[MUSIC] I will talk to you about Swiss communications in the context of pandemics and epidemics. I have this quote here from the bulletin of the World Health Organization, that emphasizes how much communication is playing a central role in protecting people's health around the world in case of outbreaks of those epidemics or pandemics. And it's something that's recognized as very important today in the way those epidemics and pandemics are being addressed by the international and national level authorities. My outline for this presentation is a definition or some definitions related to risk communication at first. Then to talk to you about public health and risk communication, how this has developed. Then to address some challenges that are raised by risk communication, especially around the H1N1 pandemic in 2009 and 2010, and then a conclusion. First about risk communication. In risk governance, communication is supposed to be at the center and that's what's shown on this figure there. It used to be that communication was sort of at the end of the process, once experts had identified, analyzed and managed risk then they would take care of communication. Today it's considered very important that communication is at the center and there right from the beginning. Risk communication refers to this exchange of information and opinions between the experts, the authorities, the agency, and the public, those who are at risk of a potential pandemic or epidemic. It's a bit different from crisis communication which refers to a critical situation where there are immediate needs for communication. Risk communication usually extends longer over time. How did risk communication developed in the field of public health? I will mostly talk about the World Health Organization at first, and then the Center for Disease Control in the United States. In the World Health Organization, it was an event, an outbreak in 2002, 2003, the outbreak of SAARS, that initiated developments in risk communication. Experts realizing that there was really an issue about communication regarding those outbreaks. And starting in 2004, the agency made some work and produced brochures and guidelines about risk communication. And here you have the objectives of this risk communication, which are a different levels. Risk communication is supposed to improve disease surveillance. We need to know, to have information about the outbreaks to be able to produce surveillance and to know the extent of the disease. It's also supposed to help protective behaviors in the population. If people have to take measures to protect themselves against an epidemic, they need to know about it. And then it's also to have a better use of resources in communities. If people know about the outbreaks, the extents they have, this will also be important thing. The allocation of resources, and then the goal is always to limit confusion. There was some confusion related to thought and the ideas to avoid this situation later on. This figure there is showing the potential objective for impact of risk communication. In red you have what happens before somehow the communication is really setting place and if nothing happens then there would be a much bigger outbreak, a much larger consequences and if risk communication is properly set up at the beginning of the epidemic. In the following show you find some guidelines, some principle about developing with communication. And there is a publication you can find online which describes them. One thing that's emphasized very much is the issue of trust. Communication is about trust. Having the public trust the agencies, the public health authorities is very important. A second principle we first taught announcing early, is not considered very important to talk about it even when there is no evidence, even when no ledge is still limited. Information will circulate anyway so it´s impossible to contain information so, authorities should communicate early. Transparency's also a very important notion, the idea to talk about what we know and also about what is not known, about the uncertainties, even though that can seem a bit scary, it's considered important to be transparent about all those issues. It's very much emphasized, it's important to understand the public. The public has different beliefs, values, positions, opinion about epidemics, and it's important to put an exam into account. And planning is the last principal. And planning refers to this idea that communication is at the center. It's considered that planning must be done right from the beginning about communication. Who will communicate with whom and what will be said as much as possible can be anticipated and that will improve risk communication. Another context in which there is a lot of development in voice communication is the Center for Disease Control in the United States. And there, the reason of these developments were also related to a specific event. It was after 9/11, the anthrax attacks that threatened the country. Undecided, the government, to make developments in this area, to be better prepared for future possible pandemics or epidemics. And you'll find a lot of material online, do you have this crisis and emergency risk communication handbooks that's very developed. With some principle also that are considered as very important. Credibility and trust, are considered as major Issues in a successful communication. So you can see there is an overlap between aspects that are being developed in the WHO and in the United States. Another thing I'd like to emphasize here is on subtitle on this book which is be first, be right, and be credible. Which is the objectives that should be reached by risk communication. And it's quite not easy today I think to be first, to be right, and credible, but this is the goal that should be set. In this context some further epidemics came up and were kind of a test for those principles in real life, and each one and one certainly was a big test in terms of risk communication. And in that context different challenges were raised by different scholars, different publications about the way risk communication was addressed in that context. For the issues related to the academics of the ineffectual disease itself with each one in one issue was the duration of the crisis, it took a very long time time from the early discovery of this virus in Mexico until the epidemic was officially considered as finished. And that was an issue because it's very difficult to continue to keep on communicating over such a long period of time especially if you need to change messages. Because information kept changing over time and different messages had to be given to the population. So that was one major issue. Another big issue that was discussed in that context was the transparency and uncertainty in regards to the [INAUDIBLE] risk communication. Here you have a photo of Margaret Chan, Director of the World Health Organization, who had To discuss the issue of transparency at length because the organization was accused of conflicts of interest because of the experts were involved in decisions. And the World Health Organization took a long time, too long time according to many people, to publish the list of their experts. In the meantime there were issues about conflict of interest that may not still have been resolved. Uncertainty was also an issue. It was blamed later on on the organization that the uncertainty relating to the pandemic was not necessarily made very clear. Elements were produced as facts as evidence. Whereas there was quite some uncertainty which affected the way things moved on over time. Another important dimension in risk communication related to the public because the public is the target of the communication. In today's view about risk communication the public should also be able to talk and bring up it's issues and preoccupation about those pandemics. But the public is very much seen as is too passive or likely to panic and that's some assumptions that are often present in the way the agencies are addressing the public. This is discussed by scholars in social sciences that that's probably too limited a view about the public because this panic isn't factually observed. There is often expectation that the public will be panicking and social science research has demonstrated that it's unlikely in fact. Another issue was brought up, is the focus of the H1N1 communication of persuasion, which goes against those newer principles in which communication, which emphasize the need to discuss, and to exchange information with the public. In that case, it was considered that WHO was trying to persuade the public about the urgency and the need to vaccinate, which was not well received in populations across the world. Interestingly, it's considered today that people will believe many different sources of information and will not trust the public health authorities. But this [INAUDIBLE] data, early November so that early in the epidemic is still showing that professional sources of information as those who are most trusted by the public in Europe. So, I think this is also important to consider that there are many possibilities for professionals to communicate and that the public will still be listening to what is being said. Finally, I would like to talk briefly about the media. Which today also an important partner and important element in the communication about epidemics and pandemics. Studies have shown that there was a very important huge coverage of epidemics, pandemics, throughout the first decade of this century. And so the media really liked to talk about those issues. Interestingly in some cases, the media today are also becoming a source of information for public health authorities. Because sometimes they start reporting on outbreaks before even authorities will go over and let us know about it. And today also there is an idea that there is a metacommunication. The media, the traditional media are important but of course, the social media are also part of the risk communication processes. And the are contributing somehow to the management of the pandemics themselves. And they are an important partner in that process in issues and elements that still need to be researched by a. So I would conclude about the fact that risk communication is certainly a very important element in pandemic epidemics management. It cannot be considered as something minor. That should be done at the end once everything else is solved. That's really something to be considered right from the beginning. It's a very complex process at the same time, as I hope I briefly emphasized it, with many actors who have all sorts of different reactions. And when you put that at the global level considering differences, cultural and social differences among countries, you can see that it's really an important challenge today of the management of epidemics for the future. Thank you. [MUSIC]
