Environmental Engineering Reference
In-Depth Information
there is now a veritable profusion of innovation, generating considerable
competition and choice. the task is not only to increase the supply, but also to assess
which of the many new innovations actually work in the intended or in an otherwise
effective way. only then can the best be selected, spread, institutionalised, and built
upon as the foundation for a new global health system in the years ahead.
Systemic Responsiveness
not all innovations work well in the predicted and desired way. Some, such as the
still outstanding vaccine against HIv/aIDS, arrive too late, if at all. others, such as
the human right to health, sound good in principle but are poorly complied with in
practice. other intuitively attractive ideas may also not be fruitful, such as using the G8
summit to mobilise money when it makes commitments for heath causes, as this does
not significantly increase member governments' compliance in the following year.
and the entire repertoire of recent innovation is self-evidently inadequate given the
high cost in human life and environmental, social, economic, and security values that
the contemporary globalised health challenge creates. It is thus important to assess the
responsiveness, appropriateness, and effectiveness of the innovation that the current
system of global health governance now brings. only on such a basis can the many
and sometimes conflicting policy recommendations offered by the contributors in this
volume be evaluated for the value, priority, and urgency they contain.
Responsiveness
responsiveness refers to the speed with which the desired innovations come, both
before and after the standard responses have failed. Here the spectrum runs from non-
existent or very slow innovation through timely and immediate novelty to proactive
and preventive measures to solve the problem before it arises and spreads.
at times innovations do come before the outbreak or spread of the disease.
as Kamradt-Scott shows, in 1995 wHo members instructed the organisation's
bureaucracy to revise the IHr. the process of revision and replacement was still
underway when the SarS epidemic broke out, but it helped give the wHo the
justification to mount a fast response. lo notes that preparedness, while absent in
the case of SarS, has led to precautionary action before the next case of pandemic
avian influenza. Similarly, the 1995 bSe outbreak led the european Union to act
against a recurrence of either it or another similar disease. but still the precautionary
principle, which has flourished in global environmental governance, is more often
applauded than applied in the field of global health.
when the challenge arises or reaches a critical threshold of cumulative spread,
there is a wide range in the rapidity of the innovative response. During the SarS
oubreak, Hong Kong, due to its earlier experience with avian influenza in 1997,
moved quickly, as did Singapore and the wHo. but china took three months before
it moved decisively with new openness. canada underestimated the speed with which
