Uncertain science : H1N1 and the World Health Organisation

Abstract

On the 11th June 2009, the World Health Organisation (WHO) declared the spread of influenza A/H1N1 virus to constitute a pandemic event. This declaration, the first in 40 years, resulted in the implementation of pandemic preparedness plans and reinforced expectations of an imminent global catastrophe. However, H1N1 failed to produce high morbidity and mortality, leading to criticism of the WHO's actions. Through the analysis of WHO documents, this thesis examines the Organisation's representation and management of the H1Nl pandemic. The thesis also examines texts produced by the Council of Europe, a key critic of the WHO, to demonstrate the contestation of the WHO's narrative and the fluidity of scientific fact-making surrounding the phenomena. Through the perspective of the sociology of scientific knowledge, and drawing upon the sociology of risk and the sociology of institutions, the research explores the way in which the WHO's representation of H1N1 was rendered vulnerable to contestation, and examines the social context in which the WHO was acting.

The thesis argues that the WHO's construction of H1N1 was susceptible to contestation due to its instability as a scientific fact. The WHO's construction was fragile in a number of fundamental aspects, including: representations of the nature of the virus; the categorisation of H1N1 as a 'pandemic'; the construction of a robust risk discourse, and; the management of HINI through the means of mass vaccination. These unstable narratives were a product of the social context surrounding HINI, which included: the presence of a high level of scientific uncertainty surrounding the virus; the previously black-boxed and ill-defined nature of key concepts surrounding the event, such as 'severity' and 'pandemic'; the institutional structure of the WHO, and; the contemporary structuring of global public health. Overall, the thesis demonstrates that while pandemic events are a matter of public concern, they are not matters of (incontestable or objective scientific) fact. Furthermore, it illustrates the context of scientific uncertainty in which decision making institutions must act in the management of contemporary global risks. This analysis thereby demonstrates the need for a critical sociology of infectious disease, and contributes to an understanding of the construction and management of contemporary global risks.