Origins of an epidemic: the methodological and political emergence of rapid assessment.

The recent emergence of rapid assessment as a public health tool in the drug and alcohol field has been a relatively ahistorical process. The lack of such an explicit historical biography is understandable - the findings and impact of rapid assessment have rarely made their way into mainstream journals. However, its continued absence presents the manifest danger of an inward-looking field. This paper describes the development of rapid assessment during the past two decades, with a detailed focus on the emergence of rapid assessment in the drug and alcohol field. This focuses on the central role played by international agencies during the 1980s and 1990s, and the development of rapid methodologies by the World Health Organization to prevent epidemics of HIV among injecting drug users, and the use of rapid methodologies by the United Nations International Drug Control Programme to instruct drug policy reform. The paper also describes key events in other fields including: the emergence of the first formal rapid methodologies in the late 1970s, and the production of the first formal guidelines on conducting rapid assessment during the mid-1980s. The paper concludes by highlighting common challenges that rapid methodologies have faced throughout their history.