Environmental Engineering Reference
In-Depth Information
effects of public health emergencies. they argue that SarS exposed the vulnerability
of existing governance structures, and that the great fear generated by the failure of
governments to control the disease had significant ramifications for the domestic
economies of affected states. these proved to be a catalyst for structural change. the
chinese and canadian experiences show how fear prompted large-scale population
flight, avoidance of public spaces and significant decreases in consumer spending
and investor confidence. Combined with an increase in healthcare delivery costs,
this took a heavy economic toll on both countries. The significant economic impacts
and the intense negative international scrutiny of government failings increased the
prominence of public health issues among political elites. they created transparency
and incentives for more proactive approaches to dealing with other pressing public
health issues. the case shows that states need to be more proactive in preparing
for unforeseen public health emergencies. SARS has led to significant macro-level
innovations at the domestic level in affected countries, most notably in china, as
well as to strengthening regional cooperation on public health in southeast asia.
However, it has not had a significant impact on global health governance. It did
highlight the antiquated nature of the IHr reporting model and temporarily increased
the power of the wHo. but it has not increased states' compliance with international
health regimes or the WHO's long-term influence.
In chapter 3, 'lessons from SarS: Past Practice, Future Innovation', carolyn
bennett emphasises knowledge improvement and dissemination, collaboration, and
leadership in improving global health outcomes. while SarS highlighted many
areas of structural weakness, most notably how governments communicated with
each other and with citizens, some jurisdictions performed admirably. Singapore
designated one hospital to treat cases, performed contact tracing within 24 hours
of case admission, held regular news briefings to share facts and uncertainties, and
provided advice to citizens on how to protect themselves from infection. It thus offers
a model for emulation and adaptation elsewhere. In canada SarS led to learning
and innovation through the creation of a fact-finding mission, the results of which
generated the political will to create the Public Health agency of canada (PHac) and
the position of chief medical officer of health at the federal level. But governments
must re-learn what public health means. there is merit in community-based 'bottom-
up' initiatives, such as thailand's community health liaisons. nGos need to be
included in public health planning and more emphasis must be placed on addressing
the social determinants of health. Finally, there is a need for government candour on
public health issues, requiring a shift in culture to be able to admit challenges and ask
for help from the international community through the wHo. effective global health
governance requires fostering relationships based on respect and trust and a model of
transparency and equity, evidence-based policy, and citizen engagement.
In chapter 4, 'the wHo and SarS: the challenge of Innovative responses to
Global Health Security', adam Kamradt-Scott examines the role and authority of
the wHo during the SarS crises. He responds to positions taken by David Fidler,
andrew cortell, and Susan Peterson that the wHo was guilty of 'agency slack',
exceeding its authority and mandate and engaging in unauthorised, unprecedented,
