governments sometimes try to _conceal_ information about a disease outbreak from the public and from international bodies like the WHO? To achieve more transparent information strategies it is first necessary to understand the incentives for governments to conceal information about disease and to otherwise engage in strategic behavior that may result in less than optimal social outcomes at both national and global levels.

# **_Educating the Educators_**

Especially in developing countries, governments themselves often function under conditions of highly imperfect information. Poor surveillance capabilities mean that officials are often uncertain about the occurrence or nature of an infectious disease outbreak. Cash and Narasimhan (2000) note that, in both the 1994 Surat plague outbreak and the 1991 cholera outbreak in Peru, lack of adequate testing facilities meant that the authorities were unable to collect reliable data quickly enough to provide an authoritative source of public information in the early days of the outbreak, allowing rumors and tendentious media reports to win the field. In these cases lack of adequate diagnostic facilities also led to the use of excessively broad case definitions and inflated case numbers, which, in turn, contributed to panic among the public and excessive trade restrictions by trading partners.

The problems of weak surveillance capacity can and should be addressed over time by devoting more effort to strengthening public health systems in this area, drawing not only on domestic resources but also on foreign financial and technical assistance. Concerns about avian influenza and a potential human influenza pandemic have indeed led to a significant increase in awareness about and development assistance aimed at strengthening animal and human health surveillance capacities in developing countries over the past 1-2 years. (See for example UNSIC 2006, UNSIC/World Bank 2006, World Bank 2006b). The revised International Health Regulations (IHR) adopted by the World Health Assembly in May 2005 also dramatically expand the scope of global public health surveillance, requiring governments to, among other things, promptly report “all events which may constitute a public health emergency of international concern” to the World Health Organization. (IHR 2005, Baker and Fidler 2006). The development of health prediction markets could also provide a powerful forward looking complement to traditional surveillance methods (as discussed in footnote 9 above).

# **_Incentives in Public Risk Communications:  Is Honesty the Best Policy?_**

Lack of public capability and resources are not the only source of poor information and lack of reporting about disease conditions. Under certain conditions governments can also have significant incentives to conceal or delay communicating information about disease conditions to the public, to other governments or to the World Health Organization. There were examples of such delays during the SARS outbreak in 2003.

There are several factors that shape the incentive for governments to delay releasing information on disease conditions. Especially in the early stages, there may be considerable uncertainty whether a disease outbreak will develop into a more serious epidemic. Sometimes a rash of illness from a known or unknown source will raise 18