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laheadle 26-Apr-2010
However, the Europeans resolved to channel their aid directly to local district authorities, bypassing the central government. This would prevent its use for political purposes, or so it was hoped. link »
Local government officials earn meager salaries, but are enormously powerful because they control access to food aid programs, fertilizers, educational opportunities, jobs, plots of land, small business loans, and even health care. 15 The opposition groups unsuccessfully petitioned the US and other donors to fund independent poll monitors, but when the EPRDF won 99.99 percent of the seats, US officials said they could not comment on the fairness of the elections because they hadn’t monitored them. 16 link »
In December 2009, the Western press began publicizing these stories, and the donors finally agreed to conduct a study of the “distortions” in the uses of aid in Ethiopia. However, this investigation will be overseen by the government. link »
For years, Ethiopia’s foreign donors supported a fledgling human rights community that provided voter education, documented political repression, and advocated for the rights of rape victims, abused children, the blind, deaf, and other vulnerable groups. In response to increasing criticism from some of these groups, the government recently enacted a Charities and Societies ( CSO ) law, forbidding them from receiving all but minimal funding from non-Ethiopian sources. Since few Ethiopians can afford to donate to charity, numerous human rights programs have shut down. The donor agency officials who once supported these programs have protested in internal reports and private meetings with the prime minister, but their public pronouncements have been conciliatory. link »
Government officials claimed that in 2005, 87 percent of children had received all major vaccines, but an independent survey suggested that the figure was closer to 27 percent. 33 Similarly, the fraction of women using contraception was 23 percent, not 55 percent as government officials claimed. The annual growth in farm production was also probably nowhere near the government’s own figure of 10 percent. 34 link »
During the nineteenth century, as the European powers were carving up the rest of East Africa into colonies, Amhara rulers from the northern highlands extended their power southward and established the boundaries of what would become Imperial Ethiopia. As they did so, they seized land, exacted tribute, and turned the once independent peoples of this region into serfs. When the last emperor, Haile Selassie, was overthrown in 1974, the new regime immediately enacted a land reform program that assigned each former serf a plot of his own. This was fine for one generation, but in rural Ethiopia, women have on average six surviving children. Now, thirty-five years later, millions of peasant families live on plots too small to support them. 35 The government retains all property rights, so if the poor leave their tiny plots, they lose their only asset. Most remain where they are, living on the verge of starvation. link »
As one farmer, who keeps his support for the opposition party a secret, told Human Rights Watch in 2009, “I am a member of EPRDF because I need relief assistance…. The list of receipts—the proof that I am paying my dues to the party—are required to get [it].” 38 link »
The problem with foreign aid in Ethiopia is that both the Ethiopian government and its donors see the people of this country not as individuals with distinct needs, talents, and rights but as an undifferentiated mass, to be mobilized, decentralized, vaccinated, given primary education and pit latrines, and freed from the legacy of feudalism, imperialism, and backwardness. It is this rigid focus on the “backward masses,” rather than the unique human person, that typically justifies appalling cruelty in the name of social progress. link »
www.nybooks.com/
articles/ archives/ 2010/ apr/ 20/ cru · Original page -
laheadle 22-Apr-2010
In the spring, from April to June, we found that schools closely followed school dismissal guidance developed by the CDC. For example, on April 26, 2009, the CDC advised schools to consider closing when they had a confirmed or suspected case of H1N1, and we found that schools adhered to that advice. On May 4 th , the CDC revised the guidance to state that schools should not close unless there was a magnitude of faculty or staff absenteeism that interferes with the school’s ability to function. And fewer schools closed, and many that were closed re-opened. link »
The lesson we learned this spring was not only that schools follow CDC’s advice on flu-related issues, but also that quickly closing a school is a complex undertaking that has consequences beyond the loss of valuable and desperately needed school time link »
we need to design a tracking system that provides accurate and on-time data on school dismissals link »
The new voluntary system includes daily direct reporting from state and local agencies, as well as daily systemic searches and confirmations of media reports. link »
SEC. SEBELIUS: -- the early yields were significantly lower than they had predicted when we started this modeling in May. SEN. LIEBERMAN: Right. SEC. SEBELIUS: That has been corrected. They now have yields which are back up to where they thought they would be. So we anticipate, again, a much more robust production line. And some of the early lines, the new lines of production, particularly the fill and finish, had some early glitches—a hard rollout, if you will, that they were trying to ramp up. But both have been corrected. And we are in daily contact with the manufacturers. SEN. LIEBERMAN: Okay. So your goal is—and you predicted, in a way guaranteed, that there will be enough vaccine to vaccinate every American who wants to be vaccinated. But am I right that there is not now enough vaccine to vaccinate every American who now wants to be vaccinated? SEC. SEBELIUS: That’s correct, Senator. Right now we are at a point where the demand is ahead of the yield. link »
But we anticipate, Senator, that there are still hundreds of millions of Americans who are potential victims of the flu who haven’t gotten the flu who will be protected by the vaccine and what the scientists are urging is even if people experience flu earlier this spring or this fall to go ahead and get the vaccine because as different strains develop over the course of the flu season, it will immunize them for what’s likely to come. link »
The chairman raised the issue of the fact that our country has largely lost the capability to produce vaccines and we have to rely on companies that are located in other countries. Is the—and it’s my understanding that a major reason that we’ve lost that capability is because of liability concerns. Is the administration developing any kind of plan or recommendations to try to ensure that we have the capability to produce vaccines right here in the United States? SEC. SEBELIU link »
SEN. COLLINS: Thank you. Speaking of liability, Secretary Duncan, in Maine many schools systems have stepped up to the plate and are conducting school based vaccination clinics. But the issue of liability has arisen in the state of Maine of whether schools that administer these vaccines could potentially be held liable in the rare case that there is an adverse reaction to the vaccine. The governor of Maine has attempted through an executive order to deal with this issue. But is this an issue that you’re hearing about from school systems? SEC. DUNCAN: It’s obviously a really important question and we’re thrilled that your schools are stepping up. We want schools to be part of the solution and young children being such an at risk and vulnerable population, it makes logical sense that schools do vaccination clinics. In all likelihood schools won’t be liable, which is the good news. Schools that are being used as vaccination distribution sites are generally protected by the PREP Act and this law protects school districts and their employees from liability for claims that may result from administration of the H1N1 vaccination in schools. So unless someone’s intentionally doing something to harm a child, they’re going to be protected. link »
SEN. MCCAIN: Are you worried about hospital overutilization, lack of capacity in the hospitals in America? SEC. SEBELIUS: Well, as Secretary Napolitano said, about $3 billion has been pushed out over the last number of years for surge capacity. What we’re trying to do is minimize the demand of the worried well on hospitals, which is why a lot of the self-evaluation tools, a lot of the information on the Flu.gov website is trying to get people to the point where they understand they don’t need to show up at the hospital unless certain situations are present. link »
SEN. MCCAIN: Thank you. Secretary Duncan, it may not be a large item in the scheme of things, but when you close schools, parents have to stay home with the children. Some of those are health care providers. What’s the answer? SEC. DUNCAN: The answer is we’ve worked extraordinarily hard to dramatically reduce the number of schools that are closed. And those numbers are down—I mentioned in my testimony—down very significantly from the peaks in the spring. link »
We do have five manufacturers at this point. That’s up from two in 2004. We have been investing—HHS has been investing in helping build capacity around the world. It not only is important here in the United States, but having—we’re now in a situation where also much of the world relies on our manufacturing capacity to, again, supply vaccine. So helping other nations around the world build capacity to take care of their own populations is part of that multiyear investment. But I think you’re absolutely right. We need to refocus on more internal manufacturing capacity, and again, new technology, because we’re still using vaccination technology of a number of decades ago. So we need to accelerate the cell-based technology that could more rapidly get from a virus identified to a vaccine. link »
we identified early on some of the challenges of getting to high-risk populations in a variety of ways. So, in addition to the normal sites, we asked very early on for our state and local partners to think carefully about sites that would be available to encourage hard-to-reach populations to get vaccinated. And that’s going on. We’re working closely with the faith-based outreach office for not only HHS’s office, but the White House’s office, to talk about how we reach into communities where people may not be presenting themselves traditionally for seasonal flu but to get the word out. We’ve had an enormous effort outreaching to not only the African- American press—radio, TV, print—but also the same thing in the Latino community and working with tribal leaders to try and make sure that information is available. So that combination, we hope, will not only get the word out, but hope to encourage people that— SEN. BURRIS: To go get vaccinated. SEC. SEBELIUS: -- it’s safe and secure. You bet. link »
I think, again, what you have is folks who traditionally maybe didn’t trust. And this is where I think schools are so important. There’s a level of trust. Every low-income minority child hopefully is in school. They have a relationship with the teacher. They have a relationship with the principal. And so having schools as sites to be vaccination clinics, I think, is hugely important. They know the families. They know the community. And they can say, “Hey, this is important to do.” And again, this is always going to be parental consent. We’re not going to mandate anything like this. But having schools step up in, you know, whether it’s an urban or rural areas in Illinois and around the country, I think, is hugely important. So far I’ve been just extraordinarily impressed by school officials’ willingness to be part of the solution here. link »
e have, among other things, a sort of “medical reserve corps,” that came together after 9/11 -- about 200,000 people identified, some of whom are medical personnel, who are retired, others are volunteers, to help with the triage situation. We have about 6,500 commissioned corps members who are able, in situations, to be deployed if needed—so, people who can move around to areas. But, for instance, here in Washington I visited one of the surge hospitals. There is a facility set up here in D.C.—and there are five of these around the country, designed specifically so that, as local hospitals would reach capacity, you would actually have a unit that would come into high readiness—who could figure out where to send patients, where to send personnel, who is ready and able to do just that. So the infrastructure, I think, for planning is there. What you see right now, in some of the tent situations, and there are hospitals with tents, they have wisely decided rather than having a potentially very sick person sit in an emergency room—and cough and sneeze on everyone around him or her, sharing the virus, to actually triage those folks in a more isolated situation outside. So some of what you’re seeing is really the planning, that the secretary has talked about, being implemented—how we separate people who really may need to be eventually in the hospital, but had to make them, make sure that they don’t make other people sick while they’re waiting to be seen. link »
SEN. MCCASKILL: So that we can have some perspective of what the numbers are that we can confirm, what are the confirmed deaths to H1N1 this year compared to what the typical deaths of regular flu would be in a year? SEC. SEBELIUS: I’m going to get you the accurate information—I mean, I know we have 86 confirmed pediatric deaths, confirmed H1N1 pediatric deaths, and that is as high, if you average the last several flu seasons, as we have in the entire flu season. So that is a high number, because obviously the kids don’t die— SEN. MCCASKILL: Right. SEC. SEBELIUS: -- with seasonal flu. SEN. MCCASKILL: And the overall numbers, what are they regardless of pediatric or otherwise? SEC. SEBELIUS: What I’ve been told by Dr. Schuchat is that’s really the number that is probably the best number to track that, and hospitalizations, what we know now is 90 percent of the hospitalizations are the under 25 year olds, which is a very different number than we see in seasonal flu. So those trends are really what we’re—we are still significantly, I mean, 36,000 people every year die from the seasonal flu. About 200,000 are hospitalized, so we’re significantly below those numbers but this is a very different population and it’s moving. link »
And let me just note that our planning has assumed that there would be some gap period between when vaccine would be commonly available and when the flu would actually be present. In other words, we have assumed a lag time between the flu spiking and vaccine availability. So if you were to look at the planning you would see that that was built in. link »
nd Mr. Chairman, I would tell you that our flu.gov website, which early on was constructed as a sort of one-stop shop, is now getting 5 million hits a week. So people are using that tool, and I think that’s very good news, because it gives some regular, detailed, scientific information on a consistent basis. link »
First of all, we’ve got a greatly enhanced surveillance system, so the numbers that we’re giving you, probably two or three years ago would have been anecdotal, at best. The system is very critical to monitoring what we’re doing and to making sure we have adequate supplies of materials and vaccine, and we can have that—rely on the fact that we’re getting accurate numbers. We have an expanded testing capability, again, that—thanks to the planning work that’s been done, intensely monitoring changes in the virus around the U.S., but also across the world. We need to know what’s happening with this virus so, again, we stay out ahead of it, and using a variety of systems to do that. The efforts improve our understanding of the magnitude and, really, the trajectory of what we’re seeing and help us stay ahead of it. link »
mail.google.com/
mail/ ?ui=2& ik=2e5d91c799& view=at · Original page -
laheadle 21-Apr-2010
he next step in this pressure campaign is the sanctions regime being crafted by Stuart Levey, undersecretary of the Treasury for terrorism and financial intelligence. This will have several interlocking components: The showpiece will be a new U.N. Security Council resolution to add sanctions against the Iranian Revolutionary Guard Corps and its affiliated companies, along with other Iranian firms involved in manufacturing, transporting and financing weapons shipments and other illicit activities. But that's just the beginning. link »
The administration knows the resolution will be watered down by Russia and China, but it wants the U.N. sanctions anyway -- as a platform for additional measures by the United States and its allies. It's these private and unilateral sanctions that will have real bite: As the Iranians try to evade them, their deception will trigger additional punitive measures. "If you focus on bad conduct, their evasion doesn't undermine sanctions but escalates them," explains one senior official. link »
An example of how the sticky trap can work is the case of the state-owned Bank Sepah. The United States imposed sanctions in January 2007, alleging that the bank had financed development of missiles that could carry nuclear weapons. The United Nations added its own sanctions against the bank in March 2007. The Iranians allegedly then turned to two other state-owned institutions to finance nuclear activities, Bank Melli and Bank Mellat. The United States hit them with sanctions, too, and pressured international banks to stop doing business with them. Banks that allegedly helped the Iranians evade controls were whacked with big fines. To settle U.S. government charges last December, the British bank Lloyds agreed to pay $217 million and Credit Suisse agreed to pay $536 million . Most global banks have decided that doing business with Tehran isn't worth the risk. link »
www.washingtonpost.com/
wp-dyn/ content/ article/ 201 · Original page -
laheadle 21-Apr-2010
You don't have to be Machiavelli to believe that the leaders of Iran and Venezuela shared the barely disguised Republican hope that health care would fail and, therefore, Obama's whole political agenda would be stalled and, therefore, his presidency enfeebled. He would then be a lame duck for the next three years and America would be a lame power. link »
www.nytimes.com/
2010/ 04/ 21/ opinion/ 21friedman.htm · Original page -
laheadle 15-Apr-2010
The outlet’s ultimate goal in developing a core readership, Kramer said, is to “convert that community into enough money to sustain the journalism.” link »
umber-one builder of intensity is face-to-face contact, not online link »
www.niemanlab.org/
2010/ 04/ intensely-engaged-follo · Original page -
laheadle 14-Apr-2010
Most recent estimates from the Centers for Disease Control are truly alarming. link »
extremely difficult to grow link »
story after story in the papers and on the news highlight the frustration that the American people are facing in trying to get the vaccine that would protect them from the disease link »
we’re getting a lot of disparity from one place to the next link »
he fact that this flu hit young children so hard and the constant news reports about rising pediatric deaths have scared the daylights out of parents. link »
emergency use authorization link »
a breaking point would have been if a normal dose didn’t give a good response. Another breaking point would be if the virus changed dramatically, and it looked like an adjuvanted vaccine could provide better protection link »
the public’s confidence in our vaccine system and in vaccines in this country—very, very fragile link »
the demand for the vaccine is actually much higher here than it is in Europe, and there’s quite a bit of skepticism. link »
we have a very complex environment. link »
And as recently in the last couple weeks with respect to the adjuvant question, the senior scientists of every agency have sat together and revisited that decision and decided do we want at this point to switch to adjuvants. It was a very complex discussion. link »
I think in the case of CSL, you know, they’re based in Australia, and they have a similar kind of arrangement or requirement with the Australian government; remember that the southern hemisphere has its outbreak at a different time. And so Australia has—was experiencing a pretty severe outbreak, and decided that it needed vaccine first for its home country. link »
As I said, the first cell-based facility has its ribbon-cutting next week, in North Carolina. But it actually—I don’t think it’s going to be able to make flu vaccine for another year. But when all is said and done, that ought to get us to the point where we can—they’ll be able to make, I think, 150 million doses. link »
adjuvants really are used for two reasons, one is so you need less vaccine, the other is if you don’t get a good immune response to that vaccine, they help you get a better immune response, it’s that substance that you mix with the vaccine. link »
some of the newer technologies are going to need the same kind of care, and that what works in a mouse, or what works in a very small production is not always the same that—and it sometimes takes some time to get it to industrial scale, and be sure it’s going to be safe and high quality for people. link »
ll of a sudden, we went from 1,000 deaths in the United States, literally overnight, to 4,000. And that’s a little—I find a little disingenuous. But there’s been this explanation that, oh well, we originally were basing cases of H1N1 on laboratory evidence. link »
With seasonal influenza, when we talk about how many deaths or how many hospitalizations they are, that’s not based on individual reporting by doctors and health departments or so forth. It is based on looking at a lot of different data sources and modeling those data. link »
What we did last week was release estimates that took information from a couple of very good surveillance systems—hospitalization data from our Emerging Infections Program Network in 10 different states, information from 30 or 35 states depending on the week about laboratory confirmed hospitalizations and laboratory confirmed deaths. We use those two as a ratio to understand from hospitalizations how many deaths might there be. link »
e looked at the influenza-like illness surveillance system, our signal providers, to divide up states into high, medium and low at any one time in terms of how common the transmission was. And then we used correction factors that were based on community surveys done to really understand for how many illnesses are in the community, you know, based on household telephone surveys for everyone who actually goes and sees a doctor. How many people that see a doctor get a lab test? link »
But we have this very exquisitely challenging time where do we risk raising demand in some communities like that, at the same time we have so much extra demand versus our supply elsewhere. link »
And this is one of the reasons why we’ve really focused on state and local support because in your community, your public health experts understand on the ground, you know. We got a supply-demand mismatch the other way at West Georgia College whereas in the national level, we may not really understand the community’s supply and demand. And so really one of our reasons to focus on state and local distribution or direction of where the vaccine goes is because of that trust of the community and that awareness of what’s going on with the local community. So I think that if you want to get back to getting—all right, okay. link »
If there had been something much worse than H1N1, we would be sitting here and saying why are we having 1,000 -- you know, tens of thousands of people dying for avian flu. What do we need to do or the agencies, all your agencies and even Congress need to do to live up to the plans and the expectations that we had from the earlier hearings where we were—you know, we were going to have enough vaccine, the distribution system was there. But right now we don’t know if the distribution centers are there simply because we don’t have enough vaccines, although we know something is working because people are lining up all over the country to receive it. link »
he cheapest thing we can do for the business community is a flu shot for their employees. link »
public health infrastructure that’s weak right now. It has been suffered many job losses, may furloughs and it leaves us little bit of a weakened core to respond to this kind of thing link »
better information systems. link »
remendous opportunity to strengthen immunization for school-age children link »
I’m Paul Perreault, president of CSL Biotherapies, Incorporated, the U.S. distributor of influenza vaccines manufactured by our parent company, CSL Limited, located in Melbourne Australia. link »
Afluria and our H1N1 vaccine come in multi-dose vials and thimerosal free pre-filled syringes. link »
SL Biotherapies entered into a one-year special contract initiated on May 28, 2009 to provide 36 million dose equivalents of H1N1 bulk antigen link »
On June 1, 2009, CSL received the first H1N1 virus vaccine seed from the New York Medical College. The yields from this slot were approximately one-third to one-half of the average H1N1 seasonal influenza yield. As a result of these low yields, CSL formally communicated to BARDA a delay to the overall timing of the H1N1 bulk antigen delivery. On the 18 th of August, CSL received a new vaccine virus seed that was introduced into the manufacturing process. Yield improvements in excess of 80 percent compared to the previous seed were observed. A revised supply schedule was sent to HHS on September 14 th incorporating production on the seed lot. link »
I would recommend there be a focus on producing a greater assortment of influenza seed lots earlier that can be utilized in the creation of future pandemic influenza vaccines. The poor yields resulting from the first available seed lot had a significant effect on reducing the amount of available H1N1 vaccines. If the 10-week gap in identifying the second higher yielding seed lot could have been avoided, higher output could have occurred sooner. link »
we are constructing the first flu cell culture manufacturing facility in the United States link »
foregoing the potential opportunity to quadruple the output of this facility using our MF59 adjuvant. link »
we recently showed that a half dose might be sufficient link »
mail.google.com/
mail/ ?ui=2& ik=2e5d91c799& view=at · Original page -
laheadle 09-Apr-2010
NEW YORK (AdAge.com) -- USA Today's website has started running thousands of pieces of original travel editorial from the Demand Media content farm, making USA Today the latest traditional news publisher to incorporate editorial from an outside supplier and a big win for Demand Media's content-generation effort. link »
Demand Media, the content studio and social media company that hired Yahoo sales chief Joanne Bradford to be its chief revenue officer last month, is paying to generate the content and is selling keyword advertising in the section. USA Today is selling its new display ad inventory. The two are splitting the revenue. link »
adage.com/
mediaworks/ article?article_ id=143168 · Original page -
laheadle 09-Apr-2010
In 2005, the Internet generated 8 percent of the ad revenue in the U.S. In 2009, that share more than doubled to 17 percent, to $22.7 billion. link »
the online ad industry managed to pull off quite a feat: it stayed almost above water in a year in which traditional media lost more than 20 percent of its revenue link »
More targetable, more measurable and seemingly more efficient digital advertising beats the selling of space (in newspapers and magazines) and time (on TV and radio). link »
www.niemanlab.org/
2010/ 04/ the-newsonomics-of-onli · Original page -
laheadle 06-Apr-2010
educe morbidity and mortality as much as possible link »
Since demand for a protective vaccine is likely to exceed supply in the event of a pandemic, public health authorities are rightly expected to allocate the scarce pharmaceutical resource as effectively and as fairly as possible. link »
In addition, and in contrast to the recommendations for vaccination during regular seasonal influenza, key government decision makers as well as vaccine and antiviral manufacturers were included in the highest tier. link »
At the core of the new scheme, as Dr. Ben Schwartz of the National Vaccine Program Office (NVPO) explained, was not the protection of vulnerable populations at risk for serious complications but rather the preservation of “essential services.” The focus was, as it were, on the “functioning of society” during a public health emergency. While the ACIP recommendations attended to the needs of young children, pregnant women, immunocompromised persons, and other high-risk groups, Dr. Schwartz argued that it was necessary to bring these valid concerns with vulnerable populations into balance with the requirements of “homeland security” and “critical infrastructure protection.” link »
eformulated in ethical terms the key question of how to allocate a scarce pharmaceutical resource in a public health emergency. link »
The ethical problematization of contemporary fields of biopolitical emergence has, in other words, become a powerful means to bring the public into existence. link »
As a local organizer of one of these meetings told me in 2007, the purpose was to “get a picture of how the public feels about vaccine prioritization.” Ethics thus operated in these meetings as a seemingly neutral idiom for the articulation of personal preferences. As it turned out, the citizens who participated in the Pilot Project rated the goal of preserving “essential services” first, while the protection of vulnerable populations came in second. link »
“My conclusion was,” as Bernier told me, “that this was a trust problem. More research was not going to solve this problem. There was a relationship problem.” Shortly after his revealing encounter with the autism activist on Capitol Hill, Bernier asked to go on a special assignment in order to explore more systematically the germ of an idea that had caught his interest: public engagement. link »
For a public engagement project to be successful it had to be launched at the outset of an emerging debate before the critical dialogue was about to turn into a polemic of accusations and become an irresolvable dispute. Furthermore, as Bernier argued, “when there is an open conflict, you really don’t want to bring in the man on the street who is not involved in the conflict.” Although the idea of public engagement was developed in response to controversial matters, it was, in fact, essential for its success to address non-controversial or not-yet-controversial matters . According to this particular model of public engagement, and in a somewhat paradoxical move, the mechanism of public engagement must be deployed in domains of public policy where controversial discussion is missing. Bernier’s comment thus illuminates how public engagement serves as a stage for the performance of a “social drama.” In this drama, a virtual controversy is enacted. Ethics has become the ubiquitous idiom for the scripting of such controversy. link »
. In this model of public engagement, experts are responsible for the determination of facts while the public is mobilized to deliberate about values. The precarious distinction between the empirical and the ethical renders public health policy amendable to participation. The price to pay for the internalization of the public is the externalization of ethics. link »
number of his colleagues in the public health policy community responded to Bernier’s enthusiastic praise of democratic deliberation quite predictably with the concern that public engagement may provide a “platform for extreme viewpoints,” that ordinary citizens, even if highly educated, may not be able to grasp “the complex technical issues,” that such mechanisms may lead to “incoherent recommendations” and that they may make policy decisions “even more political than they already are.” link »
uthorize the process of public engagement itself link »
The “public,” therefore, must assume a very particular form in order to count as a public. Ideally, participants in the forum represent a cross-section of the different parts of the population that make up the American public. It is, therefore, not simply the public that must be enrolled by public health specialists, but the right public that must be gathered into the fold of public health. And this gathering of the right public involves an act of both inclusion as well as exclusion . As the local organizer explained to me: link »
We wouldn’t take anybody with emergency management background. We wouldn’t take anybody with a big knowledge on health care. I didn’t want anybody that came in a little bit tainted, that knew already a lot about pandemic flu. link »
true picture of people who don’t really have a lot of knowledge about pandemic flu.” link »
The public must take the right shape to authorize public health policy. link »
in particular, the public must lack knowledge and expertise. link »
aim was not primarily to allow participants to engage in a process of mutual persuasion, but to provide individual subjects the formal means to articulate their personal preferences in a predetermined arrangement and to generate the kind of results on which a bureaucracy might be able to act. link »
meetings took place only a few weeks after a major hurricane devastated large parts of the U.S. Gulf Coast. In these days and weeks that followed the catastrophic “natural” disaster wrought by Hurricane Katrina, it was the loss of lives, the suffering of people, the destruction of homes, and the fatal consequences of a failed emergency response that took center stage. link »
the U.S. media kept disseminating misleading images of anarchy, crime, and lawlessness crystallizing in the ominous figure of the “looter.” These images of destruction, suffering, and insecurity generated a troubling sense of total breakdown that seemed to threaten the most basic order of a modern society. link »
The formal act of placing three dots on posters not only managed to cut off the deliberation midstream, it also offered the false hope of forever determining the meaning of the perspectives that were brought to bear on the issue, as if one could freely choose and permanently settle the true meaning of one’s words at a moment’s notice. link »
insufficient effort to comprehend these backgrounds and perspectives in the context of their articulation link »
At the Department of Homeland Security, at any rate, it was abundantly clear what the citizen voices were trying to say when the protection of society was invoked. What the public apparently was asking for was “critical infrastructure protection.” link »
the vaccination plan was specified for the case of a severe, a moderate, and a less severe pandemic. link »
new vaccination guidance was modeled not on five, but on three categories of pandemic influenza link »
When different pandemics of influenza are compared with each other in retrospect , it is indeed possible to distinguish between a severe, a moderate, and a less severe pandemic. But what if one looks at these events as they occur in real-time ? The devastating pandemic of 1918, as experts explained to me, came in three subsequent waves. The first wave was moderate, the second severe, and the third moderate again. link »
participation” has increasingly come to work as a governmental strategy for the exercise of power link »
Rather than to ask if public engagement is able to deliver on its promise, my account has drawn attention to some of the contexts in which public engagement occurred in the United States and it thus contributes to recent explorations of the animation of publics in regulatory contexts link »
However, the design of public engagement that made ethics evident also circumscribed the normative field, reducing ethical values to individual preferences and personal opinions. Deliberately built into the procedure of public engagement itself was the democratic value of equality. With the exception of this value, all other values were treated even-handedly. But this conscious commitment to equality turns out to be highly problematic when some people are at risk of dying while others are not. What, we might ask, is the ethics of giving equal weight to the perspective of a person who is at risk of dying due to his or her age, or the precarious state of his or her immune system (due to HIV/AIDS or chemotherapy) and the perspective of a person who will be affected by a pandemic primarily in his or her economic well-being? How, in fact, will people with HIV/AIDS fare during a pandemic of influenza? Will they survive? Can we simply bracket differences that make a difference? link »
My aim, in this chapter, has been to present such a kind of proposal by displacing two crucial notions animating the public engagement meetings. I specifically mean the notion of “the public” and the notion of “the emergency.” As I hope I have been able to show here, there is always another public and there is always another emergency that we must keep track of. To bring the spectral presence of these other publics and these other emergencies into sharp relief might well form the basis of an ethnographic strategy that contributes to the formulation of a critical theory of the limits of participatory forms of governance in neoliberal societies. link »
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laheadle 06-Apr-2010
There were three key issues at stake in the public controversy over how to allocate federal resources for urban security. The first is a familiar problem in federalist politics in the United States: how to fairly and rationally distribute resources to different cities and metropolitan regions, given that officials representing all parts of the nation haves clear incentives to request funds, and little cause to refrain (Kettl 1987; Wildavsky 1998; Roberts 2005). The second concerns bureaucratic rationality, in particular the question of how a fledgling governmental agency can construct methods of evaluation and calculation that a diverse set of powerful political actors will accept as fair and legitimate (Porter 1995; Strathern 2000). The third is the emerging political question of how a threat that defies probabilistic calculation is brought into the realm of governmental rationality (Beck 1999; Giddens 1990). link »
we focus on the question of how experts and political officials worked to transform the administrative definition of risk used to allocate security resources link »
While the debate was framed as a contest between rationality and politics, at stake was not a choice between the two, but rather a contest over what bureaucratic practices constitute legitimate rationality, and a struggle to have the interests of particular cities and regions codified into the formal mechanism of risk assessment. link »
Quantitative decision mechanisms thrive in settings characterized by political controversy and public scrutiny link »
On the one hand, the field of homeland security was characterized by a sense of urgency and a demand for new initiatives; on the other hand, “homeland security” was an elastic and ill-defined concept. In this context, an emerging community of homeland security experts provided a potential instrument for achieving mechanical objectivity – “risk assessment” – one that was readily adopted by DHS administrators. link »
key data remain classified link »
etails of technocratic calculation became the object of political dispute link »
In other words, the UASI controversy was based not on a conflict between “rationality” and “politics” – as many actors sought to portray it – but rather serves to demonstrate the operations of a contemporary politics of rational calculation . link »
anti-democratic insofar as it restricts input into policy-making to a technocratic elite link »
olitical strategy within a fragmented organization, link »
how did “risk assessment” become the accepted form in which rational and objective decisions about homeland security resources would be undertaken? And how was the actual decision mechanism designed? link »
A particular target of criticism was the formula in homeland security appropriation bills that automatically allocated a certain percentage to each state, rather than distributing it according to the degree of threat a given area faced. Critics called on DHS to develop an objective, “risk-based” method of determining allocations – a reform resisted by congressional officials from states that benefited from existing arrangements. link »
a long-standing problem for federalism: how to equitably, efficiently, and effectively distribute funds for the provision of public goods from the federal government to localities? link »
built into UASI was a decision mechanism that would ostensibly lead to the allocation of funds according to the relative risk faced by each jurisdiction link »
how to know which cities carried the most risk link »
We recommend that a panel of security experts be convened to develop written benchmarks for evaluating community needs” (9/11 Commission 2004.). link »
The role of such “security experts” – typically located in think tanks and policy institutes – was to define the standards of rationality that would guide DHS budgetary decisions. link »
tandardized method to link overall homeland security strategy to specific funding decisions link »
he “real security needs” that DHS 2.0 had pointed to were not yet stabilized link »
As stories about the chaotic response from DHS circulated through the media, the agency was publicly branded as incompetent. Critics charged that, through wasteful spending and a myopic focus on terrorism, DHS had actually made American cities more vulnerable to disasters. The problem of urban security became a leading public issue, and DHS faced strong pressure to reform. link »
In this way, individual jurisdictions would be encouraged to define and manage threats according to norms of efficiency and efficacy. In the model of “entrepreneurial government,” competition among jurisdictions and evaluation by experts would ensure the efficient distribution of security resources in a federal system. 4 link »
“The formula has progressed from a simple count of ‘high’ and ‘low’ criticality and numbers of threat reports in FY 2003 to a fully risk-based computation that is attack-scenario based and uses infrastructure-specific vulnerability and consequence estimates ” (ibid). Such information about vulnerability and consequences was based on an impressive amount of data: “The FY 2006 approach evaluates risk to well over 120,000 specific infrastructures.” link »
art, not a science link »
formula-driven grants processes to true risk-based processes link »
the data set, if you will, that informs the risk ranking for the non-New York areas is better. link »
journalists remained either skeptical of or confused by the particular rationale Foresman was trying to articulate: that the disproportionate cuts to New York City and Washington DC were due not to “politics” but to an increased knowledge about the “critical assets” of the rest of the country’s cities. link »
Without details on how the calculations had been made, the public would have to take DHS’s word that the process was objective and disinterested, rather than “political.” But after Katrina, the department lacked the credibility to keep further inquiries at bay by citing “classified information.” link »
broader issue of governmental responsibility for the provision of urban security: was the kind of security provided by police the obligation of cities or of the federal government? link »
the inventory of critical assets as part of a determination of infrastructural vulnerability. He emphasized the distinction between threat and risk . To calculate the latter, one needed data not only on the likelihood of an attack – what he called the “threat” – but also on the number of vulnerable critical assets in the country: link »
In light of the variation in reporting between various sectors and states as well as the lack of detailed information on sites, we are not confident that the NADB can yet support effective grant decision-making link »
Only assets that are the most vulnerable and represent significant public health, economic and national defense consequences make the final cut. This carefully screened set of target listings, roughly 600 nationwide, drives our decisions on the focus of operations, resource investments and grants.” link »
Gaining public legitimacy for its allocation decisions required not only “objective” calculation, but also transparency about the details of the calculation process. link »
To avoid the close scrutiny of its numbers an agency needs credibility – something DHS sorely lacked. link »
In the next iteration of the program, announced in January, urban regions were broken into two tiers with different systems of allocation for each. The six Tier I cities (Los Angeles/Long Beach; Bay Area; National Capital Area; Chicago; New York/New Jersey/Newark; and Houston) would receive $411 million in UASI funds, while 39 Tier II cities share get $336 million (Department of Homeland Security 2007). New York would no longer be in direct competition for resources with small cities such as Louisville. Moreover, Chertoff reversed his position on the use of homeland security funds for local counter-terrorism personnel, and allowed up to one quarter of the funds for Tier I cities to be used for what mayors and the Brookings Institute called “boots on the ground” security. link »
Meanwhile, DHS had significantly edited the National Asset Database – from o ver 77,000 critical assets to around 2,100. Popcorn stands and petting zoos had been removed. Chertoff explained the department’s more restrictive definition: “The critical assets are those which have, from an economic standpoint and other standpoint, a regional or national significance. A major dam, for example, that if something were to happen to would have a catastrophic impact. That's an example of a piece of critical infrastructure” (Chertoff 2007). link »
In the UASI controversy, a relatively new and weak bureaucracy responsible for homeland security was unable to defend its allocation decisions on the grounds of impersonal calculation, and was forced to shift its policy in response to political outcry. As critics of DHS issued public denunciations of the process through which DHS was allocating resources, the agency sought to construct a new decision tool that would fend off accusations of partiality and incompetence. In this sense, the controversy directs attention to the ways that legitimacy disputes are adjudicated and stabilized according to the norms of bureaucratic rationality, especially when the implementation of such norms is a matter of uncertainty. Transparent and shared standards of measurement must be in place to make objective, “de-politicized” calculation possible. link »
In the debate over urban security, experts played a central role in shaping what security would practically mean, by introducing the demand for an objective decision technology. However, this demand did not close off political discussion; rather, it directed political struggle into the very construction of this technology. DHS did not have the power to impose its own understanding of “risk assessment” on other political actors, for two reasons: first, the agency itself was weak and internally divided; and second, the federalist system of sovereignty grants significant power to states and localities. External critics from big cities strategically misunderstood the tool DHS had constructed, and emphasized the critique of “pork” in order to force the agency to recalibrate its risk assessment mechanism in a way that would be more amenable to their interests. link »
a distinctive kind of politics – one that is structured by the problem of objectivity link »
From the vantage of the analyst, it is not a question of saying that this is all “just” politics, then, but rather that the very basis of rational decision is an object of political struggle. link »
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laheadle 25-Feb-2010
what we have to do is get the web onto the stories of real substance that involve digging and working and money and time and resources. That, I say, is the major problem confronting American journalism today” link »
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laheadle 24-Feb-2010
They contend that a smaller news division does not mean a less competitive one. With technological advancements such as hand-held digital cameras, the news division can now dispatch one person to cover a story that once required a correspondent, a producer and a two-person crew. link »
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Cruel Ethiopia | The New York Review of Books
Old Guard: News in the Raw | Mediaite
by laheadle
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