Environmental Engineering Reference
In-Depth Information
comprehensiveness was often compromised. relevant actors and actions were
excluded from the alternatives assessed and responses chosen. bennett notes that
canada confronted SarS without a 'whole-of-government approach'. Health
ministries went alone to the wHo without their statistics agencies and other relevant
departments at their side. However, benedikte Dal, laura Sunderland, and nick
Drager note that this is starting to change as the wHo's work on health diplomacy
gets underway.
communication is often replaced by closure, cover-up, and criticism. both Hong
Kong, facing avian influenza in 1997, and China, confronting SARS in 2002, at first
refused to report they had a problem and later moved from denial to lie. canada too
disputed the wHo travel advisory against toronto, even though within the country
information was not shared among those involved and the lines of communication
among actors and with the public was very poor.
cooperation, too, is often lacking. canada confronted SarS without federal-
provincial cooperation and a collaborative framework and ethos, as bennett shows.
and Huang's ideal of a strong state working with civil society remains rare.
coordination and coherence are fragile and sporadic. tobacco became a global
pandemic in part because health ministries remain weak and isolated within their
own governments. the SarS outbreak saw a lack of leadership at the highest level
in china and canada, tensions among relevant departments, and even negotiations
among agencies in china for access to samples. and by november 2006, only
60 percent of countries had a national strategy for pandemic preparedness of any
kind. Huang judges that harmonised, holistic strategies remain rare. More broadly,
Khoubessarian emphasises the lack of integration of health with international policy
in the U.S., britain, and canada.
compliance is often weak at all levels. In the SarS case, at the local level, the
refusal of one healthcare worker to comply with a voluntary quarantine led to the
infection of dozens in a toronto religious community. the world bank and the wHo
rely on states voluntarily to survey, report, and enforce quarantines. and as John
Kirton, nikolai roudev, laura Sunderland, and Catherine Kunz show, compliance
with the G8's growing health commitments is the weakest across the six functions
G8 governance performs.
capacity is probably the greatest gap. white and banda as well as bennett note
that the neo-liberal ethos of privatisation, deregulation, and decentralisation have
weakened state capacity on animal health. Healthcare systems, infrastructure, and
personnel remain poor in the developing world. and Huang notes that even the rich
north faces the next avian influenza pandemic with technology from the 1950s,
limited production capacity, and an existing system that may be weakened once the
pandemic hits.
More important is the lack of surplus capacity and adaptive resilience in the
overall healthcare system (Dewitt and Kirton 1983). Price-Smith and Huang highlight
the lack of surge capacity in the face of SarS and avian influenza, as governments
seek to operate their healthcare systems in the most efficient and affordable way.
only in the wHo's response to SarS were there clear signs of the agency slack
