Stakeholder involvement in outbreak management: To fear or not to fear?

Infectious diseases remain a threat to public health, requiring the coordinated action of many stakeholders. Little has been written about stakeholder participation and approaches to sharing information, in dynamic contexts and under time pressure as is the case for infectious disease outbreaks. Communicable-disease specialists fear that delays in implementing control measures may occur if stakeholders are not included in the outbreak-management process. Two case studies described in this article show how the needs of stakeholders may vary with time and that early sharing of information takes priority over shared decision-making. The stakeholders itemized their needs and potential contributions in order to arrive at the collective interest of outbreak management. For this, the results suggest the potential for improvement through development of “network governance” including the effective sharing of information in large networks with varying needs. Outbreaks in which conflicting perceptions may occur among the stakeholders require particular attention.