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

Item Type

Abstract

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. © 2020

Subject

Uncertainty
Brazil
Emergency research
Public health emergency
Zika

Publication Title

Publication Year

2020

Publication Date

2020

Source

Scopus

License

Physical Description

vol. 246

Short Title

Uncertainty in times of medical emergency

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Uncertainty in times of medical emergency: Knowledge gaps and structural ignorance during the Brazilian Zika crisis, dans Science & Ignorance, consulté le 21 Novembre 2024, https://ignorancestudies.inist.fr/s/science-ignorance/item/4675

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