HIFA Blog: Month in Review, June 2020 - “A matter of life and death for people unable to access essential healthcare information during the COVID-19 pandemic”

6 July, 2020

Quote of the month: “Managing the digital divide better has become a matter of life and death for people unable to access essential healthcare information during the COVID-19 pandemic.” António Guterres, Secretary-General of the United Nations

The impact of misinformation and fake news on efforts to contain the COVID-19 pandemic was once again the main discussion topic on the HIFA forum during June 2020. Our Quote of the Month comes not from a HIFA member, but from the Secretary-General of the United Nations. It strongly echoes HIFA’s vision of 'a world where every person has access to the healthcare information they need to protect their health and the health of others'.

In the May instalment of the HIFA Blog, I quoted Juliet Shenge (HIFA member, Nigeria) who warned that the COVID-19 pandemic would be “a wake up call for Africa”. Posts on the HIFA forum during June indicated that the ‘noise’ of misinformation is showing no signs of receding in African countries. We learnt that the South Sudan President Salva Kiir and other senior officials have used so-called "protective" badges that claim to repel viruses, but which don't work. Misleading messaging from Tanzania claimed that President Magufuli has banned the wearing of masks whilst the official line from the Tanzanian government is that masks should be worn and social distancing should be practised. And in Kenya, a leading politician was explaining why cognac was included in some relief packages for Nairobi residents. Mike Sonko, the Governor of the Kenya capital, claimed that WHO had proved that alcohol could serve as a throat sanitiser. He appears to have misinterpreted WHO health advice, which states that drinking alcohol does not protect you against the coronavirus, but it does endorse the use of alcohol-based gel to clean your hands.

We learned also that official advice is not infallible. HIFA member Bernard Seytre (France) drew attention to inadvertent misinformation from official Health Ministry websites and the WHO regional office for Africa, namely erroneous warning against contact with wild and domestic animals. He later reported, "I am glad to see that... the WHO African office removed from its website the posters with these messages".

In the two previous blogs, I highlighted how rapidly misinformation can “go viral”, particularly on social media platforms. Quick, decisive action to debunk myths is essential to deter the spread of misinformation, as demonstrated recently by Nigeria in its handling of the absurd myth that coronavirus has been caused by 5G mobile phone technology, despite the fact that Nigeria doesn’t have a 5G network. “COVID-19 made waves in the months of March and April”, Joseph Ana (HIFA member, Nigeria) told the forum, “but thankfully the very robust counter intervention with dissemination of the accurate facts by the Federal Government agencies meant that the myth was quickly squashed and has disappeared completely now”. Even so, Joseph had reservations. “Whether that means that the population believed the Government is a different matter”.

For some low- and middle-income countries, there are deeper, more localised challenges. In last month’s blog, Kenny Garmendia (HIFA member, Honduras) related how a lack of basic education amongst Honduran citizens prompted them to believe a myth that medical doctors were responsible for spreading the virus. During June, HIFA members considered findings from a recent survey, conducted by Translators Without Borders (TWB), a HIFA Supporting Organisation. The majority of respondents felt they did not have enough information on COVID-19, and the information that was available was often insufficient or inaccessible. Significantly, when asked what further support or resources they needed, the most common answer was “information materials in local languages.”

Finally, a paper published in The BMJ during June and shared on the HIFA forum reveals how COVID-19 is accelerating the threat of antimicrobial resistance (AMR), which already kills 2000 people a day worldwide, and could cause 10 million deaths each year by 2050. Despite attempts by WHO to discourage prescribing of antibiotics for mild cases of COVID-19, uncertainty about the disease process and its pathology is driving up usage. Premature hype about possible therapies for COVID-19 can also cause inappropriate use of antimicrobials (azithromycin, hydroxychloroquine), when there is little if any evidence to support clinical effectiveness. As Neil Pakenham-Walsh (HIFA Coordinator) stated on the HIFA forum, “Many of us on HIFA are extremely concerned about the prospect of a post-antibiotic apocalypse: a nightmare future, driven largely by inappropriate use of antibiotics, where antibiotics are ineffective against most infections. Arguably, the greatest cause of antimicrobial resistance is failure to access and apply reliable information on medicines. Health misinformation driven by social media adds to the toxic mix”.

Metrics: In June 2020 HIFA (English) exchanged 172 messages from 72 contributors in 23 countries (Austria, Bangladesh, Canada, China, Colombia, Croatia, France, Germany, Guinea, Honduras, India, Jordan, Kenya, Madagascar, Mozambique, Nigeria, Pakistan, Sudan, Switzerland, Tanzania, Uganda, UK, USA). Our top contributors were Joseph Ana, Nigeria (13), Julie N Reza, UK (5), and Sian Williams, UK (5). Thank you all for sharing your views and your experience.

Martin Carroll was previously Head of the International Department at the British Medical Association, London UK, and has worked on issues affecting health in LMICs since 2003. He represented the BMA on the HIFA Steering Group from 2008-16 and is now an independent HIFA Steering Group member.   Martin is a member of three HIFA working groups: Multilingualism, Evaluating the Impact of Healthcare Information, and Social Media. He is also the HIFA blogger. Twitter: @MMCarroll 

Picture credit: CDC/Alissa Eckert, MS; Dan Higgins, MAM. Thanks to Wikipedia