Scoping Meeting

WORLD HEALTH EDITORS NETWORK

ICN, Geneva, 14 March 2006

REPORT

Mike Jempson, MediaWise Trust

INTRODUCTION

The meeting was called by World Health Communications Associates to examine the value and potential of an informal, multi-disciplinary, global network of health journal editors, following earlier discussions in November 2004 and January 2005 (Helsinki).

This follow-up 'scoping meeting' brought together editors from nursing, medical, dental and general health publications from 10 countries.

To provide context, additional sessions were devoted to frank discussion about the ethical and communications issues associated with the prospect of an Avian 'flu pandemic, and the 'news' potential of the World Health Report 2006, scheduled for publication on World Health Day (7 April 2006) under the shared theme 'Working Together for Health'.

The meeting was held under 'Chatham House Rules' - information and opinions may be quoted, but not attributed without prior permission.

AVIAN 'FLU

The prospect of a 'pandemic' has excited public interest but the biggest problem is the provision of reliable and up-to-date information to allow the public, their political leaders, and health professionals to make decisions about protective/preventative measures.

This is an issue both for health experts and for those communicating public health messages, and discussion raised many ethical, political and practical questions.

Who can issue authoritative information, when, and how? The WHO requires samples to be independently tested and a team of experts to agree on the meaning of the findings before authoritative statements can be made. Do key media personnel know what the established testing procedures are so they can ask the authorities the right questions?

Once news of infection reaches the media they need information. An information vacuum allows imprecise and inaccurate stories to begin circulating – especially via the internet, which could also be a source for both rebuttal of rumours and myths and delivery of reliable information. In Egypt recently a rumour that the Nile was infected was combated within two days by distribution of WHO messages via SMS, supplemented by mass media statements – but would such rapid rebuttal techniques be feasible in other settings?

How is an 'outbreak' to be defined? The number of dead birds – evidence that the virus has reached an area/country? The number of infected adults – evidence that the virus has transferred to humans? Human fatalities – evidence that some die without access to treatment? Clusters of deaths – possible evidence that the virus has transmuted into a form that allows human-to-human transmission?

How are societies to be prepared for an outbreak? Reliable information – so individuals can be prepared? Stockpiling of vaccines? Imposed protective and preventative measures?

Who can/should make decisions about prevention and treatment strategies, and priorities – especially as publicity can have damaging social, political and economic consequences?

If trust – which can be both earned and spent – is to be the currency of (WHO) public health communications, how is that trust built? Is there a place for secrecy, or should key health communicators be alerted through confidential briefings to the (specialist?) media. Should health/political leaders be open about the technical and logistical problems faced by health and political leaders?

What methodologies exist to combat/rebut myths and rumours?

What evidence is there that valid health messages are being received, understood and acted upon by the public? What lessons can be learned, and applied, from past experience – HIV & AIDS, BSE, SARS, etc?

More work still needs to be done on measuring the efficacy and effectiveness of health communications, especially on complex public health issues. Is media monitoring enough? Do health journalists covering health stories know enough about effective communication? Do they have a 'campaigning' responsibility or just an 'information delivery and interpretation' function?

'WORKING TOGETHER FOR HEALTH'

The shared theme of the World Health Report 2006 and World Health Day this year is Human Resources for Health, focusing on the global shortfall in health staff.

Such themes emerge from the impact of high level expert and governmental meetings where problems and analysis prompt shared concerns. This one has been around for a while, but it has arisen at a number of high level meetings in recent years at which national government ministers, possibly for different reasons, began take an interest.

Global and internal politics and divergences of opinion hamper smooth and swift production of World Health Reports which nonetheless highlight issues and statistics and contain valuable data. This compendium of raw material may provide a useful reference point for a variety of audiences, but may not lend itself easily or obviously to 'good stories' for the media, especially if, as with this one, the themes have been well rehearsed.

Health journal editors are key audiences for such material since they act as intermediaries between high level public health experts and specific sectors of the health professions, policy makers, the mainstream media and the public.

One of the values of WHEN could be the opportunities it might generate to provide specialist briefings about key issues to inform coverage around WHO theme days, and indicate where related 'good' news stories might be found.

It could also function as a 'quality control' channel for WHO and other agencies to receive feedback on the efficacy of their communication programmes.

WHEN 'RULES OF ENGAGEMENT'

The World Health Editors Network could form a broad 'coalition' between specialist health editors across borders and disciplines, which could help to share specialist knowledge and accelerate country-level responses to health risks.

WHEN could be an informal communication process, providing opportunities for editors of specialist and generalist health journals to 'think globally and act locally' – meeting occasionally, sharing information, gaining specialist knowledge and contacts, networking among colleagues across disciplines and national boundaries, and developing new strategies for disseminating public health messages.

By organising specialist briefings and discussions at significant international health-related conferences WHEN could achieve a dual purpose – those attending could give a higher profile to the importance of (good) communications, and would leave with authoritative stories and fresh contacts.

WHEN could nurture professionalism and collegiality (especially between those in developed economies enjoying press freedom, and those in less developed democracies with more restricted media) by providing a forum for discussion about effective communication in health journalism, ethical issues, and how to shape and develop stories around new research, health risks, etc.

This could open up possibilities for co-ordinating stories and themes (although some may feel that 'campaigning' as such is not the purpose of specialist journals), especially across disciplines. However, the cross-fertilisation of ideas and stories across borders could result in more effective communication of health messages and agenda–setting for the mainstream media. WHEN could operate in effect as a 'network of networks', with members radiating information and ideas to colleagues in national networks.

WHEN might also play a more proactive role:


CONCLUSION


WHEN should not be 'yet another specialist e-group': it should be a dynamic set of professional relationships, strengthened by common interests and occasional mutually beneficial meetings, tagged onto significant international events.

There may be competition within specific market-places between particular titles but there is also a common thread – the desire to communicate reliable public health information. WHEN's primary concern will be to promote the value of high-quality communications and to strengthen the capacities of key health communicators.

Too often, specialist sectors remain isolated from other influences, with the risk that unfamiliar issues that could have important ramifications for the sector are dealt with superficially. More importantly, some market-places are poorly served through lack of resources and expertise. The idea behind WHEN is to bridge demarcations between sectoral and national interests, and to share knowledge and contacts in the interests of improving global public health.

Membership would be voluntary and free; editors would be at liberty to engage when and where it was appropriate, but open to contribute, share and absorb ideas and information. It may open up the way for members to act as correspondents at events others are unable to attend.

In effect, WHEN could operate at a global level in the same way as informal associations of health writers operate at a national level. And by developing relationships with publications around the world editors will facilitate opportunities for professional development as well as new markets for their talents.