Strengthening Risk Prevention Policies Information should be released by an independent and trusted professional agency It is also very important who communicates the information. This should be done by recognized experts who are well qualified in the subject and who are seen to be fully trustworthy, politically independent and without conflicts of interest. Forpublic health in many countries, this important function is often best performed by the chief medica officer For controversial information, in general, the public does not trust any messages conveyed by politicians or politically appointed spokespersons An atmosphere of trust is needed between government officials, health experts, the general public and the media. This trust has to be developed and fostered Condescending attitudes and the withholding of information can rapidly lead public cynicism and accusations of a cover-up or a hidden scandal. Trust is easily lost but very difficult to regain The importance of developing trust between all parties has considerable implications for greater open government and its role in civil society. For instance, regulatory agencies need to be seen to be independent from political pressures, scientific information needs to be in the public domain, meetings of scientific advisory committees and their records need to be accessible for public scrutiny, and the mass media need to be free to investigate risks and publish their findings(10) STRENGTHENING THE SCIENTIFIC EVIDENCE BASE There have been many scientific advances in risk assessment since the subject was established in the 1960s. However, it started by focusing largely on new technologies and external environmental threats and has only latterly been extended to take into account major biological and behavioural risks to health, such as blood pressure, unsafe sex and tobacco consumption. In addition, the science of risk assessment developed mainly in North America and later in Europe, while to date there has been little application of this science in middle and low income countries. Research studies are needed to see if the lessons learned on risk perceptions and communications in industrialized countries also remain applicable in developing countries. In addition, while some reasonable global data exist, such as for risks leading to cardiovascular diseases(6, 24), data sources for other important risk factors require substantial improvement, especially for most middle and low income countries There is an urgent need, therefore, to establish new data sources for developing countries. The most important aspects of strengthening the scientific evidence base in risk. assessment and management inchude the following activities Collection of new scientific data on risk factors and exposures For the most common and importantrisks to health, collection of the essential new data needs to be replicated in many more countries. This will require international support for methodological developments in such areas as standardized protocols, data collection instruments, approaches to statistical analysis, data archiving and exchange, and disseminatio and use of research findings. Both qualitative and quantitative approaches will be necessary. Ongoing, regular collection of surveillance data is needed, in order to monitor trends in existing risk factors and to detect changes in exposure to health outcomes associated with themStrengthening Risk Prevention Policies 155 • Information should be released by an independent and trusted professional agency. It is also very important who communicates the information. This should be done by recognized experts who are well qualified in the subject and who are seen to be fully trustworthy, politically independent and without conflicts of interest. For public health in many countries, this important function is often best performed by the chief medical officer. For controversial information, in general, the public does not trust any messages conveyed by politicians or politically appointed spokespersons. • An atmosphere of trust is needed between government officials, health experts, the general public and the media. This trust has to be developed and fostered. Condescending attitudes and the withholding of information can rapidly lead to public cynicism and accusations of a cover-up or a hidden scandal. Trust is easily lost but very difficult to regain. The importance of developing trust between all parties has considerable implications for greater open government and its role in civil society. For instance, regulatory agencies need to be seen to be independent from political pressures, scientific information needs to be in the public domain, meetings of scientific advisory committees and their records need to be accessible for public scrutiny, and the mass media need to be free to investigate risks and publish their findings (10). STRENGTHENING THE SCIENTIFIC EVIDENCE BASE There have been many scientific advances in risk assessment since the subject was established in the 1960s. However, it started by focusing largely on new technologies and external environmental threats and has only latterly been extended to take into account major biological and behavioural risks to health, such as blood pressure, unsafe sex and tobacco consumption. In addition, the science of risk assessment developed mainly in North America and later in Europe, while to date there has been little application of this science in middle and low income countries. Research studies are needed to see if the lessons learned on risk perceptions and communications in industrialized countries also remain applicable in developing countries. In addition, while some reasonable global data exist, such as for risks leading to cardiovascular diseases (6, 24), data sources for other important risk factors require substantial improvement, especially for most middle and low income countries. There is an urgent need, therefore, to establish new data sources for developing countries. The most important aspects of strengthening the scientific evidence base in risk assessment and management include the following activities. • Collection of new scientific data on risk factors and exposures. For the most common and important risks to health, collection of the essential new data needs to be replicated in many more countries. This will require international support for methodological developments in such areas as standardized protocols, data collection instruments, approaches to statistical analysis, data archiving and exchange, and dissemination and use of research findings. Both qualitative and quantitative approaches will be necessary. Ongoing, regular collection of surveillance data is needed, in order to monitor trends in existing risk factors and to detect changes in exposure to risks and health outcomes associated with them