Anticipation and response: pandemic influenza in Malawi, 2009

Sambala, Evanson Z.; Manderson, Lenore

The issues relating to scientific advice have broad ramification, touching on several aspects of the relationship between planning for and coordinating pandemic influenza responses. Lack of epidemiological data may impact on authorities' level of action. In this study, participants maintained that the ministerial authorities directly involved in the planning were passive when epidemiological data, resources and critical infrastructure fell short. According to Parsons, social agents (i.e. authorities able to take action) and social structures (i.e. surveillance and health systems) are both important determining factors for action [20] . Holm also reiterates that decision-making occurs not in a vacuum, but by social agents at large, by the general social environment, and by organisational features such as those of health care institutions [21] .