Health

Comment: Ignorant reporting can be lethal

Mia Malan

As the fallout regarding misinformation about vaccines and antiretrovirals shows, words can kill.

Truth serum: The M&G Bhekisisa centre aims to avoid disseminating myths. (Eduardo Munoz/Reuters)

The vaccination rate for MMR, which protects against three of the most common childhood diseases: measles, mumps and rubella, dropped from 92% in 1996 to 73% in 2009 in England.

According to British doctor and science writer Ben Goldacre, the incidence of two of the three diseases covered by the MMR vaccine is "increasing impressively". By 2009, England and Wales had the highest number of measles cases since the introduction of current surveillance methods in 1995. Mumps "began rising in 1999" and in 2005 the "United Kingdom had a mumps epidemic, with about 5000 notifications in January alone". 

One of the main causes of the falling vaccination rates? More than likely, Goldacre says, the media. 

"People listen to journalists," he argues in his bestseller book, Bad Science. "This has been demonstrated repeatedly."

Let me explain further.

In February 1998, a group of researchers and doctors in London published a research paper in the Lancet medical journal that, according to Goldacre, "by now stands as one of the most misunderstood and misreported papers in the history of academia". 

The paper detailed the medical histories of 12 children who had bowel and behavioural problems, mostly autism, and "mentioned that the parents or doctors of eight of these children believed that their problems had started within a few days of them being given the MMR vaccine". 

Essentially, such a research study – a "case series" paper with a collection of 12 clinical anecdotes – does not tell you a thing about a link between "something as common as MMR" and something "as common as autism". For this, Goldacre explains, you would need a "cohort study", research that takes children who were given the MMR vaccine and children who were not and then compares the rates of autism between the two groups, or a "case-control study", which looks at children with autism and children without and then compares the rates of vaccination between the two groups.

Inaccurate media coverage 
Yet the British media jumped at the opportunity to misinterpret the study results and turn the supposed "link" between autism and MMR vaccines into a highly controversial and widely reported political issue for eight consecutive years. It was the "perfect story", Goldacre says, "with a single, charismatic maverick of risk, of awful personal tragedy and, of course, the question of blame. Whose fault was autism?" 

In 2003, the United Kingdom's Economic and Social Research Council found that this was the most intensively covered science story for years: it generated the most letters to the press, comment pieces and editorials, and it also resulted in the longest stories. But it was also one of the most misleading.  

According to Goldacre, "less than a third of broadsheet reports referred to the overwhelming evidence that the MMR is safe and only 11% mentioned that it is regarded as safe in the 90 other countries in which it is used". Instead, incorrect science was "pitted against the emotive concerns of distressed parents". 

Shockingly, 80% of these stories were created by generalists, not science or health reporters, who, according to Goldacre, lacked "the skills to critically appraise a piece of scientific evidence on its merits". 

Dissidence unleashed
Thousands of kilometres away, but at more or less the same time as the MMR study hit the UK, a scientific controversy of even greater proportions unfolded in South Africa. Our then deputy president, Thabo Mbeki, and the health minister, Nkosazana Dlamini-Zuma, unleashed a political storm when they appeared to have played prominent roles in fast-tracking the registration of a widely condemned "cure for Aids",  Virodene P058, which a team of researchers claimed could kill HIV. Not long after that, Mbeki, by then president, and his new health minister, Manto Tshabalala-Msimang, publicly started to doubt the causal link between HIV and Aids and announced that they considered lifesaving antiretroviral drugs toxic. 

There are striking similarities between the two debacles. Both relied ­heavily on the element of blame for sustainability – whose fault was autism or HIV? – and continued for eight years. Like the MMR vaccine, HIV became a huge story in South Africa that was more regularly covered by political correspondents with a limited understanding of science than by trained health reporters. As a result, the reporting was more often than not a case of conflict-ridden mudslinging, of who said what, rather than stories that took media consumers any closer to the "scientific truth". 

And, because news editors had a lack of understanding of science themselves, confusing op-eds and letters by anti-MMR supporters or HIV dissidents regularly found their way on to the middle pages and columns of newspapers. 

Consequences
In both cases, there were obvious, far-reaching consequences: reporters spread misinformation that resulted in media consumers' confusion about the efficiency of medical interventions and, in many cases, the abandonment of vaccinations or drugs that could save their or their children's lives. 

Accurate, responsible reporting would have emerged if trained health reporters in the UK and South Africa, with a good understanding of medical science and health policy, were in a better position to assert both their knowledge and influence in the newsroom. 

That is why we launched our health journalism centre, Bhekisisa, on Thursday evening. We are based in the middle of a vibrant, influential newsroom, rather than at a university or nongovernmental organisation, so that editors cannot ignore us when it comes to the placement, content or angles of health-related stories, and we are readily available as resources. 

We do not only report on health issues, we also share our experiences, in partnership with health experts, through hands-on, mentored fellowships for African journalists so that we help to increase the quality of health reporting around the continent. Knowledgeable health reporters are in a much better position to assert themselves and the reporting of accurate science than those without the requisite skills. 

We also host critical discussion forums such as the National Health Insurance dialogue we held this week to bring together the media and other role players for constructive discussion in the health field.  

We realise that we, too, are on a constant learning curve and that we can make mistakes. That is why we trust that you, our audience, will "bhekisisa" or "scrutinise" what we do, in the same way that we plan to "bhekisisa" health issues so that, together, we can promote a healthy media and in so doing contribute to a healthy population.

 

                                            


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