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Providing information and resources to help emergency risk communicators prepare and effectively respond in the event of a crisis.

Talking to WHO’s John Rainford about the New WHO International Communication Guidelines


In 2004, the World Health Organization (WHO) released its Outbreak Communication Principles. Since that time, risk communication experts from WHO member states and partner nations have used the evidence-based, field-tested communication guidelines to establish a comprehensive framework for effective communication during infectious disease outbreaks. Earlier this year, the guidelines were updated by a working group.

The objective of the update is to help national authorities apply the Outbreak Communication Principles to their planning and preparation activities by addressing specificpublic health objectives. The newly revised document also gives specific information about implementing the Principles and serves as a guide to help member states build required capacity for effective outbreak communication. “When we talk about global initiatives we are talking about so many diverse resources. We decided to go forward on the one specific principle of planning, to say, ‘What can member states do to concretely improve their performance?’” says John Rainford, Team Leader for Communications in the Assistant Director-General's Office of Health Security and the Environment at WHO.

According to Rainford, although the Outbreak Communication Guidelines were already established following the SARS outbreak of 2003, there was a real need to update them. Specifically, there was a significant gap in advice to member states and partner nations: “The recommendations were at an incredibly high level, and member states were demanding more concrete advice, [for example,] ‘When you say listen, who do you listen to, and how?’”

To address these concerns, a group of 15 international leaders in the field of earth risk communication met to create the guidelines. To ensure the group was representative of WHO’s global reach, Rainford said three criteria were used in the selection of participating members. Members had to be strong international leaders in the field of risk communication, provide diverse geographical representation, and represent diverse cultural and social demographics. “It’s a model that a country, region, or locality can use as well. If we want to make something that will be picked up by our African partners, then [they need to have input]. That’s a basic principle.”

The goal of the workgroup was to develop a document that captured best practices globally, and make them highly scalable so that a range of countries with an array of resources could use it. The workgroup also wanted the Guidelines to be simple and easily understood and translated to ensure the widest possible audience. Rainford believes these features are fundamental to the basic principles of effective communication.

In addition to addressing member states requests, the Outbreak Communication Guidelines describe seven steps recommended for national public health authorities implementing the WHO Outbreak Communication Guidelines. Each of the steps represents broad areas of work in building the required public communications capacity to deal with infectious disease risks.

The steps are as follows:

  1. Assessment.
  2. Coordination.
  3. Transparency.
  4. Listening during outbreaks.
  5. Communication evaluation.
  6. Constructing an Emergency Communication Plan.
  7. Training.

In contrast with many recommendations, writing the plan falls at the end of the process. Rainford explains that time and again, the experiences of member states shows that the initial steps are more helpful to communication activities overall, and that without those steps firmly established, a plan has less ability to successfully engage a community. Likewise, capturing what your agency will actually do, rather than what your agency thinks it ought to do, is far more helpful.

“We really felt that we had to confront that problem [of people not paying any attention to written plans]. Concrete capturing of all the planning components has to be done before all those other steps are done. If you haven’t really confronted the challenge about transparency, then developing a plan saying you’re going to be transparent isn’t applicable.”

Overall, the Guidelines are both broadly relevant yet detailed enough to be implemented with ease in a variety of situations. “I've seen great guides on how to do media relations and on message development, but so much of it has been American and Western driven. There are many things...that I don't think have been brought together the way they are here. When you are devising something for so many diverse cultures, governments, and populations, you have to find a way through that is useful across the board. That was a learning process for us all,” Rainford concludes.

Outbreak Communication Guidelines at the Local Level

The United States is a signatory to the Guidelines, and CDC is currently exploring how best to adopt the recommendations. According to John Rainford, WHO Team Lead for Communications in the Assistant Director-General's Office of Health Security and the Environment, the Guidelines can absolutely be adopted at the local level as well. He says the main points to remember are these three:

  1. Assessment. Building from existing steps and existing systems is vital, and it will always be different based on your location. For example, many rural areas have very little infrastructure but have strong social networks that can be used to help inform people and get feedback on that information.
  2. Coordination. There are very few limits to who can be a partner, and improved coordination with partners can mean a stronger response in an emergency.
  3. Transparency. This is the most difficult aspect of communications. Take time to familiarize yourself with best practices on the issue, and assess what is realistic for your agency.


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