When Malawian journalist Suwira Wanda participated in a recent training to sensitize the national media organizations to misinformation, she learnt for the first time that it is possible to be asymptomatic for cholera, but still infect others through contaminated water.

It was crucial training for the journalist at Zodiak, one of the country’s leading media outlets, during the response to Malawi’s worst-ever cholera outbreak, the efficacy of which was being threatened by rumours and misinformation.

“This workshop reminded me of the need to do more digging when I’m unsure of information, and to ask an expert whether or not a rumour is true,” Wanda says.

The World Health Organization (WHO)-led trainings such as the one Wanda attended provide skills to identify and debunk disinformation and rumours around health issues, especially during health emergencies or disease outbreaks. In the wake of the COVID-19 crisis, WHO launched the Africa Infodemic Response Alliance (AIRA) in 2020 to curb misinformation and conspiracy theories response to pandemic. AIRA’s network comprises 13 international and regional organizations and fact-checking groups with expertise in social and behavioural science, epidemiology, research, digital health and communications

In Malawi, these media trainings have been running since February 2023, reaching over 120 journalists, alongside significant efforts to engage communities online and offline, including videos on social media, to help mitigate the spread of harmful misinformation in order to bring the outbreak under control.  The videos, produced in multiple languages, were viewed nearly 23 million times on WHO Africa’s Facebook account alone.

“To detect, disrupt and counter misinformation”

“One of our objectives is to reinforce health systems and support partners in strengthening their capacities to respond to current and future infodemics,” says Elodie Ho, AIRA coordinator. “To do so, we detect, disrupt and counter damaging mis- and disinformation on public health issues in Africa.”

With 14 African countries facing cholera outbreaks as of mid-May, the region has already recorded 86 500 cases in 2023. This is equal to two-thirds of the entire caseload for 2021, Africa’s worst year for cholera in nearly a decade. 

Lack of access to reliable information, and an abundance of misleading rumours about the oral cholera vaccine, the best ways to treat the disease, or even whether it exists at all, have the potential to seriously derail response efforts. 

Since cholera outbreaks first captured international attention in 2013, AIRA has been working to address concerns about why these are more severe and widespread than usual, as well as around the effectiveness of one, rather than the usual two doses of vaccine that are administered to patients. 

Some allegations have even gone so far as to suggest that healthcare workers at cholera treatment centres were injecting patients with cholera-contaminated syringes, and were harvesting the organs of deceased cholera patients.

Misleading or inaccurate information can come from people or organizations with a political agenda, misinformed or ill-intentioned influencers, or people unwittingly trusting unreliable sources of information, and unintentionally spreading biased information.

Social listening and capacity building

When misleading information is detected within a community or online, AIRA experts analyse the existing information systems to identify bottlenecks that could favour the spread of mis- and disinformation at community level, in the media and on social media. They also listen to what people are saying about the disease and mobilize partners to disseminate facts about the disease.

Viral Facts Africa, AIRA’s public face, has produced 16 short videos on cholera aimed at debunking rumours, fighting misinformation, and disseminating accurate information about the disease, available treatments, and how people can protect themselves. 

“From the lessons we learned from the COVID-19 pandemic, we don’t wait for misinformation to emerge before acting. We work with countries to build their capacities so they will be able to fight infodemics, and we proactively disseminate facts,” Ho explains.

To do so, the Alliance trained 165 health workers and officials in detecting and addressing misinformation in more than 25 African countries in 2022. Among the trainees is Dr Yahya Disu, head of Risk Communication and Community Engagement (RCCE)at the Nigeria Centre for Disease Control and Prevention.

“In 2022, when a cholera outbreak occurred in Nigeria, we applied our learnings and approached the outbreak using our social- and community-listening approach,” Disu recalls. “We were able to quickly identify rumours and misinformation related to the outbreak and develop targeted risk communication and community engagement interventions to address them.”

The approach proved effective in addressing the cholera outbreak, but also served as a reminder of the critical to engage with communities and hear their concerns, to build trust and simultaneously address misinformation. 

“We also found that it is important to tailor our RCCE interventions to specific communities and contexts, since different areas may have different beliefs and practices related to health and disease,” Disu says.