Raymond Biesinger

Vaccines are one of the most important scientific inventions of all time, preventing millions of cases of disease every year and helping to consign once-deadly outbreaks to history. Yet these vital public-health tools are under threat from growing public mistrust in immunisation and the rise of so-called "fake news" drowning out expert voices. This "anti-vax" sentiment and pushback against scientific evidence threatens public health around the world, from measles outbreaks in the US and across Europe, prompting stricter vaccination laws, to persisting polio in Pakistan and Afghanistan. If this trend continues, 2018 could see a devastating resurgence of deadly diseases previously on the brink of eradication.

In the Global Risk Report published by the World Economic Forum (WEF) in 2013, two of the top three global risks were digital wildfires in a hyper-connected world and the dangers of human hubris on health. The key message of the report was that, while there are some clear benefits of digital communication, "The global risk of massive digital misinformation sits at the centre of a constellation of technological and geopolitical risks." One of those geopolitical risks is a massive disease outbreak as a consequence of intentional or inadvertent false information driving panic and refusal of the very interventions that could contain or prevent the spread of disease.


As the recent Ebola and Zika epidemics have shown, these outbreaks create local - as well as global - financial and system stresses, impacting travel, commerce and social stability.

In 2018, five years after the 2013 WEF report, the highlighted risks will only become more entrenched, converging to allow misinformation to spread in digital wildfires and disrupt vaccination and other health campaigns. These are disruptions that set back, rather than advance, scientific progress. Examples range from the 2017 WhatsApp and Facebook anti-vaccination campaigns in South India, which sparked fear and refusal of the measles rubella vaccine - some linked to now debunked autism anxieties around the MMR vaccine nearly 20 years ago in the UK - to similar social-media-propagated false rumours provoking vaccine refusals, measles outbreaks and diphtheria deaths in Malaysia. As a result of declining immunisation levels, between 2016-2017 Europe experienced 35 deaths due to measles, a disease that was nearly wiped out. All of those deaths were preventable.

Rumour outbreaks and their contagion not only put stresses on immunisation programmes, they are ubiquitous across the health field. Ebola rumours propagated disease spread among those who feared the motives for quarantine measures in Guinea, Liberia and Sierra Leone, while other rumours went viral on social media in Nigeria, stating that eating salt and bitter melon could prevent the virus, sickening some and killing others. In Brazil, rumours that Zika was caused by bad vaccines drove a decline in vaccine uptake and remains a problem, even while Zika transmission has slowed.

In 2018, the appetite for fake news will show no sign of waning, especially because of the propagation of distrust in "experts" as well as institutions. The risks are not only for sustaining confidence in the vaccines that have saved lives for decades, but preparedness for the next new emerging disease outbreak or global pandemic. The year 2018 will mark the 100th anniversary of the 1918 Spanish flu pandemic which caused an estimated 50 million deaths - more than those killed in the first world war. There was no digital communication then to disrupt - or aid - the outbreak response, but there were also far fewer health technologies available, while rapid spread of the virus by plane travel was very limited.

In 2018, when we face the next major infectious disease outbreak, it will be a test of how well we use - or abuse - the technologies and knowledge we've gained since 1918.