6.4 INFORMATION INTEGRITY
demise of USAID. For me, as a veteran of the agency who helped design the strategic architecture for global health communication – an effort advanced in 65 countries since 2001 – it was heartbreaking to watch this premier development agency disappear. USAID was not only a funding mechanism but also a driver of innovation in health communication, pioneering efforts in global health and sustainable development. Its loss epitomises the importance of the theme of both this publication and this year’s World Health Summit, both focused on global health in a fragmented world. Indeed, it has never been clearer that health is always a political choice, not merely a scientific or technical one, and communicating health information is genuinely a political act. The rise of the ‘Make America Healthy Again’ initiative in the United States has been promoted as a populist alternative to do what decades of ‘Healthy People’ agendas could not. The reality is that
MAHA has exploited a rapidly changing political landscape to populate government health policy, implementation agencies and advisory bodies with scientific contrarians on an ideological mission. Wrapped in a flag of ‘medical freedom’, the initiative emphasises individual health decisions, while limiting the proper funding, infrastructure or information to support these choices. The consequences are already visible. The US Preventive Services Task Force, long respected for its systematic evidence-based reviews, is now under siege. The CDC itself, once considered the gold standard for epidemiology and public health, has been disparaged by the US Secretary of Health and Human Services as a ‘cesspool of corruption’. This rhetoric has fostered hostility and increasing violence. The shooting at the CDC in August, motivated by anger over Covid vaccination policies, underscores the combustibility of political mistrust and misinformation. THE FRONT LINE OF TRUTH The global ripple effects are profound. The question facing us is urgent: what must we do? First, we must recognise that safeguarding science and medicine is a global political imperative. Health professionals, researchers and institutions should be equipped not only with disciplinary expertise but also with people who embody skills in rhetoric, behavioural and social change communication, and advocacy – including the effective use of digital strategies. Second, there must be renewed investment in health communication. Misinterpretation of evidence, data manipulation and the spread of falsehoods thrive in the absence of authoritative, accessible and trustworthy information. Universities, journals and professional societies must take responsibility for strengthening public trust, building communication capacity and advancing science beyond the bench and bedside in the digital milieu. Recognising that access to information is emerging as a major determinant of health, the editors of Nature Medicine have established the new Commission on Quality Health Information for All that will develop a global framework to ensure equitable access to accurate, relevant and actionable health information. With my fellow co-chairs Heidi Larson, Lawrence Gostin and Carolina Batista, we will articulate a clear vision of a world where investment in quality information is acknowledged as essential to health, and where validated evidence guides both personal, community, national and global policy decision-making. To achieve this, we must professionalise health communication as a distinct discipline that integrates political, cultural and social insights alongside evidence-based approaches. It requires harnessing digital tools, artificial intelligence and real-time strategic communication to advance health literacy. And it demands the training of a new generation of communicators who can operate effectively at the intersection of science, policy and society in the digital era. The choice before us is stark. We can stand by as more than a century of scientific and public health progress is dismantled. Or we can unflinchingly affirm the core values of evidence, ethics, communication and global solidarity. Doing so will demand courage and coordinated action: the resolve to speak truth in the face of power. In today’s fractured world, quality health information is not an option. It is the front line of public health. ▪
SCOTT C RATZAN Scott C Ratzan is the founding editor-in-chief of the Journal of Health Communication: International Perspectives . He co- chairs the Nature Medicine Commission on Quality Health Information for All and co-directs the Master’s Program in Health Communication for Social Change at CUNY Graduate School of Public Health and Health Policy in New York.
Health: A Political Choice – The Future of Health in a Fractured World 85
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