Ann C. Keller

Managing Transboundary Crises: Identifying the Building Blocks of an Effective Response System

In recent years, crises have become increasingly transboundary in nature. This exploratory paper investigates whether and how the transboundary dimensions of crises such as pandemics, cyber attacks and prolonged critical infrastructure failure accentuate the challenges that public and private authorities confront in the face of urgent threats. We explore the transboundary dimensions of crises and disasters, discuss how an increase in ‘transboundedness’ affects traditional crisis management challenges and investigate what administrative mechanisms are needed to deal with these compounded challenges. Building on lessons learned from past crises and disasters, our goal is to stimulate a discussion among crisis management scholars about the political-administrative capabilities required to deal with ‘transboundary’ crises.

Evolving strategies, opportunistic implementation : HIV risk reduction in Tanzania in the context of an incentive-based HIV prevention intervention

Background Behavior change communication (BCC) interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection. Methods In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction. Results We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence. Conclusions Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting the latent demand for STI testing should receive renewed attention as part of innovative new combination interventions for HIV prevention.

Going for the Cure: Patient Interest Groups and Health Advocacy in the United States

Citizen groups, though celebrated during their sudden arrival on the lobbying scene, are vastly outnumbered by groups representing elite, occupationally based interests. Sensitive to the odds that nonoccupational groups face, this study asks what factors have allowed patient groups to form and become active in federal politics. Using three distinct data sets--a survey of patient groups, content analysis of group websites, and in-depth interviews with group representatives and policy makers in Washington, DC--this study assesses the activities of patient groups in the United States and argues that patient advocacy organizations garner stability from the relatively easy provision of selective and solidary benefits. Larger patient groups are especially likely to make use of these structural advantages to pursue congressional lobbying strategies. However, even these groups seek out noncompetitive, distributive political environments. Moreover, the study finds that patient groups rarely form coalitions across diseases, forgoing the potential to collectively speak for shared patient interests.

The disposition of excess weapons plutonium: A comparison of three narrative contexts

The Nonproliferation Review/Winter 1998 20 Alexandra von Meier, who received her Ph.D. in Energy and Resources from U.C. Berkeley in 1995, is an Associate Specialist at the Center for Nuclear and Toxic Waste Management. Jennifer Miller is a doctoral candidate in the Department of Rhetoric, and Ann Keller is a doctoral candidate in the Department of Political Science, all at the University of California, Berkeley. THE DISPOSITION OF EXCESS WEAPONS PLUTONIUM: A COMPARISON OF THREE NARRATIVE CONTEXTS