Environmental Engineering Reference
In-Depth Information
organisations such as the World Health Organization (WHO) can play a critical role,
both at the very top, in the person of Gro Harlem brundtland exercising leadership,
and at lower levels from committed individuals equipped with both scientific
expertise and policy skills. as Kamradt-Scott shows, the case of SarS shows these
levels coming together to produce a most forceful wHo response.
Actions
Yet in most instances these many new actors still behave in old ways, with their
built-in repertoire of instruments, standard operating procedures, and inherited
knowledge. they behave in semi-conscious fashion as cybernetic actors responding
to a few stimuli, rather than as analytically rational decision makers comprehensively
assessing all inputs and alternatives to choose the optimum one (Steinbruner 2002).
they thus respond with routines that can make the challenge even worse.
Across the five cases, the tendency is for sovereign governments to assume and
assert control and to deny or suppress knowledge of the problem while they treat it in
traditional ways. In the case of SarS, this was through standard medical techniques.
with HIv/aIDS in South africa, it was on the basis of unproven theories that disputed
the links between HIv and aIDS and that privileged traditional local foods such as
beetroot rather than antiretroviral therapy (art). the resurgence of polio in nigeria
was also fuelled by local governments responding to vaccines as the malevolent
instruments of outside imperial powers. and the rules for the canadian International
Development agency (cIDa) prevent canada's official development assistance
(ODA) from financing physical infrastructure or salaries in recipient states.
compounding this tendency is the instinct of multilateral organisations to defer
to the sovereign prerogatives of their member states. thus Kamradt-Scott shows
that at the start of the SarS case the wHo acted according to its constitution,
which empowers it to 'perform duties assigned to the Organization' by its members.
Similarly bennett notes that the world bank, using its standard method, declared
that Brazil lacked the capacity to deal effectively with HIv/aIDS.
At the same time, the routines of other actors make for a contested field. Private
firms overwhelmingly invent and produce new medicines for the lucrative market in
rich countries, rather than the medicines for neglected diseases primarily of interest
to the poor. the internet meant that news about SarS leaked into china. as Sonny
Shiu-Hing lo shows, mass publics demanded actions that were not always optimal,
such as temperature-testing equipment at airports in the case of SarS and refusing
to demand pandemic preparedness plans once the SarS crisis has passed.
this reliance on old routines is often grounded in an attachment to existing
knowledge and ideas. the success in eradicating smallpox still serves as a model
for combating other infectious diseases. the almost millennium-old technique of
quarantine remains a core part of the repertoire in a now much more globalised age.
the three health goals of the Millennium Development Goals (MDGs) reflect in part
a theory of how health could best contribute to development, and have thus relegated
to second place key health objects such as access to affordable medicines for HIv/
