1. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Module 4: IHR Risk Communication Capacity: Listening through Dialogue

2. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Risk Communication in Practice Old Model: One-way communication to inform New Model: Two-way communications to dialogue Old Objective: Warn of risk New Objective: Partnership to co- manage risk

3. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Anthrax: United States 2001 Deliberate spread through postal system – 22 victims, 5 deaths. Saturday USCDC identifies new risk: letter processing machines could aerosolize anthrax spores Recommendation: antiobiotics for anyone working near machines Ciproflaxin originally recommended, but doxycycline found to be effective, available and cheaper

4. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Anthrax: United States 2001 What Happened? Message factually accurate, complete Postal workers reacted angrily Politicians and media celebrities had received Cipro (brand name) Allegation of favouritism (even racism) Direct impact: delayed risk prevention Indirect impact: eroded broader trust in CDC

5. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Marburg: Angola 2005 April to July: 300 deaths GOARN deployment Local suspicion of response teams Rejection of infection control recommendations Isolated violence

6. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Marburg: Angola 2005 White associated with the supernatural (PPE) Covered faces of medical workers raised suspicion Villagers prevented from following local burial traditions Those taken into isolation were never seen again Local communication channels and trusted leaders deployed

7. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Perceptions Beliefs Family and society Sources of information Socio-economic status Politics Culture Education Listening: Factors to Consider

8. Pan American Health Organization World Health Organization Pandemic and Outbreak Communication PAHO/WHO Listening through Dialogue IHR Risk Communication Capacity: Listening through Dialogue 1.Gather and assess existing community cultural, language and socio-economic profiles 2.Adopt listening/dialogue templates and tools for use in emergencies 3.Ensure an efficient information gathering system is in place and plan to reflect its findings into decision making processes