Laëtitia Atlani-Duault

Influenza, Anthropology, and Global Uncertainties

The response to the novel H1N1 influenza (swine flu) pandemic has been overwhelmingly biological and epidemiological in scope. While plans are moving forward on a vaccine, few of the social effects of a truly massive global catastrophe—or the issues of communication, responding to predictable inappropriate reactions, preparation of populations for these effects, or using local population resources in the epidemic—have been well considered. Anthropology can play an important and underutilized role in planning and responding to influenza and other global emergencies. This editorial discusses these issues and makes some preliminary recommendations.

State humanitarian verticalism versus universal health coverage: a century of French international health assistance revisited

The French contribution to global public health over the past two centuries has been marked by a fundamental tension between two approaches: State-provided universal free health care and what we propose to call State humanitarian verticalism. Both approaches have historical roots in French colonialism and have led to successes and failures that continue until the present day. In this paper, the second in The Lancets Series on France, we look at how this tension has evolved. During the French colonial period (1890s to 1950s), the Indigenous Medical Assistance structure was supposed to bring metropolitan Frances model of universal and free public health care to the colonies, and French State imperial humanitarianism crystallised in vertical programmes inspired by Louis Pasteur, while vying with early private humanitarian activism in health represented by Albert Schweitzer. From decolonisation to the end of the Cold War (1960-99), French assistance to newly independent states was affected by sans frontièrisme, Health for All, and the AIDS pandemic. Since 2000, France has had an active role in development of global health initiatives and favoured multilateral action for health assistance. Today, with adoption of the 2030 Sustainable Development Goals and the challenges of non-communicable diseases, economic inequality, and climate change, French international health assistance needs new direction. In the context of current debate over global health as a universal goal, understanding and acknowledging Frances history could help strengthen advocacy in favour of universal health coverage and contribute to advancing global equity through income redistribution, from healthy populations to people who are sick and from wealthy individuals to those who are poor.

Blood libel rebooted: traditional scapegoats, online media, and the H1N1 epidemic.

This study of comments posted on major French print and TV media websites during the H1N1 epidemic illustrates the relationship between the traditional media and social media in responding to an emerging disease. A disturbing “geography of blame” was observed suggesting the metamorphosis of the folk-devil phenomenon to the Internet. We discovered a subterranean discourse about the putative origins and “objectives” of the H1N1 virus, which was absent from the discussions in mainstream television channels and large-circulation print media. These online rumours attributed hidden motives to governments, pharmaceutical companies, and figures of Otherness that were scapegoated in the social history of previous European epidemics, notably Freemasons and Jews.

Public media communications about H1N1, risk perceptions and immunization behaviours: A Quebec–France comparison

During the H1N1 pandemic, governments tailored their communications plans in order to influence risk perception and promote public compliance with the public health plan measures. Considering the volume and the content of calls to flu information centres as indicators of the public risk perception, this mixed method study compares the relation between public communications, risk perception and immunization behaviour in Quebec and France. Results suggest that advocating for clear information and coordination between health authorities and the media promotes adherence to preventive behaviour. However, over-exaggerating the risks and minimizing the population’s agency may undermine health authority credibility.

Is Aleppo the grave of the United Nations

www.thelancet.com Published online November 4, 2016 http://dx.doi.org/10.1016/S0140-6736(16)32122-5 1 3 Security Council. Fourth report of the Organization for the Prohibition of Chemical Weapons-United Nations Joint Investigative Mechanism, S/2016/888. Oct 21, 2016. 4 WHO calls for immediate safe evacuation of the sick and wounded from confl ict areas. WHO News release. Sept 30, 2016. 5 United Nations High Commissioner For Refugees. Syria: UNHCR fl ash update. Oct 3, 2016. 6 United Nations offi ce for the Coordination of Humanitarian Aff airs. Syria: Aleppo Crisis Situation Report No. 2. Oct 1, 2016. 7 United Nations offi ce for the Coordination of Humanitarian Aff airs. East Aleppo Crisis— Situation Report No.4. Oct 9, 2016. 8 United Nations offi ce for the Coordination of Humanitarian Aff airs. Turkey | Syria: Flash Update—Developments in Eastern Aleppo. Oct 27, 2016. 9 World Food Programme. Eastern Aleppo city in distress; humanitarian assistance vital for food security in besieged areas. Syria Mobile Vulnerability Analysis and Mapping Bulletin 7. September, 2016. 10 United Nations Children’s Fund. Syria Crisis— September 2016 Humanitarian Results. 11 United Nations News Centre. Ban calls on UN Security Council for decisive steps to end attacks on hospitals, medical staff . Sept 28, 2016. 12 United Nations News Centre. ‘Crimes of historic proportions’ being committed in Aleppo, UN rights chief warns. Oct 21, 2016. Is Aleppo the grave of the United Nations?

Information Circulation in times of Ebola: Twitter and the Sexual Transmission of Ebola by Survivors

Introduction: The 2013-2015 outbreak of Ebola was by far the largest to date, affecting Guinea, Liberia, Sierra Leone, and secondarily, Nigeria, Senegal and the United States. Such an event raises questions about the circulation of health information across social networks. This article presents an analysis of tweets concerning a specific theme: the sexual transmission of the virus by survivors, at a time when there was a great uncertainty about the duration and even the possibility of such transmission. Methods: This article combines quantitative and qualitative analysis. From a sample of 50,000 tweets containing the words “Ebola” in French and English, posted between March 15 and November 8, 2014, we created a graphic representation of the number of tweets over time, and identified two peaks: the first between July 27 and August 16, 2014 (633 tweets) and the second between September 28 and November 8, 2014 (2,577 tweets). This sample was divided into two parts, and every accessible publication was analyzed and coded according to the authors’ objectives, feelings expressed and/or publication type. Results: While the results confirm the significant role played by mainstream media in disseminating information, media did not create the debate around the sexual transmission of Ebola and Twitter does not fully reflect mainstream media contents. Social media rather work like a “filter”: in the case of Ebola, Twitter preceded and amplified the debate with focusing more than the mainstream media on the sexual transmission, as expressed in jokes, questions and criticism. Discussion: Online debates can of course feed on journalistic or official information, but they also show great autonomy, tinged with emotions or criticisms. Although numerous studies have shown how this can lead to rumors and disinformation, our research suggests that this relative autonomy makes it possible for Twitter users to bring into the public sphere some types of information that have not been widely addressed. Our results encourage further research to understand how this “filter” works during health crises, with the potential to help public health authorities to adjust official communications accordingly. Without a doubt, the health authorities would be well advised to put in place a special watch on the comments circulating on social media (in addition to that used by the health monitoring agencies).