Showing posts with label World Health Organization. Show all posts
Showing posts with label World Health Organization. Show all posts

Saturday, February 22, 2020

Rising Tide of Disinformation about Coronavirus: the Roles of Ideologues, Quacks, Russians, and US Politicians

Introduction: Propaganda and Disinformation in Health Care

We used to write about propaganda and disinformation used to promote health care goods and services (stealth marketing campaigns), and advocate for policies favorable to private health care organizations (stealth health policy advocacy and stealth lobbying).  Some stealth marketing, lobbying and policy advocacy campaigns encompass not just propaganda, but disinformation.  For example, consider the health insurance company campaign to derail the Clinton administration's attempt at health reform as described by Wendell Potter in Deadly Spin (look here).  The tactics employed in that campaign included: use of front groups and third parties (useful idiots?); use of spies; distractions to make important issues anechoic; message discipline; and entrapment (double-think).

In fact, towards the end of its existence, the USSR sponsored a disinformation campaign which spread the notion that HIV was a bio-weapon invented by a US laboratory (look here).  Although false ideas associated with that campaign persisted for years, the risk that health care disinformation would be used by hostile state actors seemed to die off as the cold war ended.

But now we have a new (ab)normal that includes propaganda and disinformation in the service of hostile authoritarian foreign states meant to disrupt more democratic governments, whatever the cost in human health and lives.  For an example look here at  how starting around 2015 Russia was spreading disinformation about measles and measles vaccination over the internet, using new technology like bots.

Now they seem to be doing it again, this time about coronavirus.

Disinformation About Coronavirus

On January 29, 2020, the Washington Post reported on a new disinformation campaign:

As China attempts to contain the spread of a new coronavirus that has left more than 100 people dead, rumors and disinformation have spread amid the scramble for answers.

Some of the speculation has centered on a virology institute in Wuhan, the city where the outbreak began. One fringe theory holds that the disaster could be the accidental result of biological weapons research.

The story started circulating in right-wing media:

The British newspaper Daily Mail was among the first to suggest the possibility of a link between the newly spreading virus and the Wuhan National Biosafety Laboratory, reporting last week that the lab, which opened in 2014 and is part of the Wuhan Institute of Virology, had been the subject of safety concerns in the past.

A separate article published by the Washington Times, a conservative newspaper in Washington, took the theories a step further, suggesting in a headline that the 'Coronavirus may have originated in lab linked to China’s biowarfare program' and pointing to the Wuhan Institute of Virology.

So,

Despite little public evidence, the theory has spread widely on social media, to conspiracy theory websites and in some international news outlets.

Yet there was no good evidence to support this theory.

'Based on the virus genome and properties there is no indication whatsoever that it was an engineered virus,' said Richard Ebright, a professor of chemical biology at Rutgers University.

Also,

Milton Leitenberg, an expert on chemical weapons at the University of Maryland, said he and other analysts around the world had discussed the possibility that weapons development at the Wuhan lab could have led to the coronavirus outbreak in a private email chain but that no one had found convincing evidence to support the theory.

Then the bioweapon theory started appearing on more extreme sites.  BuzzFeed reported on January 31, 2020:

A popular pro-Trump website has released the personal information of a scientist from Wuhan, China, falsely accusing them of creating the coronavirus as a bioweapon, in a plot it said is the real-life version of the video game Resident Evil.

On Wednesday, far-right news site Zero Hedge claimed without evidence that a scientist at the Wuhan Institute of Virology created the strain of the virus that has led the World Health Organization to declare a global health emergency.

Note that

Zero Hedge, which describes itself as a financial blog, has more than 50,000 followers on Facebook and more than 670,000 followers on Twitter and is run by Daniel Ivandjiiski, a Bulgarian-born, US-based, former investment banker, who writes the majority of the posts published by the pseudonym Tyler Durden. The site regularly amplifies conspiracy theories from anonymous message board 4chan and writes frequently about the deep state, doomsday prep, bitcoin speculation, and New Age pseudoscience.

Furthermore,

The new focus on the scientist is the culmination of several conspiracy theories that have gained traction since the beginning of the outbreak early in January. One version of the hoax began in Facebook Groups run by supporters of the pro-Trump QAnon movement and the anti-vax community, where users claimed the outbreak was a population control plot by former Microsoft CEO Bill Gates.

The Zero Hedge take has been propagated widely:

The Zero Hedge article has been posted on Twitter over 10,000 times and shared close 2,000 times on Facebook in the last 24 hours.

And,

The rumors and lies are also being spread across 4chan. A user linked to the Zero Hedge article in a 4chan thread titled, 'All hail [the scientist], creator of Corona-Chan.' In another 4chan thread, users claimed the scientist had created a mutant superbug.

The hoaxes surrounding the coronavirus have become so prevalent that 'uncensored' subreddits about the outbreak are being created for users on Reddit who want to share the theories.

In summary, an unsubstantiated theory about the coronavirus, one that could both increase public anxiety, if not panic, and stir up hostility between China and the US, started circulating in right-wing, including extremist, web-sites and media, and soon bled into the larger social media. But why?  Cui bono? Who could benefit from this?

Using Disinformation and Extreme Ideology to Sell Dubious Products

One answer appear to be people selling quack products.

A New York Times article on February 6, 2020 focused on World Health Organization (WHO) efforts to fight disinformation about coronavirus (see below). It included the opinions of "Andrew Pattison, manager of digital solutions at the W.H.O."  He suggested:

Medical misinformation on the virus has been driven by ideologues who distrust science and proven measures like vaccines, and by profiteers who scare up internet traffic with zany tales and try to capitalize on that traffic by selling 'cures' or other health and wellness products.

'There are self-appointed experts, people working from anecdote, or making up wild claims to get traffic or notoriety,' said Mr. Pattison of the W.H.O.

Furthermore,

Sarah E. Kreps, a professor of government at Cornell University, considers the people deliberately spreading distortions to be practitioners of 'algorithmic capitalism,' in which people scare up traffic and sell against it.

Examples abound. Infowars, the far right website that purveys conspiracy theories and fake news, and others are now banned on several leading social media sites but are still advertising pseudoscientific remedies directly through their own shops. An early distortion of the coronavirus news appeared in an Infowars video on Jan. 22 — claiming that the virus could be part of some man-made plot to thin the population.

'The globalists and the deep state have declared war on humanity,' a host on the video said. 'They hate human life. This is why they kill babies.'

Next to the box in which the video appears is an advertisement for an immune gargle product that, the ad claims, 'is designed to support your immune system like no other,' and that is 'scientifically proven.'

However, the Mayo Clinic reports that the ingredient mentioned in the product, colloidal silver, has not been proved safe or effective in treating disease. And even the Infowars shop where the product is listed reads at the bottom: 'This product is not intended to diagnose, treat, cure or prevent any disease.' 

Whether these disinformationists are primarily cynical businesspeople hiding behind extreme ideology, or extreme ideologists who found a way to profit from these beliefs, or both is not clear.
 
The Russian Connection



 Furthermore, it appears that once again the Russians are involved, demonstrating their updated disinformation techniques that take advantage of the internet and social media.

On February 14, 2020, an article in Foreign Policy discussed Russian involvement in disinformation about coronavirus:

The overarching theme of the stories that appear across the Russian media, from fringe websites to prime-time television, is that the virus is the product of U.S. labs, intended to kneecap China’s economic development. Some articles have flirted with the idea that Bill Gates or Kremlin nemesis George Soros might have had a hand in the outbreak.

Note that:

Right now, the main audience is largely domestic, with a sprinkling of conspiratorial reports across the different language services of Sputnik, the more tabloid of Russia’s international broadcasters. The conspiracy theories haven’t featured prominently on English-language Russian government-backed international broadcasters such as RT and Sputnik, however, according to Bret Schafer, a fellow at the German Marshall Fund’s Alliance for Securing Democracy who studies disinformation. While these channels have historically played around the edges of conspiracy theories, 'they still want that veneer of being a legit international broadcaster,' Schafer said. 

The Russian disinformation did not appear to be focused on the escaped Chinese bio-weapon theory, but that particular theory might not be the point. 
The Russian messaging fits a now well-established pattern in that it doesn’t look to persuade audiences of a single alternative truth. That would take effort, planning, and persuasion. Modern-day Russian propaganda has instead been described by the Rand Corp. as a 'firehose of falsehood,' a steady stream of underdeveloped, sometimes contradictory conspiracy theories intended to exhaust and confuse viewers, making them question the very notion of objective truth itself.

On February 22, 2020, the Guardian provided considerably more detail, and now it is coming from official US State Department sources:

State department officials tasked with combatting Russian disinformation told the AFP false personas were being used on Twitter, Facebook and Instagram to advance Russian talking points in multiple languages.

'Russia’s intent is to sow discord and undermine US institutions and alliances from within, including through covert and coercive malign influence campaigns,' said Philip Reeker, acting assistant secretary of state for Europe and Eurasia.

'By spreading disinformation about coronavirus, Russian malign actors are once again choosing to threaten public safety by distracting from the global health response,' he said.

Some accounts have falsely claimed the US is waging “economic war on China” and that the virus is a biological weapon manufactured by the CIA.

Furthermore,

Several thousand online accounts – previously identified for airing Russian-backed messages on major events such as the war in Syria, the Yellow Vest protests in France and Chile’s mass demonstrations – are posting “near identical” messages about the coronavirus, according to a report prepared for the state department’s Global Engagement Center and seen by the AFP.

The accounts are run by humans, not bots, and post at similar times in English, Spanish, Italian, German and French. They can be linked back to Russian proxies, or carry messages similar to Russian-backed outlets such as RT and Sputnik, the report said.

'In this case, we were able to see their full disinformation ecosystem in effect, including state TV, proxy websites and thousands of false social media personas all pushing the same themes, said Lea Gabrielle, head of the Global Engagement Center, which is tasked with tracking and exposing propaganda and disinformation.

This is now looking like a big-time Russian disinformation effort aimed at further destabilizing the west,

A state official said Russian operatives appeared to have been given 'carte blanche' to attack the US.

'Whether or not a particular theme is being directed at the highest levels doesn’t matter,' the official said. 'It’s the fact that they have freelance ability to operate in this space to do whatever damage they can, which could have seismic implications.'

All from the same folks who are trying to meddle in the upcoming election, in favor of their preferred candidate, President Trump (look here).

A Prominent US Senator Helps Propagate Disinformation


During the early phases of the measles disinformation campaign, we noted that in February, 2015, the New York Times discussed the strange inability of some then Republican candidates for the presidency to discuss the issue clearly.

Now a Senator Tom Cotton (R-AK) is adding to the confusion about coronavirus.  The New York Times reported on February 17, 2020 (updated February 18):

Speaking on Fox News, Senator Tom Cotton, Republican of Arkansas, raised the possibility that the virus had originated in a high-security biochemical lab in Wuhan, the Chinese city at the center of the outbreak.

'We don’t have evidence that this disease originated there,' the senator said, 'but because of China’s duplicity and dishonesty from the beginning, we need to at least ask the question to see what the evidence says, and China right now is not giving evidence on that question at all.'

Note that he raised doubts while suggesting the plausibility of the escaped Chinese bio-weapon theory, but did not dwell on the evidence.  Instead, the Times noted he seemed to complain about the lack of relevant evidence:

Speaking to the Fox News anchor Maria Bartiromo, Mr. Cotton suggested that a dearth of information about the coronavirus’s origins was raising more questions than answers.

'We don’t know where it originated, and we have to get to the bottom of that,' he said on the program 'Sunday Morning Futures.'

But there is nothing to suggest that he used his position as a US Senator to learn more about what facts are currently known, and what public health experts currently think.  Surely organizations like the CDC and WHO could have helped him with that before he jumped into the discussion.  It would also have been possible for him to access the US State Department's information about the Russian  coronavirus disinformation campaign and about the possible malign effects of further spreading disinformation about this new disease.  But no, Sen Cotton appeared to be attending to other sources, like these mentioned in the Times article:

Last month, Mr. [Steve] Bannon [former Trump campaign manager in his 2016 campaign, former owner of Breitbart News]  invited Bill Gertz, a Washington Times reporter, to be a guest on the inaugural episode of his radio show 'War Room: Pandemic,' a spinoff of his 'War Room: Impeachment,' which defended Mr. Trump during the Senate impeachment trial.

'Bill Gertz had an amazing piece in The Washington Times about the biological labs that happen to be in Wuhan,' Mr. Bannon said on his Jan. 25 show. Mr. Gertz appeared on another show several days later to continue putting forward the bioweapons theory.

Fox News has also dabbled in the theory, in one article drawing a connection between a 1980s thriller by Dean Koontz that 'predicted coronavirus.' The book is about a Chinese military lab that creates a biological weapon.

In addition, although the NYT article suggested that Sen Cotton then attempted to "walk back" his original statements, on January 19, 2020, Fox News reported he had reiterated it:

Sen. Tom Cotton, R-Ark. stood by his earlier suggestion that the deadly coronavirus may have originated in a high-security biochemical lab in Wuhan, China, telling 'The Story' Tuesday that we 'need to be open to all possibilities' in exploring the origins of the outbreak that has sickened more than 75,000 people around the world.

When host Martha MacCallum pressed the Senator on his startling and unverified claim, Cotton cited a study published by Chinese scientists in The Lancet, which he called a 'respected international science journal.'

'I'm suggesting we need to be open to all possibilities and we need to demand that China open up and be transparent so a team of international experts can figure out exactly where this virus originated,' Cotton said.

He also brought up the 'questions' surrounding the biosafety level 4 'super laboratory' in Wuhan, the city where the virus is believed to have originated.

In epidemiology, it may be wise not to dismiss even theories that appear far-fetched, at least in the initial phases of an investigation, but there should be some effort to assess the plausibility of the competing hypotheses.  Again, notice that a US Senator with no obvious public health or epidemiological expertise was continuing to talk off-the-cuff about a major public health issue, sans any reference to the sorts of expertise and evidence he could easily access.


Discussion

The problem of disinformation about medicine, health care, and public health only seems to be getting worse. It appears to be fueled in part by the good old fashioned profit motive, but often focused on the profits from useless, possibly harmful pseudo-remedies.  It may be justified, or actually generated by extreme ideologies, all of which so far seem to be on the far-right end of the political spectrum.   Particularly disquieting is the proclivity, at least in the US, for politicians of a certain stripe to not merely downplay it, but aid in its dissemination, meanwhile ignoring all the possible resources available to them that could supply some evidence and rational assessment of same.

One small cause for hope are the growing efforts to combat it.  For example, as discussed in the New York Times, the WHO is now actively trying to combat the "infodemic" of coronavirus disinformation.

Clearly, health care professionals should be doing their part in fighting disinformation and active measures that seek to distort medicine, health care and public health.  National and local health departments, and agencies such as the CDC and FDA in the US all should be joining the WHO and the US State Department in fighting current disinformation campaigns, and preparing for future ones.  Needless to say, politicians regardless of political philosophy should be supporting these efforts, should base their remarks on evidence and logic, and certainly should not be helping the spread of disinformation.

Yet, as Chris Cilllizza wrote for CNN re Sen Cotton's dissemination of coronavirus disinformation, we are living

in a sort of post-truth world, one if not created, then pushed by President Donald Trump. Trump's candidacy was born in a conspiracy theory (former President Barack Obama wasn't actually born in the United States) and he has embraced any number of conspiracy theories in his days as President. (Millions of illegal votes were cast in the 2016 election, Obama ordered the phones at Trump Tower wiretapped, etc.)

Trump has mainstreamed conspiracy theories and convinced lots and lots of people they are true with much the same tactic Cotton used on Sunday, which amounts to this: I am not saying this is true, I am just saying people are talking about it and we owe it to ourselves to ask the question. But simply because Trump has made this sort of stuff commonplace doesn't mean it's OK. It isn't. After all, there's a difference between a random post on some Reddit message board and a US senator spinning conspiracy theories on national TV. Or at least, there should be.

However Trump, and maybe Cotton too, seem to benefit from the barrage of disinformation and active measures emanating from Russia. We just heard that the US intelligence community says Russia is once again using active measures to influence the upcoming US election - on behalf of Trump (look here). It is also hard to ignore that Sen Cotton is a big fan of US President Donald Trump (look  here) as is Trump of him.

So, it may be too much to expect them to change their ways. Instead, we may need to change our political leadership, and charge our political operating system to make it less vulnerable to hacking by hostile foreign nations, like Russia.


Thursday, November 08, 2007

BLOGSCAN - The WHO, NGOs, and the Pharmaceutical and Biotechnology Industries

On PharmaLot, Ed Silverman wrote about claims that most of the non-governmental organizations (NGOs) offering comments at a World Health Organization meeting designed to boost innovation in treatment of neglected diseases like tuberculosis and malaria were from organizations with financial ties to pharmaceutical manufacturers and biotechnology companies.

Friday, February 23, 2007

From the British Medical Journal: Financial Links Among the World Health Organization, Patient Organizations, and Pharmaceutical Companies

We have posted frequently about questionable financial links between commercial firms that produce health care goods and services (for example, pharmaceutical, biotechnology, and medical device companies) and not-for-profit organizations and government agencies that provide or regulate health care (for example, hospitals, academic medical centers, and government agencies). The latest example of such links, and one with global implications, comes from one of my now favorite outlets for investigative journalism, the British Medical Journal. [Day M. Who's funding WHO? Brit Med J 2007; 334: 338-340).
Serious questions have been raised about whether the World Health Organization is using patient groups as a conduit for receiving proscribed donations from the pharmaceutical industry. Email correspondence passed to the BMJ seems to show that in June 2006 Benedetto Saraceno, the director of WHO's department of mental health and substance abuse, suggested that a patient organisation accept $10 000 (£5000; {euro}7000) from GlaxoSmithKline (GSK) on WHO's behalf. The sum was then to be passed on to WHO—ostensibly with the intention of obscuring the origins of the donation. GSK withdrew its offer of funding when it learnt that acceptance was conditional on obscuring its origin. However, the email exchange indicates that other sums of money originating from drug companies may have already been channelled to WHO through patient groups.

When asked about this correspondence, Dr Saraceno told the BMJ that his email to the patient organisation was 'clumsily worded' and that he had 'never intended to solicit donations from the pharmaceutical industry through' the patient organisation. In the email dated 16 June 2006, Dr Saraceno thanks Mary Baker of the European Parkinson's Disease Association (EPDA), for raising the $10 000 'requested by the WHO.' The money was to have funded a report on neurological diseases, including Parkinson's disease, for which GSK produces treatments.

Dr Saraceno then seems to advise Mary Baker on how to get round the WHO's rules forbidding drug industry funding. 'Unfortunately,' he says, 'WHO cannot receive funds from pharmaceutical industry. Our legal Office will reject the donation. WHO can only receive funds from Government agencies, NGOs, foundations and scientific institutions or professional organisations. Therefore, I suggest that this money should be given to EPDA and eventually EPDA can send the funds to WHO which will give an invoice (and acknowledge contribution) to EPDA, but not to GSK.'

According to paragraph 13 of the WHO's guidelines on interactions with commercial enterprises, which deals with cash donations, WHO should avoid indirect collaboration (particularly if arranged by a third party acting as an intermediary between WHO and a commercial enterprise).' Paragraphs 15 and 16 of the guidelines state that funds may not be sought or accepted from commercial enterprises that have a direct commercial interest in the outcome of the project and that caution should be exercised even when the business has an indirect interest. And paragraph 27 says that for reasons of transparency, contributions from commercial enterprises must be acknowledged.

Richard Nicholson, editor of the Bulletin of Medical Ethics, said: 'It would be very bad indeed if the WHO were trying to obtain money surreptitiously from drugs companies. Unfortunately it's also under-funded, and sadly there's always going to be the temptation of senior officials who ought to know better than to accept such money. But they should remember that there's always a price attached to such funding.'

He adds: 'This is in line with what we have done so far with other contributions to the report which all are coming from other professional organisations,' — suggesting that less than transparent transactions were the norm for this fundraising operation.
It turns out this has not been the first time that WHO was accused of being caught up in commercial entanglements.
Ralph Edwards, the director of the WHO's drug monitoring centre in Uppsala, Sweden, warns .... 'These days it's so hard to find anyone completely free of the pharmaceutical industry. A couple of years ago we wanted to publish a safety report on Lapdap [chlorproguanil-dapsone], the combination malaria treatment. The WHO's tropical disease research group had developed the treatment jointly with Glaxo, but Glaxo weren't happy with what we wanted to publish.'

'This was a bad situation and it was very, very difficult. We raised the issue with WHO because we thought that there had not been enough safety studies done. We managed to get the report published eventually, after a lot of lobbying and pressure—but it was delayed for more than a year,' said Dr Edwards.

'It's an example of how tortuous it is working with pharmaceutical industry money.'
This story is yet another reminder of how globally pervasive are financial ties amongst various health care organizations that naively physicians and the public may think are supposed to work at arms' length. However, if we want health care that puts the needs of patients first, we have to align the incentives with the mission, and eliminate opportunities for well-heeled vested interests to pay for increased influence.

Thursday, May 25, 2006

WHO Calls for Transparency in Clinical Research

The Lancet this week contains a commentary from the WHO [Sim I, Chan AW, Gulmezoglu AM, Evans T, Pang T. Clinical trial registration: transparency is the watchword. Lancet 2006; 367: 1631-33.] calling for the creation of an international clinical trials registry. It is worth quoting from its introduction:

Recent scandals in the UK and elsewhere have diminished public trust in the clinical research industry. [References were to trials of TGN 1412 ; Vioxx; and Trovan in Africa.]
Transparency is the best antidote to such free-floating distrust. Clinical trial registration will allow the necessary tracking of trials to ensure full and unbiased reporting of the results for public benefit.
Individuals voluntarily participate in trials expecting that the results will be used to improve medical knowledge in general, and not only to serve proprietary or commercial interests. These ethical oblibations to the public good are in addition to the obligations to protect individual research participants during a trial (e.g., informed consent), and they extend to all trials regardless of study design or trial population.
Their emphasis on trial subjects' expectations that they are contributing to science, not just to a commercial project, is a welcome reminder. The authors underline this point later, asserting that their registry proposals
are consistent with the Declaration of Helsinki requirement that 'the design of all studies should be publicly available', as well as with the recognition by the Declaration of Helsinki and the Nuremburg Code that the rights of trial participants hold primacy over commercial and career interests.
The proposed WHO registry will include early trials (called Phase I and II in the US) as well larger, late-phase trials is important. Their argument was that early-phase trials "are often terminated for economic reasons." But that registration of them will "ensure that information about the risks of new interventions will be publicly available."

The WHO authors found that "arguments for delayed disclosure were neither convincing nor compelling. First, there is a large variation in disclosure practices - some companies disclose all outcomes, some none - raising the question of what disclosure is truly threatening. Second, information that is claimed to be sensitive is often available for a fee through intelligence services readily found on the internet or through trial participants and consumer websites. Finally, there is no convincing evidence that disclosure threatens competition and hence innovation."

This sort of clarity about the integrity of clinical research is welcome. Hopefully, it will get some attention.