What constitutes a “health emergency”

A PHS 795 student makes an important point about the importance of clear communication in population health (and indeed all science of public interest):

Article: http://www.npr.org/sections/goatsandsoda/2016/11/18/502616422/zika-no-longer-global-health-emergency-who-declares

I initially was looking through NPR and what was in the headlines when this article caught my eye. I was going to summarize on the update of Zika that the article mentions, but as I read it, I actually noticed two larger populations health issues. In the first part of the course, multiple lecturers touched on the responsibility of researchers to make their work clearly understood to the public and our “academic oath” in doing good research that helps the greater good, or population health as the case may be. So when I read an article titled “Zika No Longer Global ‘Health Emergency,’ WHO Declares”, I assumed it meant that Zika had finally stopped spreading or was no longer as much of a crisis as it had been. So I was very surprised that when I kept reading, the third paragraph is:

“‘It is really important that we communicate this very clearly: We are not downgrading the importance of Zika,’ Salama says. ‘In fact, by placing this as a longer term program of work, we’re sending the message that Zika is here to stay. And WHO’s response is here to stay, in a robust manner.’ One thing is clear: Zika is still spreading. And microcephaly cases are still growing. ”

To me, these two things are contradictory. It appears the researchers made an effort to clarify their statements, but somehow it was still lost in the headline.  With respect to population health, when headlines like these make the news (that are somewhat the opposite of what the research says), public support for health programs often diminishes which just exacerbates the health issues in the first place. These leads to the second issue: when support for public health programs declines, it is often people who are most at risk that feel the effects first.

The article mentions that pregnant women are most at risk and from my prior knowledge, I believe it is often women from poorer areas So then people with low socio-economic status are the ones who will first and foremost feel the adverse effects of misreporting research. I believe this is one example of how there needs to be better communication between research and the rest of the world.

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3 thoughts on “What constitutes a “health emergency”

  1. I can certainly see the confusion resulting from the contradiction between the article title and content, and I understand your concern regarding public support. If the message of the title spreads, enthusiasm for Zika research may deiminish, funding may be reduced, people may start traveling without taking precautions, pregnant mothers may not take precautions, etc.

    As an infectious disease researcher, this article is terribly concerning. When reading this article and your comments, I couldn’t help but compare the Zika epidemic to other epidemics throughout our history. Let’s take, for example, the malaria epidemic. At one point this outbreak was considered a global health emergency. The state of emergency was then lifted. Now, malaria has been eliminated from the U.S. but remains an epidemic in other countries. Perhaps this gives you optimism for the U.S., but what about other countries? According to the CDC (2016), 3.2 billion people still live in areas at risk of malaria transmission in 106 countries and territories. If public support diminishes for Zika, it is very possible for Zika to be added to the growing list of diseases disproportionately effecting low income countries, making global health goals even more difficult to achieve. In this class, we have discussed how situations that do not affect us directly can still impact us indirectly. I think it is incredibly important to maintain fighting the Zika battle and not jump to any conclusions yet. The author states “we’re sending the message that Zika is here to stay.” I think it is way too early to draw that conclusion.

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  2. I too was confused by the contradictory messages: on one hand Zika is no longer an “international emergency” and on the other it’s a persistent problem. I wonder how much of this is because of how the report framed the issue as opposed to how the WHO communicated it. I’m not familiar with the process behind handling infectious disease emergencies, but I presume that once an “emergency” is declared, certain protocols and streams of funding get activated. The media may have picked up on a routine statement put out by the WHO declaring the end of an emergency phase of dealing with Zika that wasn’t intended to diminish the importance of the public health issue but rather announce a shift in how it was being addressed. It seems to me that the end-to-the-emergency announcement was taken out of context by being placed in the title. To a reader, the title serves as a summary, and in this article that summary is contradictory to what the rest of the article describes. It shows how tricky it is to convey a message. The WHO could have worded its statement differently so that when it stands by itself it doesn’t send the wrong message. Also, the reporter could have crafted a different title that better reflects the content of the article rather than isolating the statement.

    This interested me enough to go to the source (see below). It seems to me that the main point of the WHO statement was that efforts in handling Zika needed to go from temporary (emergency) to sustained. It’s interesting how that message got flipped even though the article was factually correct. What’s troubling is that such a plain statement can be misrepresented or misinterpreted.

    http://www.who.int/mediacentre/news/statements/2016/zika-fifth-ec/en/
    “As a result, the EC felt that Zika virus and associated consequences remain a significant enduring public health challenge requiring intense action but no longer represent a PHEIC [Public Health Emergency of International Concern] as defined under the IHR. Many aspects of this disease and associated consequences still remain to be understood, but this can best be done through sustained research. The EC recommended that this should be escalated into a sustained programme of work with dedicated resources to address the long-term nature of the disease and its associated consequences.”

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  3. I’ve taken a couple of journalism courses, and the title was often stressed as one of the important pieces of an article- as it serves to draw attention to your story, and is generally the first (and sometimes only) thing readers see. Though I agree that the headline could allow people to draw inaccurate conclusions, it is technically accurate, as WHO did say that it no longer represents a public health emergency as defined by the International Health Regulations. However, since the focus of the article seemed to be on the fact that Zika is now considered a long-term public health issue, the title could maybe have stated “Zika now a Long-Term Public Health Challenge, WHO Declares” or “Zika now considered a long-term public health challenge”; or, if they still wanted to use their title, it could maybe benefit from a subtitle (such as:”Zika No Longer Global ‘Health Emergency,’ WHO Declares: Remains a significant public health challenge).

    Like the other commenters, I agree that authors of health information should be aware that not everyone reads the full article, and that some people will take the title at it’s face value. As health professionals, we should be aware of this as we write (and read) other articles.

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