Misinformation’s Impact on Public Health Policy Decisions
Introduction
Misinformation poses a significant challenge to public health policymaking since it undermines efforts to promote effective health interventions and protect public well-being. The spread of inaccurate information, particularly through online channels such as social media and internet platforms, further complicates the decision-making process for policymakers since it perpetuates public confusion and distrust. This misinformation can lead to resistance against health initiatives, such as vaccination programs, and fuels scepticism towards scientifically-backed health guidelines.
Before the COVID-19 pandemic, misinformation surrounding healthcare largely encompassed the effects of alcohol and tobacco consumption, marijuana use, eating habits, physical exercise etc. However, there has been a marked shift in the years since. One such example is the outcry against palm oil in 2024: it is an ingredient prevalent in numerous food and cosmetic products, and came under the scanner after a number of claims that palmitic acid, which is present in palm oil, is detrimental to our health. However, scientific research by reputable institutions globally established that there is no cause for concern regarding the health risks posed by palmitic acid. Such trends and commentaries tend to create a parallel unscientific discourse that has the potential to not only impact individual choices but also public opinion and as a result, market developments and policy conversations.
A prevailing narrative during the worst of the Covid-19 pandemic was that the virus had been engineered to control society and boost hospital profits. The extensive misinformation surrounding COVID-19 and its management and care increased vaccine hesitancy amongst people worldwide. It is worth noting that vaccine hesitancy has been a consistent trend historically; the World Health Organisation flagged vaccine hesitancy as one of the main threats to global health, and there have been other instances where a majority of the population refused to get vaccinated anticipating unverified, long-lasting side effects. For example, research from 2016 observed a significant level of public skepticism regarding the development and approval process of the Zika vaccine in Africa. Further studies emphasised the urgent need to disseminate accurate information about the Zika virus on online platforms to help curb the spread of the pandemic.
In India during the COVID-19 pandemic, despite multiple official advisories, notifications and guidelines issued by the government and ICMR, people continued to remain opposed to vaccination, which resulted in inflated mortality rates within the country. Vaccination hesitancy was also compounded by anti-vaccination celebrities who claimed that vaccines were dangerous and contributed in large part to the conspiracy theories doing the rounds. Similar hesitation was noted in misinformation surrounding the MMR vaccines and their likely role in causing autism was examined. At the time of the crisis, the Indian government also had to tackle disinformation-induced fraud surrounding the supply of oxygens in hospitals. Many critically-ill patients relied on fake news and unverified sources that falsely portrayed the availability of beds, oxygen cylinders and even home set-ups, only to be cheated out of money.
The above examples highlight the difficulty health officials face in administering adequate healthcare. The special case of the COVID-19 pandemic also highlighted how current legal frameworks failed to address misinformation and disinformation, which impedes effective policymaking. It also highlights how taking corrective measures against health-related misinformation becomes difficult since such corrective action creates an uncomfortable gap in an individual’s mind, and it is seen that people ignore accurate information that may help bridge the gap. Misinformation, coupled with the infodemic trend, also leads to false memory syndrome, whereby people fail to differentiate between authentic information and fake narratives. Simple efforts to correct misperceptions usually backfire and even strengthen initial beliefs, especially in the context of complex issues like healthcare. Policymakers thus struggle with balancing policy making and making people receptive to said policies in the backdrop of their tendencies to reject/suspect authoritative action. Examples of the same can be observed on both the domestic front and internationally. In the US, for example, the traditional healthcare system rations access to healthcare through a combination of insurance costs and options versus out-of-pocket essential expenses. While this has been a subject of debate for a long time, it hadn’t created a large scale public healthcare crisis because the incentives offered to the medical professionals and public trust in the delivery of essential services helped balance the conversation. In recent times, however, there has been a narrative shift that sensationalises the system as an issue of deliberate “denial of care,” which has led to concerns about harms to patients.
Policy Recommendations
The hindrances posed by misinformation in policymaking are further exacerbated against the backdrop of policymakers relying on social media as a method to measure public sentiment, consensus and opinions. If misinformation about an outbreak is not effectively addressed, it could hinder individuals from adopting necessary protective measures and potentially worsen the spread of the epidemic. To improve healthcare policymaking amidst the challenges posed by health misinformation, policymakers must take a multifaceted approach. This includes convening a broad coalition of central, state, local, territorial, tribal, private, nonprofit, and research partners to assess the impact of misinformation and develop effective preventive measures. Intergovernmental collaborations such as the Ministry of Health and the Ministry of Electronics and Information Technology should be encouraged whereby doctors debunk online medical misinformation, in the backdrop of the increased reliance on online forums for medical advice. Furthermore, increasing investment in research dedicated to understanding misinformation, along with the ongoing modernization of public health communications, is essential. Enhancing the resources and technical support available to state and local public health agencies will also enable them to better address public queries and concerns, as well as counteract misinformation. Additionally, expanding efforts to build long-term resilience against misinformation through comprehensive educational programs is crucial for fostering a well-informed public capable of critically evaluating health information.
From an individual perspective, since almost half a billion people use WhatsApp it has become a platform where false health claims can spread rapidly. This has led to a rise in the use of fake health news. Viral WhatsApp messages containing fake health warnings can be dangerous, hence it is always recommended to check such messages with vigilance. This highlights the growing concern about the potential dangers of misinformation and the need for more accurate information on medical matters.
Conclusion
The proliferation of misinformation in healthcare poses significant challenges to effective policymaking and public health management. The COVID-19 pandemic has underscored the role of misinformation in vaccine hesitancy, fraud, and increased mortality rates. There is an urgent need for robust strategies to counteract false information and build public trust in health interventions; this includes policymakers engaging in comprehensive efforts, including intergovernmental collaboration, enhanced research, and public health communication modernization, to combat misinformation. By fostering a well-informed public through education and vigilance, we can mitigate the impact of misinformation and promote healthier communities.
References
- van der Meer, T. G. L. A., & Jin, Y. (2019), “Seeking Formula for Misinformation Treatment in Public Health Crises: The Effects of Corrective Information Type and Source” Health Communication, 35(5), 560–575. https://doi.org/10.1080/10410236.2019.1573295
- “Health Misinformation”, U.S. Department of Health and Human Services. https://www.hhs.gov/surgeongeneral/priorities/health-misinformation/index.html
- Mechanic, David, “The Managed Care Backlash: Perceptions and Rhetoric in Health Care Policy and the Potential for Health Care Reform”, Rutgers University. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2751184/pdf/milq_195.pdf
- “Bad actors are weaponising health misinformation in India”, Financial Express, April 2024.
- “Role of doctors in eradicating misinformation in the medical sector.”, Times of India, 1 July 2024. https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/national-doctors-day-role-of-doctors-in-eradicating-misinformation-in-the-healthcare-sector/articleshow/111399098.cms
Related Blogs
What are Decentralised Autonomous Organizations (DAOs)?
A Decentralised Autonomous Organisation or a DAO, is a unique take on democracy on the blockchain. It is a set of rules encoded into a self-executing contract (also known as a smart contract) that operates autonomously on a blockchain system. A DAO imitates a traditional company, although, in its more literal sense, it is a contractually created entity. In theory, DAOs have no centralised authority in making decisions for the system; it is a communally run system whereby all decisions (be it for internal governance or for the development of the blockchain system) are voted upon by the community members. DAOs are primarily characterised by a decentralised form of operation, where there is no one entity, group or individual running the system. They are self-sustaining entities, having their own currency, economy and even governance, that do not depend on a group of individuals to operate. Blockchain systems, especially DAOs are characterised by pure autonomy created to evade external coercion or manipulation from sovereign powers. DAOs follow a mutually created, agreed set of rules created by the community, that dictates all actions, activities, and participation in the system’s governance. There may also be provisions that regulate the decision-making power of the community.
Ethereum’s DAO’s White Paper described DAO as “The first implementation of a [DAO Entity] code to automate organisational governance and decision making.” Can be used by individuals working together collaboratively outside of a traditional corporate form. It can also be used by a registered corporate entity to automate formal governance rules contained in corporate bylaws or imposed by law.” The referred white paper proposes an entity that would use smart contracts to solve governance issues inherent in traditional corporations. DAOs attempt to redesign corporate governance with blockchain such that contractual terms are “formalised, automated and enforced using software.”
Cybersecurity threats under DAOs
While DAOs offer increased transparency and efficiency, they are not immune to cybersecurity threats. Cybersecurity risks in DAO, primarily in governance, stem from vulnerabilities in the underlying blockchain technology and the DAO's smart contracts. Smart contract exploits, code vulnerabilities, and weaknesses in the underlying blockchain protocol can be exploited by malicious actors, leading to unauthorised access, fund manipulations, or disruptions in the governance process. Additionally, DAOs may face challenges related to phishing attacks, where individuals are tricked into revealing sensitive information, such as private keys, compromising the integrity of the governance structure. As DAOs continue to evolve, addressing and mitigating cybersecurity threats is crucial to ensuring the trust and reliability of decentralised governance mechanisms.
Centralisation/Concentration of Power
DAOs today actively try to leverage on-chain governance, where any governance votes or transactions are directly taken on the blockchain. But such governance is often plutocratic in nature, where the wealthy hold influences, rather than democracies, since those who possess the requisite number of tokens are only allowed to vote and each token staked implies that many numbers of votes emerge from the same individual. This concentration of power in the hands of “whales” often creates disadvantages for the newer entrants into the system who may have an in-depth background but lack the funds to cast a vote. Voting, presently in the blockchain sphere, lacks the requisite concept of “one man, one vote” which is critical in democratic societies.
Smart contract vulnerabilities and external threats
Smart contracts, self-executing pieces of code on a blockchain, are integral to decentralised applications and platforms. Despite their potential, smart contracts are susceptible to various vulnerabilities such as coding errors, where mistakes in the code can lead to funds being locked or released erroneously. Some of them have been mentioned as follows;
Smart Contracts are most prone to re-entrance attacks whereby an untrusted external code is allowed to be executed in a smart contract. This scenario occurs when a smart contract invokes an external contract, and the external contract subsequently re-invokes the initial contract. This sequence of events can lead to an infinite loop, and a reentrancy attack is a tactic exploiting this vulnerability in a smart contract. It enables an attacker to repeatedly invoke a function within the contract, potentially creating an endless loop and gaining unauthorised access to funds.
Additionally, smart contracts are also prone to oracle problems. Oracles refer to third-party services or mechanisms that provide smart contracts with real-world data. Since smart contracts on blockchain networks operate in a decentralised, isolated environment, they do not have direct access to external information, such as market prices, weather conditions, or sports scores. Oracles bridge this gap by acting as intermediaries, fetching and delivering off-chain data to smart contracts, enabling them to execute based on real-world conditions. The oracle problem within blockchain pertains to the difficulty of securely incorporating external data into smart contracts. The reliability of external data poses a potential vulnerability, as oracles may be manipulated or provide inaccurate information. This challenge jeopardises the credibility of blockchain applications that rely on precise and timely external data.
Sybil Attack: A Sybil attack involves a single node managing multiple active fake identities, known as Sybil identities, concurrently within a peer-to-peer network. The objective of such an attack is to weaken the authority or influence within a trustworthy system by acquiring the majority of control in the network. The fake identities are utilised to establish and exert this influence. A successful Sybil attack allows threat actors to perform unauthorised actions in the system.
Distributed Denial of Service Attacks: A Distributed Denial of Service (DDoS) attack is a malicious attempt to disrupt the regular functioning of a network, service, or website by overwhelming it with a flood of traffic. In a typical DDoS attack, multiple compromised computers or devices, often part of a botnet (a network of infected machines controlled by a single entity), are used to generate a massive volume of requests or data traffic. The targeted system becomes unable to respond to legitimate user requests due to the excessive traffic, leading to a denial of service.
Conclusion
Decentralised Autonomous Organisations (DAOs) represent a pioneering approach to governance on the blockchain, relying on smart contracts and community-driven decision-making. Despite their potential for increased transparency and efficiency, DAOs are not immune to cybersecurity threats. Vulnerabilities in smart contracts, such as reentrancy attacks and oracle problems, pose significant risks, and the concentration of voting power among wealthy token holders raises concerns about democratic principles. As DAOs continue to evolve, addressing these challenges is essential to ensuring the resilience and trustworthiness of decentralised governance mechanisms. Efforts to enhance security measures, promote inclusivity, and refine governance models will be crucial in establishing DAOs as robust and reliable entities in the broader landscape of blockchain technology.
References:
https://www.imperva.com/learn/application-security/sybil-attack/
https://www.linkedin.com/posts/satish-kulkarni-bb96193_what-are-cybersecurity-risk-to-dao-and-how-activity-7048286955645677568-B3pV/ https://www.geeksforgeeks.org/what-is-ddosdistributed-denial-of-service/ Report of Investigation Pursuant to Section 21 (a) of the Securities Exchange Act of 1934: The DAO, Securities and Exchange Board, Release No. 81207/ July 25, 2017
https://www.sec.gov/litigation/investreport/34-81207.pdf https://www.legalserviceindia.com/legal/article-10921-blockchain-based-decentralized-autonomous-organizations-daos-.html
Introduction
The Computer Emergency Response Team (CERT-in) is a nodal agency of the government established and appointed as a national agency in respect of cyber incidents and cyber security incidents in terms of the provisions of section 70B of the Information Technology (IT) Act, 2000. CERT-In has issued a cautionary note to Microsoft Edge, Adobe and Google Chrome users. Users have been alerted to many vulnerabilities by the government's cybersecurity agency, which hackers might use to obtain private data and run arbitrary code on the targeted machine. Users are advised by CERT-In to apply a security update right away in order to guard against the problem.
Vulnerability note
Vulnerability notes CIVN-2023-0361, CIVN-2023-0362 and CIVN-2023-0364 for Google Chrome for Desktop, Microsoft Edge and Adobe respectively, include more information on the alert. The problems have been categorized as high-severity issues by CERT-In, which suggests applying a security upgrade right now. According to the warning, there is a security risk if you use Google Chrome versions earlier than v120.0.6099.62 on Linux and Mac, or earlier than 120.0.6099.62/.63 on Windows. Similar to this, the vulnerability may also impact users of Microsoft Edge browser versions earlier than 120.0.2210.61.
Cause of the Problem
These vulnerabilities are caused by "Use after release in Media Stream, Side Panel Search, and Media Capture; Inappropriate implementation in Autofill and Web Browser UI, “according to the explanation in the issue note on the CERT-In website. The alert further warns that individuals who use the susceptible Microsoft Edge and Google Chrome browsers could end up being targeted by a remote attacker using these vulnerabilities to send a specially crafted request.” Once these vulnerabilities are effectively exploited, hackers may obtain higher privileges, obtain sensitive data, and run arbitrary code on the system of interest.
High-security issues: consequences
CERT-In has brought attention to vulnerabilities in Google Chrome, Microsoft Edge, and Adobe that might have serious repercussions and put users and their systems at risk. The vulnerabilities found in widely used browsers, like Adobe, Microsoft Edge, and Google Chrome, present serious dangers that might result in data breaches, unauthorized code execution, privilege escalation, and remote attacks. If these vulnerabilities are taken advantage of, private information may be violated, money may be lost, and reputational harm may result.
Additionally, the confidentiality and integrity of sensitive information may be compromised. The danger also includes the potential to interfere with services, cause outages, reduce productivity, and raise the possibility of phishing and social engineering assaults. Users may become less trusting of the impacted software as a result of the urgent requirement for security upgrades, which might make them hesitant to utilize these platforms until guarantees of thorough security procedures are provided.
Advisory
- Users should update their Google Chrome, Microsoft Edge, and Adobe software as soon as possible to protect themselves against the vulnerabilities that have been found. These updates are supplied by the individual software makers. Furthermore, use caution when browsing and refrain from downloading things from unidentified sites or clicking on dubious links.
- Make use of reliable ad-blockers and strong, often updated antivirus and anti-malware software. Maintain regular backups of critical data to reduce possible losses in the event of an attack, and keep up with best practices for cybersecurity. Maintaining current security measures with vigilance and proactiveness can greatly lower the likelihood of becoming a target for prospective vulnerabilities.
References
Introduction
The Telecom Regulatory Authority of India (TRAI) on 20th August 2024 issued directives requiring Access Service Providers to adhere to the specific guidelines to protect consumer interests and prevent fraudulent activities. TRAI has mandated all Access Service Providers to abide by the directives. These steps advance TRAI's efforts to promote a secure messaging ecosystem, protecting consumer interests and eliminating fraudulent conduct.
Key Highlights of the TRAI’s Directives
- For improved monitoring and control, TRAI has directed that Access Service Providers move telemarketing calls, beginning with the 140 series, to an online DLT (Digital Ledger Technology) platform by September 30, 2024, at the latest.
- All Access Service Providers will be forbidden from sending messages that contain URLs, APKs, OTT links, or callback numbers that the sender has not whitelisted, the rule is to be effective from September 1st, 2024.
- In an effort to improve message traceability, TRAI has made it mandatory for all messages, starting on November 1, 2024, to include a traceable trail from sender to receiver. Any message with an undefined or mismatched telemarketer chain will be rejected.
- To discourage the exploitation or misuse of templates for promotional content, TRAI has introduced punitive actions in case of non-compliance. Content Templates registered in the wrong category will be banned, and subsequent offences will result in a one-month suspension of the Sender's services.
- To assure compliance with rules, all Headers and Content Templates registered on DLT must follow the requirements. Furthermore, a single Content Template cannot be connected to numerous headers.
- If any misuse of headers or content templates by a sender is discovered, TRAI has instructed an immediate ‘suspension of traffic’ from all of that sender's headers and content templates for their verification. Such suspension can only be revoked only after the Sender has taken legal action against such usage. Furthermore, Delivery-Telemarketers must identify and disclose companies guilty of such misuse within two business days, or else risk comparable repercussions.
CyberPeace Policy Outlook
TRAI’s measures are aimed at curbing the misuse of messaging services including spam. TRAI has mandated that headers and content templates follow defined requirements. Punitive actions are introduced in case of non-compliance with the directives, such as blacklisting and service suspension. TRAI’s measures will surely curb the increasing rate of scams such as phishing, spamming, and other fraudulent activities and ultimately protect consumer's interests and establish a true cyber-safe environment in messaging services ecosystem.
The official text of TRAI directives is available on the official website of TRAI or you can access the link here.
References
- https://www.trai.gov.in/sites/default/files/Direction_20082024.pdf
- https://www.trai.gov.in/sites/default/files/PR_No.53of2024.pdf
- https://pib.gov.in/PressReleaseIframePage.aspx?PRID=2046872
- https://legal.economictimes.indiatimes.com/news/regulators/trai-issues-directives-to-access-providers-to-curb-misuse-fraud-through-messaging/112669368
