Information Ecosystem Readiness for Health Emergencies: What We Can Do Now to Better Communicate in the Next Crisis – World

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The deleterious effects of the COVID-19 pandemic, along with heightened risks increasing the potential for future health emergencies, have prompted a collective reassessment of health emergency preparedness from a variety of perspectives. International agencies, heads of state and public health are deeply engaged in reassessing the role of health in global security. Discussions are underway on amendments to the International Health Regulations to align with the new Pandemic Preparedness and Response Agreements. Therefore, strengthening health system capacity, promoting a One Health approach, and advocating for whole-of-government and whole-of-society solutions are some of the priority processes to anticipate and prevent future pandemics.
The importance of communication in preparing for and responding to health emergencies has long been recognized by public health experts and authorities. Risk communication is indeed one of the eight core functions that WHO Member States must perform as signatories to the International Health Regulations.

As such, it is included as one of the key elements to be strengthened and implemented in national and local structures as part of the WHO strategic framework for emergency preparedness. In addition, the recent UN General Assembly Declaration on Pandemic Prevention, Preparedness and Response (PPPR)3 recognizes the need for more robust measures to address the negative impacts of infodemics, including health-related misinformation, disinformation, hate speech and disease -related stigmatization. The document also recognizes the critical role of timely, accurate and evidence-based information in building trust in public health systems and authorities.

We would argue that access to such information is critical, and we appreciate the recognition of infodemic-related structures as central to health emergency preparedness. However, additional steps to build trust should be considered. They require sustainable and adequate structures that go beyond stand-alone “information-based interventions” and consider longer-term ecosystem-building approaches. In this sense, programs that focus on communication as a stand-alone method of influencing specific behaviors often rely on debated assumptions:

■ Information alone does not guarantee protective or adaptive behavior during crises. Behavior change communication (BCC) programs often ignore the multiple factors influencing emergency decision-making, including trust in responsible actors and rapidly changing situations.
They often lack a holistic, long-term perspective.

■ Stand-alone, information-based interventions emphasize “rational” decision-making, ignoring the complexity of choices people face in crises (including the choice of inaction) and the gap between knowledge and actual behavior. *

■ Top-down approaches to behavior change communication ignore community participation in creating, prioritizing and sharing information. They also ignore individuals’ agency in trusting and acting on information based on their values, beliefs, and context.

All of these points highlight the importance of recognizing agency and choice, crucial elements in building trust in health information and communicators5 – while taking into account the long-term context of environments and communities. It is therefore essential to recognize the role of information ecosystems (IE) in promoting community resilience and preparedness against health emergencies by enabling communities to access, create and disseminate critical information to understand the challenges they face face, adapt to rapidly changing scenarios and make decisions to protect themselves and their loved ones.6 In this way, robust information ecosystems improve health crisis responses by providing timely, accurate and widely accessible information to all involved in response, promoting informed decision-making and coordinated action.

In the context of health emergencies, gaps in adequate information sharing can lead to negative impacts on people’s health.

They may be confused about what protective measures to take, where to get care, or how to behave during an emergency. It may also lead to a growing distrust of those responsible for protecting public health, as we are currently witnessing in this post-pandemic era.

As such, building a strong and resilient information ecosystem as a means of enhanced health emergency preparedness means that all actors:

■ You have access to locally relevant, timely and actionable information (not only about health and science issues or facts, but also about decisions, intentions, plans, gaps and challenges);

■ You have a capacity that promotes critical evaluation and use of information;

■ Have access to resources or mechanisms to verify information and contextualize it when they have questions;

■ You have the ability, capacity and resources to plan and execute as the emergency stages evolve; and

■ May inform other responsible participants of their needs, concerns, questions and ideas.

Therefore, it is critical that strategies aimed at preventing, mitigating and responding to future health emergencies include the strengthening of information ecosystems as a core element. To achieve this, a key step for health communicators is to change our understanding of communication. We need to move away from a static, one-way process where “experts” deliver information to “communities” and abandon the assumption that providing facts alone is enough to convince people. Responding to contextual needs, taking into account the realities of the people we are dealing with, including their lived experiences and belief systems, is essential to ensure that communication is both relevant and actionable.

Viewing communication as a dynamic and two-way process provides a more accurate picture of how information circulates in communities. In this perspective, all actors in the ecosystem continuously generate, share, consume and evaluate information for decision making. This multidimensional understanding of information landscapes helps identify different structures operating at hyper-local, national, regional and global levels, contributing to communication processes.

It also enables the identification of gaps in the exchange of information between systems, facilitating collective functioning and rapid responses.

A narrow view of communication may overlook relevant ecosystem actors who possess unique insight into community priorities and needs but are ill-equipped to address them. This can perpetuate a top-down approach to what should be communicated and how, rather than encouraging collaboration with community structures. Ultimately, the information ecosystem approach enhances the capacity of other community actors, such as local media and civil society organizations, to hold individuals accountable for decisions made before and during emergencies, ensuring that communities remain at the forefront of preparedness efforts.

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