Precautionary Principle And Strategies In The Control Of Globalized Diseases

In the modern "risk society" by means of science and technology, people speed uppaces to reform nature, gather treasures and improve life quality, and at the same time, they have brought series of modern risk problems unlike the "normal society" risks, suchas environment problems, climate problems, ecology crises, and globalized diseases(AIDS, SARS, BSE and HPAI).On the course to manage health and environment risks, people have experienced twoindex stages, i.e. from emphasis on treatment to emphasis on prevention. The mainfeatures of risk management strategy of "prevention first" is stressing on the hard evidencesof health and environment risks, considering that science can objectively and reliablyassess or qualify risks, and any behavior actions should be based on sufficient scientificdemonstration and argumentation. Scientific research and decision-making management onhealth and environment has been dominated by the model represented by "cause-effectrelation" and "dose/response relation".Precautionary principle is considered as the third stage model to protect human andenvironment, and the reasonable guideline to deal with scientifically uncertain riskscurrently on environment, climate, ecological crises and globalized diseases. In thispaper, control strategies are discussed under scientific uncertainty with regard to theglobalized diseases, and BSE and HPAI in particular, according to precautionaryprinciple. The specific goals and contents include: firstly, legislation, policy andmanagement: how to identify and response uncertainties with regard to BSE and HPAI andwhat treatment and decision-making routes exist under uncertain conditions; secondly, significance of precautionary principle studies, how to combine precautionary principlewith actual globalized disease risk management practice; thirdly, can precautionaryactions effectively minimize globalized risks of BSE and HPAI ? and what are theimplications and consequences of precautionary actions? and what are the advantages anddisadvantages of precautionary management compared with non-precautionarymanagement or policy; fourthly, the effects of precautionary principle on social economy, existence and development, including effect of precautionary actions on social-economic cost-benefit of different groups; fifthly, implications of precaution on management, participation and decision-making, and who will participate and influence thedecision-making, including risk identification, appropriate response policy-making andprecautionary level adopted; sixthly, precautionary principle in relation to scientific riskanalysis and preventive principle and seventhly or lastly, by reconsidering UK (EU) BSEcontrol actions and analyzing the current international AI control measures, experiencesand lessons are gained in relation to precautionary principle.Origin and definition of precaution and the international legal position of precautionaryprinciple are elucidated by confirmative studies including observation, analysis anddemonstration; and the background, goals, principles and method of precautionaryapplication are explored. Three-stage analysis of precautionary trigger, precautionarydecision and precautionary application is adopted to reflect and analyze in a precautionaryway the control measures for BSE and HPAI, the two globalized diseases, indicating thatprecautionary principle is a very valuable guideline to deal with disastrous risks under highcertainty.The main conclusions and enlightenments gained in observation and demonstrativeanalysis of precautionary theory are as follows:First, in response to the risks of globalized diseases like BSE and AI, the governmentcan not delay or does not take actions by reasoning scientific uncertainty; science is not theonly reason for action.The globalized disease risks are generally characterized by internality, externality, potential disastrousness, high uncertainty and irreversibility, and in case should riskoccur, it would express in globalization trend. In spite that risk occurs at beginningwithin a country, its disastrous effect will soon spread to the surrounding countries andfinally become a worldwide disaster. More importantly, due to high development ofmodern information technology, fear and untrustworthiness brought about by risks anddisasters would soon spread to the whole society through modern communication means, further causing turbulence and unrest.Reflection on UK (EU) BSE control measures indicates that there are many scientificuncertainties with regard to BSE risks to human health, from initial suspicion whether ornot beef from BSE infected cattle has influences on human health to current exploration ofwhat is the infective dose of BSE agent for human. Is BSE transmitted through blood and which phenotypes of the disease exist in human? As studies on BSE are further deepened,more and more scientific uncertainties about BSE are revealed, and scientific assessmentson BSE and their conclusions are often uncertain too. Therefore, facing risks of BSE andHPAI, policy-makers can not delay or do not take actions by reasoning scientificuncertainty. They have to make decisions and take actions based on currently availableinformation within possible short period of time, or there would be serious public healthconsequences and social impact.Over-reliance on risk assessment as the sole analytical technique for health option willlimit policy makers' ability to predict and prevent risks. The professional range related inrisk assessment is relatively narrow and risk assessment is unable to offer convincingevidence or information with regard to uncertainties, therefore science is not the solereason for decision-making. In dealing with the highly sensitive risk issues like BSE andHPAI, scientific risk assessment can only be considered as one of reference reasons, thegovemment must consider other health factors and value-based opinions, as well as ethic,ecological and social factors.Second, precautionary principle is the reasonable guideline in response to uncertainrisks of globalized diseases like BSE and HPAI and the ideally scientific decision-makingdoes not exist, and is not practical either.Scientists would not become vexed because of uncertainties and no solutions inrecognizing the globalized disease problems, and in contrast, the globalized diseasesproblems are pointing out the new research dimension and direction for the scientists.Policy-makers must decide in limited period of time whether or not to take measures inresponse to the potential uncertain risks about BSE and AI, including legal measures andmust decide between "Yes" and "No". In legal society, any decisions made by thegovernment must be clear, certain and predictable, and no ambiguity is allowed.Scientific uncertainties exist everywhere, and sometime, scientific conclusions areuncertain by themselves, therefore, scientists may not necessarily provide sufficientscientific evidences for policy makers, who have to adopt non-scientific judgments andconsiderations.Third, measures required by precautionary principle can either prevent or control orminimize occurrence of the potential uncertain risks like BSE or HPAI.Precautionary actions include series of precautionary measures, ranging from enhancement of public trust, early monitoring and warning, liability shift, toconstraining measures. From intensity, the precautionary measures can be divided intoweak, moderate and strong precautionary measures; and from stages, the precautionarymeasures include short term measures, mainly to tackle with emergencies, mid-termmeasures to minimize the negative effect of the globalized diseases and the long-termmeasures based on bio-security. However, the final decision should be value-based.Fourth, precautionary principle argues that the government attaches importance to theduality of risk, and the public values of risks in particular.People possess duality viewpoint in recognizing risks, science based view andvalue-based view. The scientists explore risks from probability and take risk as "productof event probability multiplied by possible adverse consequence" i, e. R(isk)=P(robability)×H(azard). While risk in the public eyes, is not simply the probability, they considerrisks more from values. The more value factors involved in risks, the stronger anxious,alert, fearful and outrageous the public will feel. The public risk concept can besummarized as: R(isk) =H(azard) +O(utrage); the acceptance of risk is mainly determinedby "fear and number of people who accept".Scientists pay more attention to hazard degree of the risk, and public is concernedmore with terror degree of the risk. Therefore, the government can not work out riskmanagement level and actions acceptable to the public until it holds accurately the dualityof risks in making decision and thus the public will not hesitate their trust in thegovemment.Fifth, precautionary degree in positive relation to the economy and sciencedevelopment of a country.The degrees and complexity of preparedness against AI vary extremely with differentcountries in the world. On one hand, some developed countries like the U.S.A haveadopted very broad precautionary measures and contributed huge resource to prepareagainst risk of pandemic influenza. On the other hand, some most deeply affected andpoverty stricken and less developed countries are neither able to produce or purchaseadequate quantity of vaccines and antiviral drugs, nor able to compensate economic lossesof farmers whose poultry had been slaughtered due to disease outbreaks. The farmers arelack of initiative to report diseases and even hide the diseased animals, thus exacerbatingdisease spreading. Generally speaking, developed or rich countries have more comprehensive precautionary measures than the less developed countries in control andprevention of globalized diseases like HPAI.Sixth, precautionary decision-making should be based on transparency participationand consultation.Any citizen is entitled to obtain policy information related to his (or her) interests.The more transparent, the higher good management standard is. From precautionaryanalysis of international AI control decision-making, one will know that it is essential toconsider and address Asymmetric Information, access unaquitability and intellectualproperty right in order to reach global cooperation and share information, and theapproaches can only be based on transparency, participation and consultation.Precautionary principle is considered to be the guideline in dealing with highlyuncertain and potential disastrous risks in environment, climate, ecology and globalizeddiseases and the important principle of sustainable laws and policies.The U.S.A and EU that have undertaken relevant studies on precaution, though foronly a short period of time, have plentiful gains on protection of environment biologicaldiversity and resources. Since BSE crisis, EU has introduced precautionary principle fromenvironment protection to food safety, and however has induced great conflict with U.S.A.At present, the precautionary principle remains in dispute on its definition and legalposition internationally. Its relevant applications and especially precautionary studies onglobalized diseases are rare, and there are essentially no information and model for directreference. And domestically, introduction of the concept of precaution is just beginningand it may be said that there is blank in the application studies related to precaution. Thestudy is a brand new attempt to apply the precautionary principle in research of globalizeddisease control strategy.