Conceptualising strategies of containment: an interdisciplinary framework
In this study we take ‘strategies of containment’ to mean: “an assemblage of principles and practices put in place by industry and the state to limit and control outbreaks of disease and their wider social and economic repercussions” Our overall framework for investigation is interdisciplinary in approach and rests on the idea that that ‘strategies of containment’ have four key stages:
- Strategies of prevention – in which the concern is to create policy interventions that prevent the occurrence of disease. The issue here is about taking pre-emptive forms of action that reduce the chances of a disease outbreak.
- Strategies of anticipation – in which the concern is to design interventions that can recognise potential disease outbreaks in a timely fashion. The issue here is about the measures we have in place to identify failures of deterrence.
- Strategies of alleviation – in which the concern is to put response mechanisms in place in light of recognising the incidence of disease. The issue here is about the nature of procedures employed to eliminate the disease when it occurs.
- Strategies of care – in which the concern is to design measures to restrict the wider burden of disease. The issue here is about the way in which policy makers rationalise the consequences of disease and its mitigation.
In this study we suggest that each of these stages in containment practice are characterised differently depending on the level of policy discourse we are inspecting. Important distinctions exist between:
- The command/oversight level – in which the focus of concern is on understanding the management structures put in place to oversee/coordinate the overall implementation of the strategy
- The tactical level – in which the focus of concern is on understanding how aims & objectives are translated into practical guidelines.
- The operational level – in which the focus of concern is on understanding how these guidelines are adopted and used in practice.
It is in the intersection of these two issues – containment stage and policy level – we are starting to tease out the kinds of uncertainty embedded in strategies of containment as they operate in particular areas (such as technologies of surveillance), as we move between different levels (such as from tactical guidelines to practical action), and as we move between different strategies in the containment cycle (such as the shift from anticipation to alleviation). By ‘uncertainties’ we broadly mean circumstances governing the principles and practice of disease containment where knowledge and understanding is weak, unsettled or inadequate. Whichever aspect of the matrix we are looking at, our interest in uncertainty is focusing on three levels of inquiry:
- Scientific and technological uncertainties – e.g. those surrounding the nature of the ‘evidence base’ underpinning disease containment.
- Institutional uncertainties – e.g. those shaping the co-ordination of ‘effective’ cross-sectoral approaches to containment.
- Moral and ethical uncertainties – e.g. those defining what constitutes ‘appropriate’ and ‘acceptable’ courses of action in the event of disease outbreaks
A simplified map of our Conceptual Framework has been produced.