Having recently entered its second year, the outbreak of the Ebola virus disease in the Democratic Republic of the Congo (DRC) continues to challenge national, regional, and international health officials. Since being declared on August 1, 2018, the epidemic has grown significantly in cases, deaths, and as a threat to neighboring countries. In July, the Director-General of the World Health Organization (WHO) declared that the outbreak constituted a public health emergency of international concern.
The reasons why this outbreak developed into an international emergency are many, including problems created by armed conflict in the DRC and inadequate support from the international community. Included in the mix of factors is the spread of disinformation through social media about the Ebola outbreak and responses to it. The context in the DRC has proved ripe for proliferation of online disinformation about Ebola. Violence associated with the armed conflict, divisiveness in Congolese politics, and skepticism about the intentions of foreign assistance have, with other factors, produced an environment in which “rampant misinformation fuels a distrust of outsiders in medical garb.”
Unfortunately, the proliferation of disinformation online amidst the DRC’s outbreak is not novel. The biggest Ebola outbreak in history occurred in West Africa in 2014, and those battling that crisis grappled with false and misleading information spread through social media. The online disinformation problem has become just as ubiquitous in health as in other policy areas. Efforts to curb bad information and conspiracy theories on social media about vaccinations for various diseases attest to the pervasive scope and pernicious effect of online misinformation on health issues.
Disinformation threatens health because it undermines confidence in the underlying science, questions the motivations of health professionals, politicizes health activities, and creates problems for responses to disease challenges. This disturbing phenomenon is not, however, all about the internet. Outbreaks of disinformation during disease epidemics have old, deep, and disconcerting roots in domestic and international politics.
Domestically, actual and feared outbreaks of disease have often been blamed, without justification, on foreign countries or immigrants. In addition, spreading misinformation about diseases was a tactic of disinformation campaigns by governments before the social media era. For example, Soviet propaganda in the 1980s claimed that the United States was responsible for the spread of HIV/AIDS in Africa. Thus, diseases—and the fear of epidemics—have long proved fertile for “weaponized health communication” that exploits anti-immigrant prejudice, xenophobia, politically-polarized populations, and geopolitical competition.
All these features of the disease disinformation playbook have appeared in Ebola outbreaks in Africa. During the 2014 outbreak in West Africa, Russian internet trolls disseminated information that accused the United States of bringing Ebola to that region. Social media platforms, such as Facebook and WhatsApp, have been used to blame foreigners for the ongoing presence and spread of Ebola in the DRC. Such messaging has informed attacks that armed factions have launched against Ebola treatment centers in the DRC as symbols of foreign meddling. Claims that immigrants and asylum seekers threaten to bring Ebola into the United States from Africa have appeared on social media.
The deep political roots of disease disinformation, combined with social media’s effectiveness in spreading false information about outbreaks, has cyber experts, health specialists, and global leaders worried. Cybersecurity expert Bruce Schneier argued that, “when the next pandemic strikes, we’ll be fighting . . . the deluge of rumors, misinformation and flat-out lies that will appear on the internet.” Heidi Larson of the London School of Hygiene and Tropical Medicine warned that the flood of “conflicting information, misinformation and manipulated information on social media should be recognized as a global public-health threat.” The UN Secretary-General asserted that, “the spread of false information poses a threat to people’s lives, health security and to public health systems across the world.”
Health organizations, such as WHO, have developed strategies to address online disinformation about outbreaks and other issues, such as vaccinations. These strategies resemble efforts in other areas to combat disinformation in cyberspace. As Schneier observed, the health strategies look “like what we’re already talking about with regard to government-run and other information influence campaigns that target our democratic processes: methods of visibly identifying false stories, the identification and deletion of fake posts and accounts, ways to promote official and accurate news, and so on.”
However, the rampant disinformation associated with the DRC’s Ebola outbreak—coming on the heels of similar problems during the 2014 Ebola outbreak and global concerns about vaccine misinformation—suggests these approaches are proving no more successful in health than in other contexts. Recommending that health organizations devote more time and resources to this challenge rings hollow. As the DRC’s Ebola crisis shows, outbreak prevention and response efforts already suffer shortages of personnel, equipment, medicines, funds, and political will. In such resource-challenged contexts, the brutal triage required to set priorities for controlling outbreaks can marginalize the fight against the convergence of the ugly politics of disease disinformation and the matchless potential of social media to spread misinformation.