Conversation with Tim Nguyen, WHO
A conversation between Tim Nguyen, Head of Unit, High Impact Events Preparedness, World Health Organization, and Grace Lown, Head of Public Affairs, Kantar Public
The World Health Organization (WHO) has been a lead player in the global coordination for mitigating the COVID-19 pandemic. They have been spearheading initiatives in response to the spread of the virus – from trials investigating treatment options, to fundraising for the pandemic response, and the COVAX vaccine-sharing programme which aims to distribute 2 billion doses of the vaccine for free or at reduced costs by the end of 2021.
The WHO has also played a critical role in the global response to mis- and disinformation during the pandemic. In June 2020, they hosted the first ‘infodemiology’ conference, which aims to better understand and manage ‘infodemics’ – that is the overabundance of information occurring during an epidemic.
In this conversation with Grace Lown from Kantar Public, Tim Nguyen talks about the role of WHO’s Information Network for Epidemics, and the creation of new evidence-based measures and practices to prevent, detect and respond to mis- and disinformation.
Grace: From your perspective at the World Health Organization, what was the impact of COVID-19 on the role of international cooperation in public health policy?
Tim: I think when we talk about international cooperation, it’s better defined as multilateralism. COVID-19 cannot be beaten by one country at a time. We are all in this together and we need joint solutions.
We have proven through international cooperation that we can speed up the production and delivery of vaccines within a year. The vaccine endeavours have also been strongly dependent on international cooperation – in research, manufacturing, capacity, procurement and investment in delivery, on the sharing of wisdom and knowledge.
The concerns about the different variants of COVID-19 demonstrate the importance of collective action, especially in equitable distribution of vaccines all over the world.
International cooperation and multilateralism are key elements to overcome what has been referred to as ‘vaccine nationalism’ , and to roll out an equitable vaccination campaign around the world.
Indeed, if we only vaccinate a few countries entirely, but leave most of the rest of the world unprotected, variants might make current vaccines ineffective, and the virus will continue to spread.
International cooperation relies on significant political and financial commitment from governments to support a system where public health measures underpin the scaling up of vaccine manufacturing.
As well as this, there must be equitable access to the vaccine including for the most vulnerable and overcoming vaccine nationalism. All ultimately with the goal of defeating the COVID-19 pandemic.
Grace: How were these efforts perceived by the public? In your view, did the pandemic impact people’s trust in public authorities and public health experts?
Tim: I think this brings us to the concept of the infodemic, when too much information makes it difficult for people to find the right information, and then consequently to take the right action.
How we communicate science and risk during an epidemic is key to gaining and keeping trust in our institutions and in the way we use science for public health.
As the COVID-19 pandemic is a global event affecting the global population, everything has been under the spotlight, even the scientific processes themselves. And these processes haven’t changed! Science has always evolved by one academic entering a discussion with a colleague who may have a different viewpoint: this is what drives research forward.
It's just that many people before the pandemic didn't understand or engage with how the scientific process works. Since COVID-19, suddenly everyone is interested in the scientific process.
However, it’s not always straightforward to provide clear answers as science progresses by the hour, so the attention given to it is creating a lot of information and noise – and potentially confusion.
Another contributing factor to the increasing volumes of information, is the sheer number of scientific publications out there about the virus and disease: about 200,000 research papers were written on COVID-19 in 2020. Nobody could read all this literature! So, it’s also about delineating the relevant research that actually contributes to public health decision making. A lot of research out there is not necessarily relevant, and this can be confusing, overwhelming, and detrimental to public trust.
Finally, an important step in the scientific process is peer review where other academics can read and challenge the author about their research methodology, their results, and conclusions. However, we have seen papers coming out as ‘pre-prints’ where peer review hasn’t taken place yet.
The media are picking up these pre-prints and reporting the findings as definitive results of the scientific process, leading on many occasions to confusion.
Indeed, anyone can pick up parts of the research pre-print and say “the research has just shown that…..”, whilst the check and balance through peer review is not yet completed.
So, this ‘publication-by-Twitter’ approach is another facet of this infodemic.
Grace: What lessons can you share on addressing this infodemic?
Tim: The epidemic happens to people and it impacts communities, so engaging with people and communities is central to tackling any public health crisis.
It’s critical to encourage everyone to respect the rules and to integrate public and social measures into our daily routine, including hand hygiene, wearing a mask, and maintaining physical distance; but these things don't work via top-down messaging.
This is something that must be embedded in communities and by working with communities.
Gaining people’s trust during health emergencies is vital. This can be done by reaching out to trusted community figureheads.
For example, religious leaders or youth leaders. Employers can also play this role in engaging their communities and teams. Every figure that can be trusted as a reliable source should be engaged to support the process of listening and understanding their concerns, with respect to decisions coming from governments or sources not seen to be part of the community.
An important lesson learnt in terms of co-development and co-creation of guidance is that we need to bring in the people who are best placed to reach the communities on the ground.
The WHO works with communities helping them to understand why certain measures are in place, how they are being implemented, and to plan and evaluate the process of tackling the pandemic.
An example of these actions is the publication of “10 Steps to Community Readiness” which highlights how best to engage communities through joint planning and the co-development of initiatives. This is our best chance of gaining trust and ensuring acceptance of and adherence to social measures.
Organizations like the WHO can develop global recommendations to a certain degree, but the actions need to be adapted to a cultural and language context.
When we work with religious leaders, their feedback is that we supply good technical documents, talking to the “minds”, but that these only reach a certain group of people. To win over a wider community, you need to touch their hearts too.
The phenomenon and inherent challenge of high volumes of readily available information, should be addressed by meeting people and working with them to help to amplify what they can do to protect themselves and their love ones.
Grace: How can we increase people’s ability to identify and recognise mis- or disinformation? Have we made progress on enhancing these skills during COVID-19?
Tim: We cannot fight every piece of mis- or disinformation out there. We need to increase the literacy people have to detect it themselves. It’s important to understand the difference between disinformation and misinformation.
Misinformation is inaccurate information without an intention to do harm or mislead. Disinformation is inaccurate and false information with the intention of misleading and doing harm.
What we see most of the time is misinformation, with people sharing information they believe is right because they didn’t know better. They believe the information will help their friends, their family or their communities.
At the beginning of the pandemic especially, many of us wanted to absorb all the news and information available. I remember trying to read every article because I had this desire to be informed about what was going on, to give me a sense of control. My feeling was that, in these uncertain times, “the more information I have, the better I can control the situation”.
This urge to absorb and seek out information is an expression of being scared and confused. We know that people have questions, and people have concerns.
As public health institutions, we need to understand these concerns and questions, to offer better information to help people in these stressful situations. It’s about coming from a place of empathy and understanding in responding.
To help people build resilience to mis- and disinformation, we also need to explore different routes for different people. This can be through the educational systems where our children can learn digital literacy.
It is important that they understand how information is created and spread, and that they realise they should not believe everything and that they need to check the sources.
In Finland for instance, schools are teaching digital literacy programmes to educate children about information.
Similarly, the UK’s Cabinet Office has partnered with the University of Cambridge to create “Go Viral”, an online game designed to boost people’s confidence in detecting misinformation and to help them better understand how the mechanisms work on social media.
The game explains, for example, that most algorithms favour posts with “emotional” language. So, the more emotional the language is, the more engagement you have, the more likes you get. And understanding these algorithms is part of digital literacy.
These are good examples of the fact that we need to help people understand their attitudes to information, the tactics of disinformation, and the dynamics of what is happening out there.
Grace: When it comes to tackling the challenges of mis- and disinformation, what do you think government and public authorities could do to find the right balance between improving digital literacy and controlling or ‘policing’ information and platforms?
Tim: My recommendation is to develop preventative approaches, and these include building resilience. By the time you take down a social media post or an account because it is sharing misinformation, it is already too late. This should be a last resort, happening within a legal framework clearly established and agreed on.
What we believe works better is prevention, building resilience to misinformation, and the inoculation of people with “good” information to better develop their capability to understand whether or not they are being misled.
I would add that mis- and disinformation is highly localised; it builds on existing disparities in countries and building that resilience is often localised in terms of environments and communities. For example, there is a difference between developing and developed countries. In a developing country, many people may not have access to stable internet connection.
Therefore, we're then talking about a different kind of mis- and disinformation which is more word-of-mouth, or happening in closed messaging groups, like WhatsApp, rather than from social media sites.
Since the mechanisms are very different and can vary locally, initiatives that work to build resilience in one context, may not work elsewhere.
Grace: Do you think we have learned and are better prepared to deal with the continued impact of this virus?
Tim: I think countries have become wiser because of COVID-19: they know that they must invest more and commit more into preparedness.
We have seen many discussions around this recently, with countries calling for a treaty on pandemic preparedness and reconfirming their commitment to learn from this pandemic. It is really reassuring to hear that message coming from many Heads of State, and this is something we all need to build on to come out of this experience better and stronger.
The key point is that we must prepare better and invest more in preparedness measures, learning from this pandemic.
This includes learning from the impact of such events on mental health, as well as the rise in conflict and violence within homes and communities; and learning from the critical health inequalities that COVID-19 has highlighted, both within and between countries.
