World Health Organization and disease surveillance: Jeopardizing global public health?

Abstract

Health issues now evolve in a global context. Real-time global surveillance, global disease mapping and global risk management characterize what have been termed 'global public health'. It has generated many programmes and policies, notably through the work of the World Health Organization. This globalized form of public health raises, however, some important issues left unchallenged, including its effectiveness, objectivity and legitimacy. The general objective of this article is to underline the impacts of WHO disease surveillance on the practice and theorization of global public health. By using the surveillance structure established by the World Health Organization and reinforced by the 2005 International Health Regulations as a case study, we argue that the policing of 'circulating risks' emerged as a dramatic paradox for global public health policy. This situation severely affects the rationale of health interventions as well as the lives of millions around the world, while travestying the meaning of health, disease and risks. To do so, we use health surveillance data collected by the WHO Disease Outbreak News System in order to map the impacts of global health surveillance on health policy rationale and theory.

Epidemiological surveillance and performance assessment: the two roles of health indicators during the COVID-19 pandemic

“…In 2008, these organisations elaborated a 'Strategic Framework for Reducing Risks of Infectious Diseases at the Animal-Human-Ecosystems Interface', which underlines the importance of 'surveillance and emergency response systems at the national, regional and international levels' (FAO et al, 2008, p. 17). The 'One health' approach is thus consistent with the idea that emerging infectious disease constitutes the main threat to 'global health'a vision that, according to some scholars, tends to concentrate efforts on some specific diseases that present a threat to Western countries at the expense of other ills such as endemic diseases, which nonetheless cause millions of deaths (Blouin Genest, 2015).…”

“…The rise of bacteriologyagainst the miasma theoryas a paradigm for explaining infectious disease confirmed the view that there was a need to control and secure national frontiers from microbial enemies coming from abroad. On the one hand, the idea that diseases are caused by microorganisms that can circulate around the world and, on the other, the increased movements of persons and goods favoured a process of 'bacterial globalisation' (globalisation par les germes) (Rasmussen, 2015) and consequently enhanced the conviction that epidemics had to be dealt with internationally (Blouin Genest, 2015).…”

Communication strategies and media discourses in the age of COVID-19: an urgent need for action

“…When dealing with a PHEIC, the authorities’ communication strategies are embedded in a multilevel and diffuse governance structure, which introduces additional challenges. The WHO has long recognized the importance of communication and information management as key to effective global health governance ( Hyer and Covello, 2005 ; WHO, 2008 , 2020b ; Blouin-Genest, 2015 ; Dye et al , 2016 ; Vayena et al , 2018 ). This is especially important when it comes to the current COVID-19 outbreak, as the objective of the WHO is to ‘communicate critical risk and event information to all communities and counter misinformation’ ( WHO, 2020a ).…”

“…Some issues that could be explored through discourse analysis include the translation process from WHO technical advice to national emergency policies and the framing of national health policy. Identification of the learning processes [or unlearning ( Schiffino et al , 2015 ; Blouin-Genest, 2015 )] and multi-level governance tension in knowledge translation/transmission ( Lyall and Tait, 2004 ; Wilson, 2004 ; Stephenson, 2013 ) could then be evaluated.…”

Data Performativity and Health: The Politics of Health Data Practices in Europe

“…Health data are also deeply embedded in evidence-based public policy-making (Brownson, Chriqui, and Stamatakis 2009). Produced through automated digital systems embedded into everyday life practices (Lupton 2016), health data are now extracted from the consumption of goods and services, online behaviors, tracking devices, financial activities, or cellphone uses (Blouin-Genest and Miller 2017; Blouin-Genest 2015). We are increasingly becoming “digital citizens” (Isin and Ruppert 2015).…”