Improving health communication to save lives during epidemics

During epidemics of Ebola, COVID-19, Zika and other public health emergencies, effective communication of public health messages is crucial to control the spread of disease, maintain public trust, and encourage compliance with health measures. In a new evidence review to be given at this year’s ESCMID Global Congress (formerly ECCMID) in Barcelona, Spain (27-30 April), Dr Benjamin Djoudalbaye from the Africa Centres for Disease Control and Prevention (AFRICA CDC) in Ethiopia, will discuss the challenges and lessons learnt from public health communication strategies during multiple epidemics across the African continent.

Public health communication is critical for the African continent faced with a slew of infectious-disease epidemics and public health emergencies. Between 2001 and 2022, the region reported 1,800 public health emergencies, most of them emerging infectious diseases such as cholera, meningitis, Ebola, measles, yellow fever, Mpox (monkeypox), Zika, Rift valley fever, and COVID-19 [1].

Information about the epidemic, prevention measures, and health guidelines must be clear, concise, easily understandable, and reach a wide audience. As Dr Djoudalbaye explains, “One of the main communication challenges is disseminating accurate and timely information to the public who have limited access to reliable information and communication channels. Compounding the problem is that only around 40% of Africa’s population has access to the internet. This can lead to misinformation and rumours spreading rapidly, undermining public health efforts to control the epidemic.”

Failure to communicate in the over 2,000 local languages spoken across the continent, or to consider cultural norms and beliefs, can lead to confusion, mistrust, and resistance to public health measures. “Recurrent epidemics negatively impact already weak healthcare systems, devastate struggling economies, and can lead to a colossal toll on human life”, says Dr Djoudalbaye. “Developing and applying well-thought-out public health communication strategies requires not only taking into account Africa’s diverse linguistic and cultural landscape, but also addressing these underlying social and economic factors, and engaging with more vulnerable populations who may be at greatest risk of exposure to disease outbreaks.”

Despite these challenges, there have been successful efforts to communicate public health policy during epidemics in Africa. Take the 2014-2016 Ebola epidemic in West Africa and the COVID-19 pandemic. “Rapid response teams were deployed to remote areas to provide information and engage with local communities”, says Dr Djoudalbaye. “This approach helped to build trust, dispel myths, and encourage compliance with public health measures, ultimately contributing to the containment of the epidemic.”

The COVID-19 pandemic has highlighted the need for innovation and flexibility in African countries. As Dr Djoudalbaye explains, “Countries like Ghana, Rwanda, and Senegal have used technology to support their response to the pandemic. Rwanda and Ghana deployed drones to deliver medical supplies and test results to remote areas, while Senegal has used rapid diagnostic kits to test for COVID-19. These countries have also demonstrated flexibility in their response, with the ability to adapt to changing circumstances and implement new policies and protocols as needed.”

Given that around 80% of the population in 33/54 African countries have access to, or own, a mobile phone, text messaging is playing an increasingly crucial role in bridging gaps in communication, reaching underserved populations, and promoting positive health behaviours across the continent [2]. “This means that more people can now be reached with messaging about interrupting infection chains and refuting rumours and misunderstandings about emerging infectious diseases”, says Dr Djoudalbaye. “But there is a lot of inequity in mobile phone ownership when it comes to age and gender, with men twice as likely to own a phone as women and phone ownership declining after the age of 40.”

What more can be done to improve communication during epidemics? According to Dr Djoudalbaye, “It is imperative that governments and health authorities invest in robust communication strategies that are tailored to the needs of the local population and reach a wide audience. This includes making use of a variety of communication channels, from radio and TV to social media (e.g. Instagram or YouTube) and community outreach. Central to this is working more closely with local community leaders, healthcare workers, and civil society organisations to ensure that information is accurate, culturally sensitive, and easily accessible to all.”

Community engagement has been critical in the fight against COVID-19 in African countries, especially vaccine hesitancy. Countries like Uganda and Ghana have used community engagement to spread awareness about the virus, promote preventative measures, and debunk misinformation. In Nigeria, community engagement has helped to combat social stigma and discrimination against COVID-19 patients and healthcare workers.

Ultimately, Dr Djoudalbaye will highlight the importance of providing clear, honest, and credible sources of information to the public. “It is vital that public health authorities make as much use of technology as possible including mobile apps, text messaging, and social media platforms to provide real-time updates on the epidemic and health guidelines. As expressed by The Lancet, ‘There may be no way to prevent a COVID-19 pandemic in this globalised time, but verified information is the most effective prevention against the disease of panic’” [3].