Les sites de culte ancestraux, entre histoires locales et mondialisation des ressources (Ankaratra, Madagascar)

L’article interroge les effets de la politique étatique de reconnaissance des savoirs thérapeutiques dits traditionnels sur la forêt sacrée de l’Ankaratra, proche de la capitale de Madagascar. Cette politique, induite par les dispositifs mondiaux de protection de l’environnement et de valorisation de la médecine traditionnelle, a entraîné une augmentation des prélèvements en plantes dans la forêt sacrée et modifié le marché de plantes brutes dans les villages environnants. Dans ce contexte, les chefs rituels locaux rencontrent des difficultés grandissantes à maintenir leur autorité pour assurer la protection de la forêt. Des guérisseurs étrangers, principalement des présidents d’associations de tradipraticiens venus de la capitale, profitent de cette situation pour contester leur légitimité et accéder plus librement aux ressources de la forêt sacrée. L’article analyse les rivalités entre les guérisseurs urbains et les chefs rituels locaux, en mettant en évidence les stratégies de légitimation et les dynamismes sociaux qui sont à l’œuvre.The article analyses the effects of the policy of recognizing ‘traditional’ therapeutic knowledge on a sacred forest located in Ankaratra, near Madagascar’s capital, Antananarivo. This policy was formed by international plans to protect the environment and valorize traditional medicine. It has led to an increase in plants being taken from the sacred forest, and has modified the plant market in the surrounding villages. In this context, local ritual leaders have growing difficulties maintaining their authority to ensure the forest’s protection. External healers, mainly presidents of associations from the capital, take advantage of this situation to dispute the leaders’ legitimacy and so increase their own access to the resources of the sacred forest. This article analyzes the rivalries between urban healers and local ritual leaders by highlighting the strategies of legitimization and the social dynamics which are at work

Epidemic intelligence in Europe: a user needs perspective to foster innovation in digital health surveillance

International audienceBackground European epidemic intelligence (EI) systems receive vast amounts of information and data on disease outbreaks and potential health threats. The quantity and variety of available data sources for EI, as well as the available methods to manage and analyse these data sources, are constantly increasing. Our aim was to identify the difficulties encountered in this context and which innovations, according to EI practitioners, could improve the detection, monitoring and analysis of disease outbreaks and the emergence of new pathogens. Methods We conducted a qualitative study to identify the need for innovation expressed by 33 EI practitioners of national public health and animal health agencies in five European countries and at the European Centre for Disease Prevention and Control (ECDC). We adopted a stepwise approach to identify the EI stakeholders, to understand the problems they faced concerning their EI activities, and to validate and further define with practitioners the problems to address and the most adapted solutions to their work conditions. We characterized their EI activities, professional logics, and desired changes in their activities using NvivoⓇ software. Results Our analysis highlights that EI practitioners wished to collectively review their EI strategy to enhance their preparedness for emerging infectious diseases, adapt their routines to manage an increasing amount of data and have methodological support for cross-sectoral analysis. Practitioners were in demand of timely, validated and standardized data acquisition processes by text mining of various sources; better validated dataflows respecting the data protection rules; and more interoperable data with homogeneous quality levels and standardized covariate sets for epidemiological assessments of national EI. The set of solutions identified to facilitate risk detection and risk assessment included visualization, text mining, and predefined analytical tools combined with methodological guidance. Practitioners also highlighted their preference for partial rather than full automation of analyses to maintain control over the data and inputs and to adapt parameters to versatile objectives and characteristics. Conclusions The study showed that the set of solutions needed by practitioners had to be based on holistic and integrated approaches for monitoring zoonosis and antimicrobial resistance and on harmonization between agencies and sectors while maintaining flexibility in the choice of tools and methods. The technical requirements should be defined in detail by iterative exchanges with EI practitioners and decision-makers