Risk Governance for Infectious Diseases - Analysing the applicability of the IRGC-framework
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The IRGC developed a framework in which it is argued that risks can be categorized according to simple, complex, uncertain and ambiguous risks in the assessment process (Renn 2005). Each risk category comes with a specific risk governance approach, including a differing level of stakeholder participation (thereby taking into account the societal context in which a risk occurs, and the principles of good governance). Although this proposed framework is not empirically tested yet, its aim is (among other things) fostering more effective, efficient and accepted risk governance. Dutch infectious disease governance seemed to be a good field to test the IRGC-framework because of the increasing belief that risk governance should comprise more than standard risk calculations (RIVM 2003). Furthermore, recent national and international outbreaks (SARS, Influenza A, Q-fever, EHEC) have emphasized the fact that infectious diseases remain a serious risk. Complexity and uncertainty with regard to infectious diseases seem to have increased (due to climatological changes, intensified food production, globalization etc.) and ambiguity with regard to the size or severity of a risk can be a serious issue for infectious disease governance (e.g. Q-fever, Mexican flu, HPV). However, time pressure involved in infectious disease governance is an issue. Therefore, the main research question of this thesis is: To what extent is the IRGC-framework useful for Dutch infectious disease control and if applied, what is the added value in terms of effectiveness, efficiency and acceptance? A qualitative case study analysis was chosen as a means to answer this question. Desk research to two recent infectious disease risks (Q-fever and Schmallenberg Virus) had to reveal absent IRGC-framework steps in the actual risk governance process and served as a means to get an indication of actual effectiveness, efficiency and acceptance. The results of desk research served as a basis for interviews with stakeholders (n=18), who were asked for the feasibility and added value if absent IRGC-steps would have been applied. This study revealed that both Q-fever and SBV showed partial resemblance with the suggested IRGC-approach; some (partly) missing IRGC-ideas could foster the success of Dutch infectious disease governance. The feasibility of appliance of IRGC-elements under time pressure was often questioned, which suggests that urgency adds an extra dimension to risk governance.