Hostname: page-component-745bb68f8f-b95js Total loading time: 0 Render date: 2025-01-10T21:13:53.182Z Has data issue: false hasContentIssue false
  • English
  • Français

An Uncertain Risk: The World Health Organization's Account of H1N1

Published online by Cambridge University Press:  28 July 2014

Sudeepa Abeysinghe
Sudeepa Abeysinghe*
Affiliation:
University of Edinburgh E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Argument

Scientific uncertainty is fundamental to the management of contemporary global risks. In 2009, the World Health Organization (WHO) declared the start of the H1N1 Influenza Pandemic. This declaration signified the risk posed by the spread of the H1N1 virus, and in turn precipitated a range of actions by global public health actors. This article analyzes the WHO's public representation of risk and examines the centrality of scientific uncertainty in the case of H1N1. It argues that the WHO's risk narrative reflected the context of scientific uncertainty in which it was working. The WHO argued that it was attempting to remain faithful to the scientific evidence, and the uncertain nature of the threat. However, as a result, the WHO's public risk narrative was neither consistent nor socially robust, leading to the eventual contestation of the WHO's position by other global public health actors, most notably the Council of Europe. This illustrates both the significance of scientific uncertainty in the investigation of risk, and the difficulty for risk managing institutions in effectively acting in the face of this uncertainty.

Type
Research Article
Information
Science in Context , Volume 27 , Issue 3 , September 2014 , pp. 511 - 529
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

WHO Press Briefings cited hereafter are accessible at <http://www.who.int/mediacentre/multimedia/swineflupressbriefings/en/index.html>; (last accessed March 13, 2014).;+(last+accessed+March+13,+2014).>Google Scholar
Abeysinghe, Sudeepa. 2013. “When the Spread of Disease Becomes a Global Event: The Classification of Pandemics.” Social Studies of Science 43 (6):905–926Google Scholar
Alaszewski, Andy. 2003. “Risk, Trust and Health.” Health, Risk & Society 5 (3):235–239.CrossRefGoogle Scholar
Atlas, Ronald M. and Reppy, Judith. 2005. “Globalizing Biosecurity.” Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science 3 (1):51–60.CrossRefGoogle ScholarPubMed
Baker, Michael, and Fidler, David P.. 2006. “Global Public Health Surveillance under New International Health Regulations.” Emerging Infectious Diseases 12 (7):1058–1065.Google Scholar
Bashford, Alison. 2006. “Global Biopolitics and the History of World Health.” History of the Human Sciences 19 (1):67–88.CrossRefGoogle Scholar
Bauman, Zygmunt. 1999. Post-Modernity and Its Discontents. Cambridge: Polity Press.Google Scholar
Beck, Ulrich. 1992. Risk Society: Towards a New Modernity. London: Sage.Google Scholar
Beck, Ulrich. 1999. World Risk Society. Cambridge: Polity Press.Google Scholar
Ben Embarek, Peter K. 2009. WHO Press Briefing, May 4. World Health Organization.Google Scholar
Best, Joel. 2001. Damned Lies and Statistics: Untangling Numbers from the Media, Politicians, and Activists. Berkeley: University of California Press.Google Scholar
Briand, Sylvie. 2009. WHO Press Briefing, May 8. World Health Organization.Google Scholar
Caduff, Carlo. 2012. “The Semiotics of Security: Infectious Disease Research and the Biopolitics of Informational Bodies in the United States.” Cultural Anthropology 27 (2):333–357CrossRefGoogle ScholarPubMed
Calain, Philippe. 2007. “Exploring the International Arena of Global Public Health Surveillance.” Health Policy and Planning 22 (1):2–12.Google Scholar
Chan, Margaret. 2009. WHO Press Briefing, June 11. World Health Organization.Google Scholar
Cohen, Jon, and Enserink, Martin. 2009. “After Delays, WHO Agrees: The 2009 H1N1 Pandemic Has Begun.” Science 324 (5934):1496–1497.Google Scholar
Cooper, Melinda. 2006. “Pre-empting Emergence: The Biological Turn in the War on Terror.” Theory, Culture & Society 23 (4):113–135.Google Scholar
Council of Europe PACE Meeting. 2010. Questions and Debate. March 29. The Council of Europe. http://www.assembly.coe.int/CommitteeDocs/2010/20122329 (last accessed June 20, 2010).Google Scholar
Davis, Mark. 2011. “Living ‘Post-Pandemic’ and Responding to Influenza.” The Australian Sociological Association Conference, November 28 - December 1. Newcastle, TASA.Google Scholar
Dean, Mitchell. 2010. Governmentally: Power and Rule in Modern Society. London: Sage.Google Scholar
Dehner, George. 2012. Influenza: A Century of Science and Public Health Response. Pittsburgh: University of Pittsburgh Press.Google Scholar
Dreyer, Marion, and Renn, Ortwin, eds. 2009. Food Safety Governance. Integrating Science, Precaution and Public Involvement. Heidelberg and New York: Springer.Google Scholar
Flynn, Paul. 2010a. Memorandum: The Handling of the H1N1 Pandemic: More Transparency Needed. The Council of Europe, March 23. http://www.assembly.coe.int/CommitteeDocs/2010/20122329_MemorandumPandemic_E.htm (last accessed June 20, 2010).Google Scholar
Flynn, Paul. 2010b. Speech – Paul Flynn, Rapporteur. The Council of Europe, March 29. mms://coenews.int.vod/100329_w01_w.wnv (last accessed June 20, 2010).Google Scholar
Flynn, Paul. 2010c. The Handling of the H1N1 Pandemic: More Transparency Needed. The Council of Europe [Doc no. 12283 – Passed by the Council of Europe, June 24].Google Scholar
Fogarty, Andrea, Holland, Kate, Imison, Michelle, Blood, R. Warwick, Chapman, Simon, and Holding, Simon. 2011. “Communicating Uncertainty – How Australian Television Reported H1N1 Risk in 2009: A Content Analysis.” BMC Public Health 11 (1):181.Google Scholar
Fukuda, Keiji. 2009a. WHO Press Briefing, April 26. World Health Organization.Google Scholar
Fukuda, Keiji. 2009b. WHO Press Briefing, April 29a. World Health Organization.Google Scholar
Fukuda, Keiji. 2009d. WHO Press Briefing, May 6. World Health Organization.Google Scholar
Fukuda, Keiji. 2009e. WHO Press Briefing, May 7. World Health Organization.Google Scholar
Fukuda, Keiji. 2009f. WHO Press Briefing, May 11. World Health Organization.Google Scholar
Fukuda, Keiji. 2009g. WHO Press Briefing, May 14. World Health Organization.Google Scholar
Fukuda, Keiji. 2009h. WHO Press Briefing, May 22. World Health Organization.Google Scholar
Fukuda, Keiji. 2009i. WHO Press Briefing, June 9. World Health Organization.Google Scholar
Funtowicz, Silvio, and Ravetz, Jerome. 1993. “The Emergence of Post-Normal Science.” In Science, Politics and Morality: Scientific Uncertainty and Decision Making, edited by Schomberg, Rene von, 85–123. Dordrecht: Kluwer.Google Scholar
Funtowicz, Silvio, and Ravetz, Jerome. 1994, “Uncertainty, Complexity and Post-Normal Science.” Environmental Toxicology and Chemistry 13 (12):1881–1885.Google Scholar
Giddens, Anthony. 1991. Modernity and Self-Identity: Self and Society in the Late Modern Age. Cambridge: Polity Press.Google Scholar
Giddens, Anthony. 1999. “Risk and Responsibility.” Modern Law Review 62 (1):1–10.CrossRefGoogle Scholar
Giles-Vernick, Tamara, and Craddock, Susan, eds. 2010. Influenza and Public Health: Learning from Past Pandemics. London: Earthscan.Google Scholar
Gollier, Christian, and Treich, Nicolas. 2003. “Decision-Making under Scientific Uncertainty: The Economics of the Precautionary Principle.” Journal of Risk and Uncertainty 27 (1):77–103.Google Scholar
Hacking, Ian. 1999. The Taming of Chance. Cambridge: Cambridge University Press.Google Scholar
Hindess, Barry. 1973. The Use of Official Statistics in Sociology: A Critique of Positivism and Ethnomethodology. London: McMillan Press.Google Scholar
International Health Regulations (IHR). 2011. Report of the Review Committee on the Functioning of the International Health Regulations (2005) in Relation to Pandemic (H1N1) 2009. Geneva: WHO.Google Scholar
Jasanoff, Sheila. 2004a. “The Idiom of Co-Production.” In States of Knowledge: The Co-Production of Science and Social Order, edited by Jasanoff, Sheila, 1–12. London: Routledge.Google Scholar
Jasanoff, Sheila. 2004b. “Ordering Knowledge, Ordering Society.” In States of Knowledge: The Co-Production of Science and Social Order, edited by Jasanoff, Sheila, 13–45. London: Routledge.Google Scholar
Keil, Roger, and Ali, Harris. 2007. “Governing the Sick City: Urban Governance in the Age of Emerging Infectious Disease.” Antipode 39 (5):846–873Google Scholar
Keil, Ulrich. 2010. Introductory Statement by Prof. Dr. Ulrich Keil. The Council of Europe, January 26. http://www.coe.int/t/DC/Files/PA_session/jan_2010 (last accessed June 20, 2010).Google Scholar
Kuhn, Thomas S. 1970. The Structure of Scientific Revolutions. Chicago: University of Chicago Press.Google Scholar
Latour, Bruno. 1998. “Essays on Science and Society: From the World of Science to the World of Research?” Science 280 (5361):208–209.Google Scholar
Lazzari, Stefano, and Stohr, Klaus. 2004. “Avian Influenza and Influenza Pandemics.” Bulletin of the World Health Organisation 82 (4):242–242A.Google Scholar
Levidow, Les. 2001. “Precautionary Uncertainty: Regulating GM Crops in Europe.” Social Studies of Science 31:842–874.Google Scholar
Liess, William, and Hrudey, Steve E.. 2003. “Risk Management and Precaution: Insights in the Cautious use of Evidence.” Environmental Health Perspective 111 (13):1577–1581.Google Scholar
Luhmann, Niklas. 2002. Risk: A Sociological Theory. New Brunswick NJ: Transaction Publishers.Google Scholar
Mack, Eric. 2007. “The World Health Organization's New International Health Regulations: Incursions on State Sovereignty and Ill-Fated Response to Global Health Issues.” Chicago Journal of International Law 7 (1):365–377.Google Scholar
MacPhail, Theresa. 2010. “A Predictable Unpredictability: The 2009 H1N1 Pandemic and the Concept of ‘Strategic Uncertainty’ within Global Public Health.” Behemoth. A Journal on Civilisation 3:58–7.Google Scholar
Marshall, Brent K., and Picou, J. Steven. 2008. “Postnormal Science, Precautionary Principle, and Worst Cases: The Challenge of Twenty-First Century Catastrophes.” Sociological Inquiry 78 (2):230–247.Google Scholar
Martinez, Lindsay. 2000. “Global Infectious Disease Surveillance.” International Journal of Infectious Diseases 4 (4):222–228Google Scholar
Miller, Clark A. 2004. “Climate Science and the Making of a Global Political Order.” In States of Knowledge: The Co-Production of Science and Social Order, edited by Jasanoff, Sheila, 46–66. London: Routledge.Google Scholar
Nerlich, Brigette, and Koteyko, Nelya. 2012. “Crying Wolf? Biosecurity and Metacommunication in the Context of the 2009 Swine Flu Pandemic.” Health and Place 18 (4):710–717.Google Scholar
Nowotny, Helga. 2003. “Democratising Expertise and Socially Robust Knowledge.” Science and Public Policy 30 (3):151–156.Google Scholar
Nowotny, Helga, Scott, Peter, and Gibbons, Michael. 2001. Re-Thinking Science: Knowledge and the Public in an Age of Uncertainty. Malden: Polity Press.Google Scholar
Ravetz, Jerome. 2004. “The Post-Normal Science of Precaution.” Futures 36 (3):347–357.Google Scholar
Renn, Ortwin, and Elliott, E. Donald. 2011. “Chemicals.” In The Reality of Precaution. Comparing Risk Regulation in the United States and Europe, edited by Wiener, Jonathon B., Rogers, Michael D., Hammitt, James K., and Sand, Peter H., 197–202. London: Earthscan.Google Scholar
Rivasi, Michele. 2010. Speech – Michele Rivasi. The Council of Europe, March 29. mms://coenews.int.vod/100329_w01_w.wnv (last accessed June 2, 2010).Google Scholar
Ryan, Mike. 2009. WHO Press Briefing, May 2. World Health Organization.Google Scholar
Shackley, Simon and Wynne, Brian. 1996. “Representing Uncertainty in Global Climate Change Science and Policy: Boundary-Ordering Devices and Authority.” Science, Technology & Human Values 21 (3):275–302.CrossRefGoogle Scholar
Shrader-Frechette, Kristin. 1993. “Probabilistic Uncertainty and Technological Risks.” In Science, Politics and Morality: Scientific Uncertainty and Decision Making, edited by Schomberg, Rene von, 43–60. Dordrecht: Kluwer.Google Scholar
Solantra, Tuomo. 2001. “Post-Normal Science and the Global Climate Change Issue.” Climatic Change 50 (4):395–404.Google Scholar
Stebbing, Margaret. 2009. “Avoiding the Trust Deficit: Public Engagement, Values, the Precautionary Principle and the Future of Nanotechnology.” Journal of Bioethical Inquiry 6 (1):37–48.Google Scholar
Tausczik, Yla, Faasse, Kate, Pennebaker, Jay W., and Petrie, Keith J.. 2012. “Public Anxiety and Information Seeking Following the H1N1 Outbreak: Blogs, Newspaper Articles, and Wikipedia Visits.” Health Communication 27 (2):179–185.Google Scholar
Turnpenny, John, Jones, Mavis, and Lorenzoni, Irene. 2011. “Where Now for Post-Normal Science? A Critical Review of Its Development, Definitions, and Uses.” Science, Technology & Human Values 36 (3):287–306Google Scholar
Wagner-Egger, Pascal, Bangerter, Adrian, Gilles, Ingrid, Green, Eva, Rigaud, David, Krings, Franciska, Staerkle, Chriasian, and Clamence, Alain. 2011. “Lay Perceptions of Collectives at the Outbreak of the H1N1 Epidemic: Heroes, Villains and Victims.” Public Understanding of Science 20 (4):461–476.Google Scholar
Warren, Adam, Bell, Morag, and Budd, Lucy. 2010. “Airports, Localities and Disease: Representations of Global Travel during the H1N1 Pandemic.” Health and Place 16 (4):727–735.Google Scholar
Watson, Rory, 2010. “WHO Is Accused of ‘Crying Wolf’ over Swine Flu Pandemic.” British Medical Journal 340.Google Scholar
Webby, Richard J., and Webster, Robert G.. 2003. “Are We Ready for Pandemic Influenza?” Science 302 (5660):1519–1522.Google Scholar
Webster, Robert G. 1997. “Predictions for Future Human Influenza Pandemic.” Journal of Infectious Diseases 176:514–519.Google Scholar
Weingart, Peter. 2011. “How Robust Is ‘Socially Robust Knowledge’?” In Knowledge and Democracy: A 21st Century Perspective, edited by Stehr, Nico, 143–158. Piscataway NJ: Transaction Publishers.Google Scholar
WHO 2011. Strengthening Response to Pandemics and Other Public-Health Emergencies. Report of the Review Committee on the Functioning of the International Health Regulations (2005) and on Pandemic Influenza (H1N1) 2009. Geneva: WHOGoogle Scholar
Wilson, Kaumanan, Brownstein, John S., and Fidler, David P.. 2010. “Strengthening the International Health Regulations: Lessons from the H1N1 Pandemic.” Health Policy and Planning 25 (6):505–509.Google Scholar
Wodarg, Wolfgang. 2010. Hearing on “The Handling of the H1N1 Pandemic”: More Transparency Needed?” The Council of Europe, January 26. http://www.coe.int/t/DC/Files/PA_session/jan_2010 (last accessed June 20, 2010).Google Scholar