By Calvin Wai-Loon Ho
With the mainstreaming of digital technology across many spheres of social life, infodemic management must be an integral part of public health emergency prevention, preparedness, response, and recovery.
While the Principles and Guidelines on Human Rights and Public Health Emergencies (the Principles) do not make explicit reference to infodemics, the application of digital technologies in response to a public health emergency is a clear concern. This article provides further elaboration and critique of the Principles and their treatment of this emergent phenomenon.
The World Health Organization (WHO) defines an infodemic as having “too much information including false or misleading information in digital and physical environments during a disease outbreak.” Over the course of the COVID-19 pandemic, the accompanying infodemic gained visibility through the widespread use of digital resources, platforms and tools to support a range of social interactions, activities, and pandemic countermeasures. False and misleading information was rapidly disseminated on the nature of SARS-CoV-2, hidden political agenda linked to public health countermeasures, serious safety concerns over vaccines, vaccination and treatment options, and the risks of infection posed by health care providers and people and communities of particular ethnicity.
WHO has been pivotal in framing and operationalizing COVID-19 infodemic countermeasures through initiatives that monitor harmful information, and counter false information. More recently, it launched “infodemic management” as a public health program, comprising practices underpinned by the science of infodemiology – a relatively new specialty in epidemiology – that seek to listen to community concerns and questions, promote understanding of risk and authoritative health information, build information resilience and empower (through engagement with) communities to take positive action.
From a systems perspective, infodemic management may be seen as falling within WHO’s wider mandate under the International Health Regulations (IHR) of supporting its Member States in developing informational capabilities (for disease surveillance, for instance). In the months ahead, targeted amendments may be made to the IHR to render infodemic an explicit concern.
Meanwhile, in previous drafts of the the pandemic treaty under negotiation, certain provisions made limited reference to “combat[ing] the infodemic, and tackl[ing]false, misleading, misinformation or disinformation” through measures that include promoting and facilitating the development and implementation of risk communication strategies, conduct regular community outreach and consultations with civil society organizations and media outlets, promoting communications on technical advances, and taking effective measures to increase digital health literacy among the public and within the health sector.
These measures put forward in the pandemic treaty are largely technical in nature, and hence do not adequately account for human rights or ethical concerns. In this respect, they fail to adequately account for the complexity of an infodemic, which is often, if not always, interlinked with other information disorders that may be driven by political, economic, or other motivation that have no direct connection to health. The UN system’s response to the COVID-19 infodemic reflects this complexity in the participation of other UN agencies like the UN Department of Global Communications, UNESCO (with a mandate to protect and promote freedom of expression), and UNICEF (in its focus on vaccination and immunization) in countering different types of harmful information, including misinformation, disinformation and hate speech. However, effective collaboration across the different UN agencies and their external partners was hampered by the lack of a common understanding, as a review of the UN system reports. Other challenges encountered include inadequate capacity to analyze and manage the infodemic, inability to conduct impact assessments in different contexts, and difficulty to work effectively with large technology platforms. Although largely technical in focus, these challenges have a normative dimension, as well as concerns that relate to appropriate governance, which the pandemic treaty is largely silent on.
Read with the pandemic treaty, the Principles and Guidelines on Human Rights and Public Health Emergencies (the Principles) constitute a critical framework for forging a common and more holistic understanding of infodemic-related harm. In Section V, the rights-based approach is not confined to a single human right obligation, but takes into account limitations and derogations to human rights (e.g., the right to freedom of expression, the right to freedom of association, and the right to peaceful assembly), as well as underscores the importance of having strict regard for the principles of legality, necessity, proportionality and non-discrimination. Given that UN agencies have mandates that give differential emphasis to one or more human right obligations, the Principles’ framework could foster common understanding that may be both epistemic and applied.
The Principles’ explication of what a participatory approach should look like from a human rights perspective could also help to address the other challenges that hampered the UN’s response to the COVID-19 infodemic. For instance, Article 7 instructively highlights that states must “consult and take into account the self-expressed needs, knowledge, expertise and perspectives of rights holders,” and “guarantee effective and institutionalized public participation and deliberation mechanisms which are accessible to everyone, in order to meet its human rights obligation of respecting and ensuring meaningful and effective participation.” Just as crucial is the explication (in Article 5) of the human rights duties relating to non-State actors, such as social media companies where infodemic is concerned. Non-state actors, particularly business enterprises, have a duty to respect and, where applicable, to contribute to the fulfillment of human rights. They should, where relevant, “proactively engage, collaborate and coordinate with States, individually and collectively, to ensure the full realization of health and human rights” (Article 5(b)(ii)). This statement is especially pertinent in the light of the challenges that UN agencies faced in the lack of resources to pay full-price to social media platforms for advertising UN messages about COVID-19, and to customize social listening tools (initially developed for marketing) for public health purposes. More recently, the announcement by Twitter to charge a substantial data access fee is likely to have a profound impact on infodemic management, unless exceptional arrangements are put in place for public health emergencies.
In sum, a number of key concerns that infodemic management seeks to address are implicitly considered in the Principles. Moving forward, these considerations could be made more explicit in subsequent versions of the framework or possibly in an addendum directed at more applied objectives. It is less clear to what extent the Principles, and for that matter the pandemic treaty, apply to serious health threats like antimicrobial resistance (AMR), despite their relevance and potential utility.
Calvin Wai-Loon Ho is an Associate Professor with the Department of Law and Co-Director of the Centre for Medical Ethics and Law at the University of Hong Kong.