slow, and command-and-control driven. Too often, local realities and informal influences are sidelined or ignored to the extent that disaster governance can be harmed through endeavours to impose formal and/or political structures. Efforts to include so-called ‘bottom-up’, local, and/or participatory approaches have not changed the FDG-centred disaster narrative. This study considers the role of informality in disasters, encapsulated here as Informal Disaster Governance (IDG). It theorises IDG and situates it within the long-standing albeit limited literature on the topic, paying particular attention to the literature’s failure to properly define informal disaster risk reduction and response (DRR/R) efforts. Empirically, this study explores IDG in two locations—the settlement of Longyearbyen in the Arctic archipelago of Svalbard and the southern region of the Commonwealth of Dominica—where IDG might be expected to be more powerful or obvious, namely in smaller, more isolated communities. Fifty-four semi-structured interviews were conducted, visually aided by an innovative use of the PRISM (Pictorial Representation of Illness and Self Measure) tool, to examine residents’ perceptions of disaster risks, and informal sources of disaster-related information and help. The findings suggest that informality plays a significant and complementary role in disasters in both locations and highlight the role of proximity/propinquity, relationships, experience, and power as contributing factors for why people choose informal sources of disaster information and help. Thus, this study conceptualises the drivers and far-reaching implications of IDG but also considers its ‘dark sides’. By presenting IDG as a framework and exploring its merits and challenges, this research restores the conceptual importance and balance of IDG vis-à-vis FDG, paving the way for a better understanding of the ‘complete’ picture of disaster governance

Aerospace Medicine and Biology: A continuing bibliography with indexes, supplement 171

This bibliography lists 186 reports, articles, and other documents introduced into the NASA scientific and technical information system in August 1977

Communication with media in nuclear or radiological emergencies : General and practical recommendations for improvement

Communication with mass media during and after a nuclear emergency presents both a challenge and an opportunity for emergency management. The challenge lies with the different motivations and types of process applied by mass media and emergency management; the opportunity arises from the power of mass media to reach out to an audience with information important for compliance with protective actions. This article summarises recommendations for improved media communication by nuclear emergency management professionals. Recommendations address both the traditional and new media, and are the result of empirical and qualitative research conducted in the context of the FP7 PREPARE project, including: (i) a media content analysis of newspapers articles reporting about Fukushima (N = 1340); (ii) a content analysis of tweets about Fukushima (N = 914); and (iii) a qualitative approach - round table discussions with stakeholders (N > 100) involved in communication about nuclear emergencies. Results show that although challenging, nuclear emergency communication can be improved by using mass media and developing skills, training and resources during the preparedness phase of a nuclear emergency cycle. Some general recommendations and practical advice for communication with media is given

National security exceptions: a shield or a weapon?:Balancing States’ autonomy to adopt security measures and International Economic Law

For nearly seventy years, countries did an excellent job of protecting the multilateral trading system from deciding whether national security was a legitimate defense for any given country’s measures, whether it was a trade ban, sanctions, or export restrictions. Then, in 2017 and 2018, several panels of the World Trade Organization (WTO) were established after respondents declared that they considered the challenged measures necessary to protect their essential security interests. Notably, these disputes started to mushroom when national security rhetoric gained prominence, partly due to emerging concerns raised by cybersecurity, geo-economic rivalry, technological nationalism, climate change, supply chain crisis, and migration flows. Such concerns have provoked reforms and strategic policies. Yet, by attempting to restore their sense of security, states have actually enlarged insecurity in the global economy, for example, by claiming that security exceptions can allow anything under the sun. The question that this dissertation tackles is how countries can restore the balance between states’ autonomy to protect national security and binding international law, taking into account new economic and political realities. This dissertation argues that existing security exceptions are either drafted too broadly, making it difficult to control their good faith application and creating verification problems for international courts, or too narrowly, arguably excluding from their scope the protection against insidious, imminent, yet severe emerging security threats. There is a risk that both approaches might undermine the balance between states’ sovereignty and international economic law by unjustifiably limiting the ability of states to take efficient security actions or opening the door to protectionism or opportunism by allowing any measure that a state considers necessary. Unlike other proposals, this dissertation starts from the premise that countries will be given the most space for dialogue if they admit that some national security questions are more prone to stricter regulation than others. To this end, this dissertation suggests states renegotiate existing security exceptions and change the approach to drafting them in future agreements. This dissertation synthesizes the existing doctrinal and empirical work on the application of security exceptions under international trade and investment law but also turns to the case studies of the United States, the European Union, and BRICS countries (Brazil, Russia, India, China, and South Africa) – by virtue of the economic and political power of such WTO members, their importance in global supply chains, and their roles in the transformation of the global order. It aims to expand the rulebook on the application of security exceptions, improve cooperation between the WTO and the United Nations, and incentivize states to use trade and investment restrictions more efficiently, thereby permitting more policy space for calibrated responses to new externalities while reinforcing the function of security exceptions to shield states from responsibility only in extreme situations. The interdisciplinary constituency of such research affects the normative understanding of security exceptions and enables the discussion over the practice of application of security measures from different analytical lenses, making this research interesting for practitioners, academics, and policymakers dealing with the intersection between international economic law and national security

Advancing the Right to Health: The Vital Role of Law

Effective laws and an enabling legal environment are essential to a healthy society. Most public health challenges – from infectious and non-communicable diseases to injuries, from mental illness to universal health coverage – have a legal component. At global, national and local levels, law is a powerful tool for advancing the right to health. This tool is, however, often underutilized. This report aims to raise awareness about the role that public health laws can play in advancing the right to health and in creating the conditions for all people to live healthy lives. The report provides guidance about issues and requirements to be addressed during the process of developing or reforming public health laws, with case studies drawn from countries around the world to illustrate effective practices and critical features of effective public health legislation. Advancing the right to health: the vital role of law is the result of a collaboration between the World Health Organisation, the International Development Law Organisation (IDLO), the O’Neill Institute for National and Global Health Law, Washington D.C., USA, and Sydney Law School, University of Sydney. The Project Directors were: Professor Lawrence O. Gostin, Linda D. and Timothy J. O’Neill Professor of Global Health Law and University Professor, Georgetown University; Faculty Director, O’Neill Institute for National and Global Health Law, Georgetown University; Mr David Patterson, Senior Legal Expert – Health; Department of Research & Learning, International Development Law Organization; Professor Roger Magnusson, Professor of Health Law & Governance, Sydney Law School, University of Sydney; Mr Oscar Cabrera, Executive Director, O’Neill Institute for National and Global Health Law, Georgetown University Law Center; Ms Helena Nygren-Krug (2011–2013), Senior Advisor, Human Rights & Law, UNAIDS. The content and structure of the report reflect the consensus reached at the second of two international consultations in public health law that preceded the preparation of the report, hosted by WHO and IDLO in Cairo, Egypt, 26-28 April 2010. Part 1 introduces the human right to health and its role in guiding and evaluating law reform efforts, including efforts to achieve the goal of universal health coverage. Part 2 discusses the process of public health law reform. The law reform process refers to the practical steps involved in advancing the political goal of law reform, and the kinds of issues and obstacles that may be encountered along the way. Part 2 identifies some of the actors who may initiate or lead the public health law reform process, discusses principles of good governance during that process, and ways of building a consensus around the need for public health law reform. Part 3 turns from the process of reforming public health laws to the substance or content of those laws. It identifies a number of core areas of public health practice where regulation is essential in order to ensure that governments (at different levels) discharge their basic public health functions. Traditionally, these core areas of public health practice have included: the provision of clean water and sanitation, monitoring and surveillance of public health threats, the management of communicable diseases, and emergency powers. Building on these core public health functions, Part 3 goes on to consider a range of other public health priorities where law has a critical role to play. These priorities include tobacco control, access to essential medicines, the migration of health care workers, nutrition, maternal, reproductive and child health, and the role of law in advancing universal access to quality health services for all members of the population. The report includes many examples that illustrate the ways in which different countries have used law to protect the health of their populations in ways that are consistent with their human rights obligations. Countries vary widely in terms of their constitutional structure, size, history and political culture. For these reasons, the examples given are not intended to be prescriptive, but to provide useful comparisons for countries involved in the process of legislative review