Q&A: WHO's global strategy to tackle health misinformation

MANILA — The World Health Organization’s digital health team has been working to help combat misinformation about the 2019 novel coronavirus. And they are working with technology companies to ensure search engines show results with reliable and accurate health information.

“The good news is that the tech giants are collaborating with us to improve the situation,” said Bernardo Mariano, WHO CIO and director the department of digital health and innovation.

But he said there’s more work to do. The approval of WHO’s draft global strategy on digital health, up for discussion by member states at this week’s executive board meeting, could pave the way for them to better address these challenges.

But what exactly is the scope of WHO’s digital health work?

In October, Mariano told Devex there are two processes in place: one is the change within WHO and the other is supporting countries in their digital health journey.

This conversation has been edited for length and clarity.

I understand WHO’s digital health strategy is still being discussed for approval by the member states. But can you share how that change within WHO is going to happen as well as how you envision supporting countries on their digital health journey?

Yes. I think that the change at WHO is happening as we speak. We have a number of departments and divisions, and they all are working towards delivering what is in our global program of work, which is what we call the triple billion targets.

Now for all the teams working toward those targets, digital health is the accelerator. So capacity building for internal WHO teams to deliver those triple billion targets is what is at the core of digital health. When we talk about building that internal capacity, be it mental health, malaria, tuberculosis, [we talk about] how those vertical areas use the digital health tools and solutions to accelerate the achievement of the triple billion targets.

Can you give an example of how that works in practice?

For instance, using mobile technology to reach out for mental health. Just as an example, WHO produces a guideline on mental health. And that guideline is a book or a PDF, and is meant to assist health practitioners, ministers of health, to design programs and the implementation of mechanisms to address the mental health issue at national level. This is what we have today.

But then how can the digital accelerate the triple billion target? As I mentioned, the books and the PDFs [that contain] guidelines from WHO on mental health are geared towards practitioners and policymakers. Yet, the public they search Google, they search Facebook, YouTube to address their mental health issues.

The WHO digital content on mental health is not accessible to these people that are currently searching these platforms. Sometimes these people are getting inaccurate information. The anti-vaccine movement is one of them. The current emergence of measles is one of the issues where people go and get inaccurate information about a vaccine.

But let's talk about mental health. So the department is sitting with the mental health team to help redesign the guidelines to be people-centric, which is part of the [draft] global strategy.

One of the strategic objectives is to advocate for people-centered health-enabled digital health. It's starting with the WHO guidelines. But second is that we want to support the industry by accessing accurate information on mental health. To do that we need to have a digital presence, meaning that we need to have either a mental health bot that uses WHO guidelines, or we need to have a platform where app developers can just carry that platform which has WHO-approved content to address that particular condition.

How are you going to boost your digital presence? Are you going to have more people at WHO being online, and tap on more IT expertise on how WHO can engage with online users searching for information about mental health?

We will leverage on machine learning to learn WHO content and make it available for the public.

So if I go to the WHO website and I have a quick question, machine learning will be able to answer that question?

Exactly. And we want more than that. We don't want people just to come to WHO websites to learn that. We want the app developers to also use that. We want Google and Facebook to use that.

So our website will be one venue. But we know that many of the millennials don't come to the WHO website. They use apps on their phones. So we want those apps to say that this app is certified with WHO content, meaning that it gives the answer according to WHO guidelines.

Our role is to really make sure that we have that accurate information. And we're talking to Google and Amazon and Facebook to say, you have responsibility to make sure that accurate information is [on] your platform. We're not saying don't have other types of information, [for example] if somebody believes that vaccinating children against measles is not a good thing. But we want to make sure that that's not the only thing that is there.

We want to make sure that the recommendation of WHO on vaccines is something that appears if you go to [these platforms]. So some sort of certified, accurate information that gets priority, and then the rest can come, but at least the person has the chance to see [WHO’s recommendations]. And if the person decides to ignore that, that's a person's decision. But right now the current situation is that we're not there yet.

Will you also be prescriptive in saying to governments which digital technologies they should be adopting?

In our global strategy we have four objectives. One is to promote global collaboration. The other one is to advance implementation of national digital health strategies. The third is strengthening the governance of digital health. And fourth is to advocate for a people-centered approach.

So under strategic objective number two, prioritization of digital health investment is key. And that touches the other point. While we're doing the internal digital WHO content, we also support countries... [by ensuring] what is the key basic infrastructure that is needed, be it electronic health record ... or health information systems, and the interoperability of those things. So we will work with countries to advise them and then help them to actually implement [these digital health investments]. That's really the support we will provide to the countries to navigate their digital transformation journey.

What happens before the World Health Assembly?

We will be building partnerships, and then somewhere in June we will have a back-to-back meeting with the advisory group, but also we'll bring donors — we'll put a donor round table on digital health to mobilize resources for countries, and for ourselves as well to ensure that we are able to implement the approved global strategy, and that we are able to support countries to implement their national strategies on digital health.

What's the biggest challenge you're seeing as you move ahead with this plan?

One of the challenges in any transformation is culture change. People are used to working in one way, be it the practitioners, be it us, be it the ministers of health, be it governments, be it the private sector. And within that change there are different interests, from the private sector, academia, the government, the public sector.

So to navigate across these multiple interests while ensuring the health gains are realized is the biggest challenge. Just to give you an example, how can Google continue to bring their revenue leaning on data of the people that use their platform, while on the other side, we want to make sure that there's ethical issues there?

There's the privacy issues. We want to make sure that the data is not monetized as a public good. So those are the key challenges — how to strike the balance between data for public good and understanding that some other entities want to monetize data.