This important and thought-provoking work offers a detailed and wide-ranging discussion of the global public health challenges posed by emerging infectious diseases. Whilst centred on Avian Influenza in both the main discussion and the detailed case studies, the notion of ‘One World, One Health’ and the challenging questions of ‘Whose World?, Whose Health?’ are woven throughout the book.
The opening chapters of the book focus on the international response to Avian Influenza, examining the role of disease narratives in shaping the problems, the solutions and the outcomes. The dominant, competing ‘outbreak narratives’ of a bird disease with agricultural and livelihood issues, a human disease with potentially catastrophic public health consequences and an humanitarian disaster requiring pandemic preparedness strategies are presented. Each has mobilized different sets of global actors, networks and policy responses over the past decade. Yet, Scoones argues, there are alternative narratives, largely obscured or overlooked, which focus on the underlying causes and patterns of new diseases; on poverty, equity and livelihoods and on issues of access and global governance. It is these debates and the multiple perspectives they offer, that are central to the future understanding and management of emerging diseases.
The central four chapters use a comparative approach to examine what happened when international responses to Avian Influenza met national and local contexts across the disparate nations of Cambodia, Vietnam, Indonesia and Thailand. The authors present rigorous analyses of the policies selected in each country and the outcomes of these, with reference to the unique cultural, ecological, political, economic, historical and risk-based contexts. Field-based interviews and discussions with a wide range of individuals and organizations are combined with extensive material from local, national and international sources. Together these reveal the multiple narratives at work and the dazzling complexity of disease control and surveillance efforts.
An analysis of the lessons learnt from the Avian Influenza pandemic and the challenges for the ‘One World, One Health’ agenda forms the basis for the concluding chapter. The themes of uncertainty, resilience, adaptability, diversity, learning, innovation and integration run through many of the ten discussion strands. These in turn point to ten areas of action necessary for a fundamental shift in international disease response strategies.
This engaging and illuminating book, which stresses so eloquently the need for multi-disciplinary approaches will appeal to a diverse readership. It should be read not only by those from medical, veterinary and ecological backgrounds but by anthropologists, sociologists, political scientists and anyone with an interest in the future of global public health.
