The Avian Influenza: Communication Strategy and Plan for Egypt is being developed by Egypt’s Ministry of Health and Population (MOHP), in co-ordination with international agencies, the Ministry of Agriculture and the Ministry of Environment. This document aims to present a comprehensive communication strategy and implementation plan to prepare for a possible outbreak of avian influenza (AI also known as avian flu or bird flu). According to the plan, public health science recognises the vital role of strategic communication in helping to prevent and mitigate the impacts of an outbreak. The AI Communication Strategy will guide the implementation plan with the aim of helping to provide reliable, timely, and authoritative communication to the public. Key partners supporting the Ministry of Health and Population include the World Bank, the United Nations Children's Fund (UNICEF), the World Health Organisation (WHO), the United States Agency for International Development (USAID), Johns Hopkins Bloomberg School of Public Health Center for Communication Programs and the Communication for Health Living Project. The goals of this are to: limit the spread of avian flu among animals; improve hygiene to limit the spread from animals to humans; and strengthen the government system preparedness and response should a pandemic outbreak occur.

The approach of the communication strategy includes the following elements:

• Multi-sectoral action - An effective communication strategy will involve partners from several ministries, sectors, and industries in critical activities.
• Multi-level implementation - Activities are designed to be implemented on the national, community, and interpersonal level.
• Sustainable - It is thought that the AI threat may remain indefinitely, and Egypt must stay alert to pandemic potential. Activities must be ongoing so as to avoid complacency and a return to at-risk attitudes and behaviours.
• Dynamic - The level or phase of AI in Egypt is likely to change over time, and could change rapidly, along with the required messages and target audiences. The communication plan must therefore be continually refined and adapted to address identified threats and gaps.

The plan includes lessons drawn from other public health experiences:

• Preventive action is much more effective than post-hoc reaction in controlling the spread of disease. Systems must be in place to allow early and rapid interventions;
• Clear, concise, and accurate information is vital to combat rumours and myths;
• Trust in authorities is crucial and must be earned;
• Public health issues can have a major impact on business and the economy;
• Public health measures must be balanced with human rights issues like privacy, freedom of movement, and other concerns; and
• Preventing stigmatisation of those infected enhances the effectiveness of disease control.

Key lessons from polio eradication in Egypt include:

• Changing behaviour (to facilitate disease prevention and control) requires more than disseminating information about risks. Community engagement and social mobilisation are imperative;
• Mass media can be an effective means of disseminating public health messages, but they are only one of many alliances and networks that can be used;
• Scientific communication strategies and public campaigns do have a strong impact on changing knowledge, attitudes and behaviour especially when they are based on sound research evidence and are well coordinated and efforts are undertaken in an organised manner;
• Highest level of political will and government commitment is a major pre-requisite for any public health campaign to succeed.

The communication response is conceptualised as a unified programme that provides reliable, timely, and authoritative information in what may become a rapidly changing environment. Working on national public information level and the sub-national level where more interpersonal and community based interventions are undertaken are important to accomplish consistency and ensure reach. According to the document, Egypt has a sophisticated communication environment, with access to print, internet, and broadcast technology, as well as extensive networks of outreach workers in the government, nongovernmental organisation, and private sector. These organisations will form both the main communication channels and the responsible parties for implementing the strategy. A unified strategic approach aims to help to ensure that all campaign interventions are easily identified, have consistent messages or a clear relationship if coming from multiple sectors, and are credible for each stage of epidemic prevalence.

Reflecting WHO guidelines for effective outbreak control, Egypt’s communication strategy shall be guided by key principles of outbreak communication.

• Communication with the public must build, maintain, or restore trust. A public that does not trust the authoritative source of the communication will be less likely to adopt the recommended behaviours and actions.
• Information about outbreaks is difficult to keep hidden. Official announcements that serve as an early warnings help establish the parameters of trust.
• Maintaining the public’s trust requires communication that is candid, easily understood, comprehensive, and factually accurate. In effect, transparency allows the public to “view” the information-gathering, risk-assessing, and decision-making processes associated with outbreak control. The public must see competence behind the decisions and messages.
• Successful messages bridge the gap between the expert and the public. Messages must address misconceptions and fears as well as what the public must do to protect themselves.
• Communication planning should be part of outbreak management planning so that a communication plan based on risk analysis and risk management for each phase of the outbreak is ready before it is needed.

The key audiences, communication objectives, broad messages, and communication channels are presented in a matrix form within the document.

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