May the Sheep Safely Graze? A Reflexive View of the Expert–Lay Knowledge Divide

Abstract

This paper argues for a rethinking of disease preparedness that puts incertitude and the politics of knowledge at the centre. Through examining the
\nexperiences of Ebola, Nipah, cholera and COVID-19 across multiple settings,
\nthe limitations of current approaches are highlighted. Conventional
\napproaches assume a controllable, predictable future, which is responded
\nto by a range of standard interventions. Such emergency preparedness
\nplanning approaches assume risk – where future outcomes can be predicted –
\nand fail to address uncertainty, ambiguity and ignorance – where outcomes
\nor their probabilities are unknown. Through examining the experiences of
\noutbreak planning and response across the four cases, the paper argues for
\nan approach that highlights the politics of knowledge, the constructions of
\ntime and space, the requirements for institutions and administrations and the
\nchallenges of ethics and justice. Embracing incertitude in disease preparedness responses therefore means making contextual social, political and cultural dimensions central.