Authors: Heidi Tworek, Joseph Flores
Just as most countries lifted Covid-19 measures, another pandemic emerged in the summer of 2022: mpox. Mpox is an infectious disease caused by the monkeypox virus. It is endemic in East, Central, and West African countries. However, in May 2022, large clusters of mpox cases began appearing outside of its endemic region, bringing global attention to the virus. More cases quickly emerged across Europe and in the Americas, spreading through sexual networks of men who have sex with men (MSM). By July 23, with over 16,000 reported cases in 75 countries and territories, World Health Organization (WHO) Director-General Dr. Tedros declared the global mpox outbreak a Public Health Emergency of International Concern (PHEIC).
Given that poor-quality information affected Covid-19 responses around the world, robust communications are more important now for pandemic preparedness than ever. Therefore, this report analyzes the efficacy of communications during the first four months of the mpox pandemic from May to August 2022 across five jurisdictions: British Columbia, Ontario, Nigeria, Spain, and the United States.
Although not exhaustive, these five case studies showcase a range of approaches to communications, enabling us to identify more effective strategies and tactics. The cases were analyzed through the lens of the RAPID Principles, developed by Heidi Tworek, Ian Beacock, and Eseohe Ojo after assessing communications in the first six months of Covid-19.
The principles are:
- Rely on Autonomy, not Orders
- Attend to Emotions, Values, and Stories
- Pull in Citizens and Civil Society
- Institutionalize Communications
- Describe It Democratically
Our analysis found some principles to be more pertinent than others for mpox. Mpox had a different epidemiology and affected certain populations more than others, specifically networks of men who have sex with men (MSM). This made managing stigma even more important in health guidelines than strict preventive measures. Mpox’s emergence soon after the removal of Covid protections also created unique challenges. Two years of Covid-19 politicized public health in certain countries and/or pulled away resources from certain communities. Based off these considerations and analysis, we identified further recommendations for effective pandemic communications.
Our simplest recommendation is to prioritize communications for managing any pandemic or epidemic. This aspect of pandemic management often remains underprioritized, even after the experiences of Covid-19. Across all five cases, communications were crucial to managing distrust in public institutions, curbing transmission, and minimizing further marginalization of affected communities. Beyond the lessons of the original RAPID framework, mpox highlighted two further lessons for health authorities and governments. The first is the importance of managing stigma. Addressing stigma directly using the voices of the most affected communities tended to be the most effective approach to minimize stigmatization of queer and Black communities. To support this, a key recommendation is for governments to have well-established networks with community organizations that they can call on to help develop and deliver messages. The second is for governments to prioritize the health of diverse communities with specific policies that meet their needs, as this will enable quick mobilization when crises do arise. Finally, the lack of specialized aid and support for those who fall ill with the virus should be addressed.
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About the Authors
Dr. Heidi Tworek is a Canada Research Chair and professor of international history and public policy at UBC. She directs the Centre for the Study of Democratic Institutions. Her work examines history and policy around communications, particularly the effects of new media technologies on democracy. She is a senior fellow at the Centre for International Governance Innovation as well as a non-resident fellow at the German Marshall Fund of the United States and the Canadian Global Affairs Institute. She co-edits the Journal of Global History. She is the author or co-editor of three books as well as over 30 journal articles and book chapters. Her latest book is the prizewinning News from Germany: The Competition to Control World Communications, 1900-1945 (Harvard University Press, 2019). Her current work examines the history and policy around health communications. She has testified before and advised governments around the world on social media, hate speech, and disinformation. Alongside regular appearances on radio and TV, her writing in English and German has appeared in media outlets including The Atlantic, Foreign Affairs, Washington Post, Columbia Journalism Review, The Independent, and Süddeutsche Zeitung.
Joseph Flores recently completed his Master of Public Policy and Global Affairs at UBC with a focus on global human rights, sustainability, and queer health. With growing tensions in society amid various global crises, Joseph believes that strong democratic institutions can help alleviate these issues. He hopes that his research brings light to how democracies can work to address issues of inequality and prevent further injustice around the world. His work with CSDI involves researching the efficacy of mpox health communications around the world.