OPINION: Public mistrust threatens global health security

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The COVID-19 pandemic has taught us many lessons that call for proactive public health leadership. The COVID-19 pandemic has revealed vulnerabilities in our health systems and has highlighted the egregious level of inequity in global health. Public mistrust has also been a defining theme in our response. 

A recent poll conducted on LinkedIn shows that emerging infectious diseases and public mistrust of our institutions remain a significant threat to global health security.

Our response to the covid-19 pandemic has shown that money, technical know-how and scientific knowledge do not assure reasonable pandemic control. Culture, leadership, and the public’s trust in institutions are critical factors ensuring effective response. Several countries are now dealing with vaccine hesitancy stemming from mistrust and misinformation.

In 2020, I co-authored a publication cited several times by institutions, policymakers, and health NGOs. Our analysis revealed huge discrepancies between the Global Health Security Index and the actual response to the COVID-19 pandemic. The Global Health Security Index is an elaborate and comprehensive framework developed in 2019 by a panel of 21 experts from 13 countries to assess a country’s ability to avert and mitigate outbreaks.

It seemed that the panel of experts did not consider the impact of decisive leadership and public trust in government and scientific communities in their assessment. They failed to account for the consequences of poor leadership and dysfunctional political environments. For example, New Zealand was ranked 35th on the Global Health Security Index. However, our initial assessment revealed they were doing much better in their response than the top 10-ranked countries in the GHSI report.

The general theme that runs through most of the publications that cited our paper affirms that pandemic leadership is crucial. Selecting advisors with public health experience to lead control efforts is imperative.

As public health leaders, we have promoted risk communication by politicians over public health experts. The lack of public health input by experts has resulted in unscientific theories and the propagation of misinformation.

Investing in risk communication and community engagement is crucial in ensuring effective responses to current and future pandemics. Public health leaders should assume a more active role in risk communication to boost public health confidence in our institutions.  

Fortunately, trust can be built and fostered. Public health leaders and Governments should maintain or increase the availability of accurate, timely information no matter how limited the information may be.

As we continue to face threats from infectious diseases, the messenger’s identity in risk communication can be a deal-breaker in trust-building. Communicating the risk and relevant vulnerabilities should be the core mandate of public health leaders with little or no political interference.  

Dr Banda Khalifa is an advisor at the Tony Blair Institute for Global Change