Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis

Uncertainty was a defining feature of the Brazilian Zika crisis of 2015–2016. The cluster of cases of neonatal microcephaly detected in the country's northeast in the second half of 2015, and the possibility that a new virus transmitted by Aedes mosquitoes was responsible for this new syndrome,...

Full description

Bibliographic Details
Main Authors: Kelly, AH, Lezaun, J, Löwy, I, Matta, GC, de Oliveira Nogueira, C, Rabello, ET
Format: Journal article
Language:English
Published: Elsevier 2020
_version_ 1826271940456742912
author Kelly, AH
Lezaun, J
Löwy, I
Matta, GC
de Oliveira Nogueira, C
Rabello, ET
author_facet Kelly, AH
Lezaun, J
Löwy, I
Matta, GC
de Oliveira Nogueira, C
Rabello, ET
author_sort Kelly, AH
collection OXFORD
description Uncertainty was a defining feature of the Brazilian Zika crisis of 2015–2016. The cluster of cases of neonatal microcephaly detected in the country's northeast in the second half of 2015, and the possibility that a new virus transmitted by Aedes mosquitoes was responsible for this new syndrome, created a deep sense of shock and confusion in Brazil and around the world. When in February 2016 the WHO declared a Public Health Emergency of International Concern (PHEIC), it noted that it did so on the basis of what was not known about the virus and its pathogenic potential. To better understand the role that non-knowledge played in the unfolding of the Brazilian Zika crisis we differentiate between three different kinds of uncertainty: global health uncertainty, public health uncertainty, and clinical uncertainty. While these three forms of uncertainty were difficult to disentangle in the early weeks of the crisis, very soon each one began to trace a distinct trajectory. Global health uncertainty centered on the question of the causative link between Zika virus infection and congenital malformations, and was declared resolved by the time the PHEIC was lifted in November 2016. Public health and clinical uncertainty, in contrast, persisted over a longer period of time and did, in some important ways, become entrenched. This taxonomy of uncertainties allows us to explore the systematic nonproduction of knowledge in times of medical emergency, and suggests structural limitations in the framework of “emergency research” that global health institutions have developed to deal with unexpected threats.
first_indexed 2024-03-06T22:04:40Z
format Journal article
id oxford-uuid:4fbcaf1c-4fad-47cc-afff-33747bea4fd2
institution University of Oxford
language English
last_indexed 2024-03-06T22:04:40Z
publishDate 2020
publisher Elsevier
record_format dspace
spelling oxford-uuid:4fbcaf1c-4fad-47cc-afff-33747bea4fd22022-03-26T16:09:17ZUncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4fbcaf1c-4fad-47cc-afff-33747bea4fd2EnglishSymplectic ElementsElsevier2020Kelly, AHLezaun, JLöwy, IMatta, GCde Oliveira Nogueira, CRabello, ETUncertainty was a defining feature of the Brazilian Zika crisis of 2015–2016. The cluster of cases of neonatal microcephaly detected in the country's northeast in the second half of 2015, and the possibility that a new virus transmitted by Aedes mosquitoes was responsible for this new syndrome, created a deep sense of shock and confusion in Brazil and around the world. When in February 2016 the WHO declared a Public Health Emergency of International Concern (PHEIC), it noted that it did so on the basis of what was not known about the virus and its pathogenic potential. To better understand the role that non-knowledge played in the unfolding of the Brazilian Zika crisis we differentiate between three different kinds of uncertainty: global health uncertainty, public health uncertainty, and clinical uncertainty. While these three forms of uncertainty were difficult to disentangle in the early weeks of the crisis, very soon each one began to trace a distinct trajectory. Global health uncertainty centered on the question of the causative link between Zika virus infection and congenital malformations, and was declared resolved by the time the PHEIC was lifted in November 2016. Public health and clinical uncertainty, in contrast, persisted over a longer period of time and did, in some important ways, become entrenched. This taxonomy of uncertainties allows us to explore the systematic nonproduction of knowledge in times of medical emergency, and suggests structural limitations in the framework of “emergency research” that global health institutions have developed to deal with unexpected threats.
spellingShingle Kelly, AH
Lezaun, J
Löwy, I
Matta, GC
de Oliveira Nogueira, C
Rabello, ET
Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
title Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
title_full Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
title_fullStr Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
title_full_unstemmed Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
title_short Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis
title_sort uncertainty in times of medical emergency knowledge gaps and structural ignorance during the brazilian zika crisis
work_keys_str_mv AT kellyah uncertaintyintimesofmedicalemergencyknowledgegapsandstructuralignoranceduringthebrazilianzikacrisis
AT lezaunj uncertaintyintimesofmedicalemergencyknowledgegapsandstructuralignoranceduringthebrazilianzikacrisis
AT lowyi uncertaintyintimesofmedicalemergencyknowledgegapsandstructuralignoranceduringthebrazilianzikacrisis
AT mattagc uncertaintyintimesofmedicalemergencyknowledgegapsandstructuralignoranceduringthebrazilianzikacrisis
AT deoliveiranogueirac uncertaintyintimesofmedicalemergencyknowledgegapsandstructuralignoranceduringthebrazilianzikacrisis
AT rabelloet uncertaintyintimesofmedicalemergencyknowledgegapsandstructuralignoranceduringthebrazilianzikacrisis