FROM THE EDITOR

Elections, pandemics and information disorder

More than 50 countries, including South Africa (SA), Mexico, India, the UK and the USA, will have or already have had elections by the end of this year. Potential voters total more than 2 billion in number. In parallel, misinformation and disinformation have reared their ugly heads again, and the World Economic Forum has ranked misinformation as its top global risk over the next 2 years. Besides misinformation having the power to mislead people, it can also result in many people losing faith and trust in robust systems, from science and healthcare to fair elections.^[1] In SA, it has been reported that there has been an orchestrated campaign of disinformation to destabilise the country post elections.^[2] This information disorder is starkly reminiscent of the information disorder during the COVID-19 pandemic. It is also a reminder that preparing for the next pandemic, which could be even more devastating than COVID-19, must include planning to prevent and manage information disorder.

From the very beginning of the COVID-19 pandemic, there was a tsunami of information locally and globally, leading to a global information crisis.^[3] This provided fertile ground for the complex phenomenon of information disorder - that of misinformation, disinformation and mal-information. Misinformation is when false information is shared with no intention to cause harm. Disinformation is when false information is shared to intentionally cause harm, and mal-information is when real and authentic information that needs to remain private is transferred into the public domain with the intention of causing harm.^[4] Misinformation gained rapid momentum during the COVID-19 pandemic, and gave rise to an infodemic in itself of pandemic proportions (misinformation pandemic). According to the World Health Organization, an infodemic consists of too much information, including false or misleading information, in digital and physical environments during a disease outbreak, which leads to confusion and risk-taking behaviours that can harm health, lead to mistrust in health authorities, undermine the public health response and intensify or lengthen outbreaks. Growing digitisation results in information spreading more rapidly. While this assists with filling information vacuums quickly, it can amplify harmful messages,^[5] and result in global challenges to public health. Given the magnitude of the COVID-19 infodemic, there was great difficulty experienced with identifying correct information and implementing effective measures to prevent the spread of the virus.^[6-

The role of communication during an outbreak is critical. Through robust communication, information is disseminated, meaningful exchanges realised, goals achieved and even people who are far distant and in rural areas reached.^[3] Communicating during an outbreak needs to allay public fears, assure communities of the work that health agencies are doing, mitigate rumours and information disorder, offer preventive solutions and procedures for recovery and be credible and transparent.^[7] However, it is acknowledged that the many challenges with communication during the COVID-19 pandemic were not only related to a lack of correct information. Problems of trust in science, politicians' decisions, pharmaceuticals and the media were also contributory factors. In addition, the lack of health literacy, a lack of culture of public engagement and lack of skills by scientists to convince the public that uncertainty in science is inevitable further compounded the issue.

The SA Medical Research Council, in its position paper 'Communication during pandemics: Lessons learnt from the COVID-19 pandemic', advanced several recommendations, which are summarised below:^[3]

• Meaningful and honest communication is at the crux of management of pandemics. All the objectives of pandemic communication must be achieved: reassuring the public; advising on preventive measures; raising awareness and enhancing solidarity on the issue; providing timely and regular information as the threat evolves; and adapting the approach as new knowledge emerges. Timely communication of the best information available at the time is essential to counter information disorder.

• Focused, honest, meaningful and culturally appropriate communication strategies based on available scientific evidence, including candid information on uncertainties, are necessary, and communication must be comprehended by all persons. Building trust, using trusted messengers and communication mediums in understandable languages are key in communication on preventing spread.

• In the context of vaccines, transparency with regard to, inter alia, the benefits, risks, adverse events and te limits of available evidence must be communicated, with the patient-healthcare encounter providing a valuable opportunity to take forward the communication.

• Respectful and collaborative community engagement, to include civil society organisations, non-governmental organisations, religious leaders and leaders from within communities to customise messages, would assist in motivating communities to trust and accept preventive interventions, including vaccinations.

• Because media plays a significant role in disseminating information, monitoring and investigative responses to identify and debunk disinformation, and instituting and implementing content credibility, labelling initiatives are recommended.

• The role of the government includes equipping the population with the tools to access relevant information. It is the state's responsibility to promote health literacy and public dialogue, address the problem of the digital divide and to promote health communication as integral to the social determinants of health. More research on contextually relevant pandemic communication is necessary and must be conducted before the outbreak of the next pandemic. The state has an obligation to fund and support these studies.

It is imperative that communication is managed effectively during pandemics, and the failures of communication experienced during the SARS CoV-2 outbreak are avoided. Hopefully, the information disorder experienced during the elections this year has jolted us out of the dispassionate disinterest typically seen at the end of pandemics and activities, including communication strategies towards preventing and confronting the next pandemic are robustly taken forward.

Ames Dhai

Acting editor

Ames.Dhai@wits.ac.za

References

1. Adam D. Misinformation might sway elections - but not in the way you think. Nature Communications 18 [une 2024. https://www.nature.com/articles/d41586-024-01696-z?utm_source=Live+Audience&utm campaign=507caab053-nature-briefing-daily-20240618 (accessed 24 June 2024).         [ Links ]

2. Davis R. Disinformation nation - a concerted campaign to destabilise SA post elections. Daily Maverick, 2 June 2024. https://www.dailymaverick.co.za/article/2024-06-02-disinformation-nation-a-concerted-campaign-to-destabilise-sa-post-elections (accessed 25 June 2024).         [ Links ]

3. Dhai A. Communication during pandemics: Lessons learnt from the COVID-19 pandemic. Position Paper. South African Medical Research Council, 2024. https://www.samrc.ac.za/sites/default/files/attachments/2024-04/SAMRCPositionPaperPandemicCommunication.pdf (accessed 24 June 2024).         [ Links ]

4. Wardle C, Derakhshan H. Information disorder: Toward an interdisciplinary framework for research and policy making. Council of Europe Report (preprint), 2017. https://rm.coe.int/information-disorder-toward-an-interdisciplinary-framework-for-researc/16807627 (accessed 20 January 2023).         [ Links ]

5. World Health Organization. Infodemic. Overview. Geneva: WHO, 2023. https://www.who.int/health-topics/infodemic#tab=tab_1 (accessed 10 December 2023).         [ Links ]

6. United Nations Educational, Scientific and Cultural Organization. Report of the International Bioethics Committee (IBC) on the Covid-19 pandemic: Lessons learnt and recommendations for future directions. UNESCO, 2023. https://unesdoc.unesco.org/ark:/48223/pf0000386467 (accessed 10 December 2023).         [ Links ]

7. Della Togna M, Garman A, Adjin-Tettey TD, et al. Chapter 4. Communication. In: Department of Planning, Monitoring and Evaluation, Government Technical Advisory Centre and National Research Foundation, eds. South Africa Covid-19 Country Report, 1st ed. NRF: Pretoria: June 2021. https://www.gtac.gov.za/wp-content/uploads/2021/06/Covid-19-Country-Report-Chapter-4-Government-Mobilization-and-Communication.pdf (accessed 25 June 2024).         [ Links ]