McLeod Group blog, September 24, 2018
Medical advances in public health, notably in the realm of vaccinations, have transformed the life expectancy of people in all parts of the world. They have also vastly improved the quality of life: less blindness, less deafness, less brain damage, and fewer other crippling effects from contagious diseases such as measles. Even the poorest countries in the world have invested “blood and treasure” in vaccination campaigns.
Thus, it was no surprise that “vaccines for all” was included in the targets for the United Nations’ Sustainable Development Goals (SDGs), given the overwhelming evidence that vaccination saves lives. So why have there been 41,000 proven measles cases (and 37 deaths) in Europe in January-July 2018, according to World Health Organization (WHO) statistics? Why do parents decide not to vaccinate their children? And what could this mean for the achievement of the SDGs and the creation of public demand for and confidence in vaccination in developing countries?
The majority of this year’s European measles cases are in Eastern Europe, where vaccination rates have declined considerably since the fall of the Berlin Wall. Demonstrably, authoritarian rule can be good for public health measures. For example, vaccination rates are excellent in both North Korea and Rwanda (only 5 measles cases in January-July 2018, according to WHO stats). But in the former Soviet states, particularly Ukraine (23,070 cases) and Georgia (1,128), as well as in Serbia (4,954), coverage rates have declined. Local authorities bow to parents who cite religious authorities, are worried about information they have read about alleged vaccine side effects, or consider measles and other contagions to be natural childhood events.
Added to the mix is populism. In Italy (2,020 measles cases in January-July 2018), the Five Star Movement and its coalition partner, the far-right League, have voiced their opposition to compulsory vaccinations. League leader and Interior Minister Matteo Salvini has said that compulsory vaccinations for measles, tetanus, polio and seven other diseases “are useless and in many cases dangerous, if not harmful”. The Italian government recently introduced legislation to remove the requirement for vaccination for schoolchildren.
Lest anyone think Canada is immune (pun intended) from such scepticism towards vaccination, the CBC recently noted that 11% of Canadian children have not received their measles shots. The vaccination rate in Canada is actually lower than in the US.
In August, the American Journal of Public Health published a study of the health content of messages communicated by Twitter bots and trolls. The researchers found that these bots were disseminating anti-vaccine messages and were contributing to an erosion of public trust in public health measures such as vaccination. The Lancet, in a recent editorial, reflected on the measles outbreak in Ukraine and noted that “Kremlin-supported social media accounts spreading discredited theories about the measles, mumps, rubella (MMR) vaccine” are one of the main causes of the outbreak.
All too often, discussions of “fake news” focus on politicians trying to deflect from their foibles and economical use of the truth. Significant attention needs to be paid as well to disinformation campaigns that put lives directly at risk.
Fake news is not the only obstacle to preventing contagious disease. For example, weak health care systems, high drug prices and the lack of trained medical workers are also factors. But the risk of the contagion of fake news in the developed world is also important to address because our global progress in reducing contagious diseases is based on popular consensus and trust. If that is lost in Europe, how can it be sustained in developing countries?