In the national committee of epidemic management of Niger the preparedness is a common ethos since meningitis pandemic of years 1990. We will analyze one of the much controversy mechanism, the threshold alert and will give a clue to resilience as an unthought-of a health policy.
Paper long abstract:
The meningitis pandemic which had occurred in countries of the "meningitis belt" has been a singularly case in the 20th century. It gave a lesson for the management of future epidemic. The new paradigm of preparedness which will be on the top of practices in the second half of 1990 underlined an implacable desire to rationalize public health policy with epidemiology. The preparedness became a common ethos in national committee of epidemic management of Niger, the main tool to prepare epidemics. Bringing together actors of the north and the south, partners of national public health sector and international agencies, the committee is in charge to apply a controversy method called "reactive strategy" for meningitis epidemic. The aim of this method is to use a threshold and active surveillance to make response. The construction of the threshold creates controversies and negotiation before the consensus of 2000 between international institutions and agencies and public health actors. This paper will describe how in years 2000 the threshold is constructed and what effects are there. In the same time we will try to give a clue to resilience as an unthought-of a health system hitted by recurrence epidemics.