Editor's note: The following summary is based on the World Health Organization (WHO) report "Sixth Futures Forum on Crisis Communication". This summary is provided by, and is from the perspective of, The Communication Initiative team.

This 36-page report aims to help public health decision-makers work toward better understanding the dynamics of communicating in a health crisis. The report offers reviews of five case studies: the dioxin crisis in Belgium, the avian influenza (bird flu) alert in Austria, the severe acute respiratory syndrome (SARS) alert in Norway, the SARS crisis in Ontario and examples of health risk communication in the United
Kingdom.

This publication comes out of the Sixth Futures Forum on Crisis Communication held in Iceland where high-level professionals learned from colleagues who had faced public health crises. The report contributes to a set of policy tools for these individuals to help them in times of crisis and provides information on how to best handle crisis communication as well as how to develop and maintain good communication channels between crises.

Participants of the Futures Forum broadly agreed that effective risk communication has become a key responsibility of public health professionals who must
"inform, persuade and motivate" in the face of a crisis. They further agreed that crisis communication is sensitive to context and situation and that crisis
communication has to take into account a variety of different stakeholders such as health journalists and health executives. As a result, the group is described as agreeing that there are no “one size fits all” recommendations.

The publication asserts that communications can both be a means and an end to a crisis in many countries where people are becoming increasingly health literate. The goal of health officials and policy makers is to use crisis communication as a tool to achieve the best possible health outcome, based on an incidence of certain or uncertain health risk.

The publication describes a number of crises that developed from communication gaps. In the case of SARS being reported in Ontario, Canada, a number of different communication problems emerged. According to this report, there was an absence of reliable information on health service utilisation in hospitals; there was poor communication between the hospitals and public health and care institutions; press conferences were hard to manage because of peoples varying degrees of knowledgeable about the health risks of SARS thus fostering confusion; and messages targeted for the local population were picked up and broadcast all over the world.

The case study of Belgium’s dioxin crisis describes one of the major communication gaps as regarding information that showed uncertainty about what exactly happened to cause the release of dioxin to the environment. The subsequent opinions of scientific experts were described as "massively diverged on the causality of events."

The case study of Austria's 2004 avian flu alert provides key lessons related to public messages. It showed that using a one-voice principle (stakeholders agree to messages by consensus) to communicate in a crisis may be valuable but not always realistic. For example, scientific statements differ from those of decision-makers; a decision will sometimes need to be made on what messages to disseminate at the political level and what at the scientific level. In addition, one-voice communication may be more challenging in countries in which authority for public health is extensively delegated to the local and regional levels.

The report offers a number of solutions and suggestions which are drawn at the end of each case study. Several overlapping ones include: simply deciding on what to do and then communicating it; communicating early about health risks that arise suddenly and what the government is doing in managing that risk; acting proactively with a strategy driven by authoritative and reliable information rather than speculation from the mass media; proceeding carefully with what is communicated to the press; and, recognising that there is no such thing as standard rules for health ministries on since each ministry in each country has to decide on what is appropriate for its country.

Click here to access a related peer-reviewed summary on the Health e Communication website, and to participate in peer review.