I study rumors. Not tabloid gossip or the kind of rumors that are making stock markets crash -- or soar -- but the kind of rumors that affect your health ... and the world's health. Like eating a lot of garlic or drinking a lot of water is going to help protect us from coronavirus -- if only. Rumors have a bad reputation. They're seen as not fact, wrong, or "just a rumor." But I've studied rumors for years, and one thing I've learned is that they all have a story, and often, an important story.
Raziskujem govorice. Ne tračev v tabloidih niti govoric, zaradi katerih borzni tečaji strmoglavljajo ali rastejo, ampak govorice, ki vplivajo na vaše zdravje... in zdravje človeštva. Kot ta, da če jemo veliko česna ali pijemo veliko vode, nas bo to pomagalo zaščititi pred koronavirusom -- ko bi vsaj. Govorice so na slabem glasu. Pomenijo ne-dejstva, so napačne ali "so samo govorice". A govorice raziskujem že leta in spoznala sem, da ima vsaka svojo zgodbo, ki je pogosto pomembna.
One of the most moving or alarming rumor episodes that I investigated was in northern Nigeria. I was working with UNICEF's Global Immunization programme. And it wasn't the rumors themselves that I found so alarming; it was the global impact of those rumors. The rumors were suspecting that the polio vaccine was actually a contraceptive. It was controlling populations -- or maybe it caused AIDS. No, no, maybe it's the CIA spying on them or counting them. I mean, why else would they have people knocking on their door again and again with the same polio vaccine? When children were dying of measles, no one was coming with measles vaccines.
Ena najbolj ganljivih in skrb zbujajočih govoric, ki sem jih raziskovala, prihaja iz severne Nigerije. Delala sem za Unicefov globalni program cepljenja. In govorice same po sebi niso zbujale skrbi, jih je pa globalni vpliv teh govoric. Govorice so domnevale, da je cepivo proti otroški paralizi v resnici kontracepcijsko sredstvo. Nadzorovalo naj bi prebivalstvo ali pa povzročalo AIDS. Ne, ne, morda za ljudmi vohuni CIA ali jih prešteva. Zakaj bi sicer ljudje kar naprej trkali na vrata z istim cepivom proti otroški paralizi? Ko so otroci umirali zaradi ošpic, nihče ni prišel s cepivom proti ošpicam.
This wasn't about getting the facts right. This was about trust. It was about broken trust. Why so much distrust? It wasn't the mothers who were particularly distrusting, actually. It was the local leaders, the religious leaders, the local political leaders. It was the governor of the state of Kano who decided to boycott the entire polio eradication effort in that state ... for 11 months.
Tu ni šlo za dejstva. Šlo je za zaupanje. Šlo je za izgubljeno zaupanje. Zakaj toliko nezaupanja? Najbolj nezaupljive pravzaprav niso bile matere. Lokalni voditelji so bili taki, verski voditelji, lokalni politiki. Guverner zvezne države Kano se je odločil za bojkot vseh poskusov izkoreninjenja otroške paralize v državi... za celih 11 mesecev.
Why such distrust? Well, it was 2003. It was two years after 9/11. And they were convinced that the West, and particularly the United States, was at war with Muslims. And they knew that the West, and particularly the United States, was a huge supporter -- and funder -- of the global polio eradication initiative. They had their reasoning. That lack of trust, that "just a rumor or two" cost the polio eradication program 500 million dollars to reset the clock, to regain the progress lost during those 11 months and beyond. The Nigerian strain of the polio virus traveled to over 20 countries, as far as Indonesia. The cost of a rumor.
Zakaj tako nezaupanje? Bilo je leta 2003. Dve leti po enajstem septembru. In prepričani so bili, da je Zahod, sploh pa Združene države Amerike, v vojni proti muslimanom. In vedeli so, da Zahod, sploh pa Združene države Amerike, močno podpira in financira globalno pobudo za izkoreninjenje otroške paralize. Imeli so svoje razloge. To pomanjkanje zaupanja, ta "govorica ali dve" so program za odpravo otroške paralize stale 500 milijonov dolarjev. Morali so začeti znova ter nadoknaditi napredek, izgubljen v tistih 11 mesecih ter kasneje. Nigerijski sev virusa otroške paralize se je razširil v 20 držav, vse do Indonezije. Toliko stane govorica.
The Nigeria episode was one of many episodes that I investigated when I was with UNICEF and earned the title of the "director of UNICEF's fire department."
Nigerijska zgodba je ena od mnogih, ki sem jih preiskovala, ko sem delala za Unicef. Tam sem postala “direktorica Unicefovega gasilskega društva”.
(Laughs)
(smeh)
We -- at that point I realized I never really had enough time. I was too busy putting out the fires and not enough time to understand what was driving not just the individual episodes, but why was there an epidemic of these happening around the world.
Na tej točki sem spoznala, da nisem nikoli imela dovolj časa. Preveč dela sem imela z gašenjem požarov in premalo časa, da bi ugotovila, kaj poganja posamezne epizode, pa tudi, zakaj se epidemija govoric širi po vsem svetu.
I left UNICEF and went back to research -- applied research -- and I set up in 2010 what I called the Vaccine Confidence Project at the London School of Hygiene and Tropical Medicine. I convened anthropologists, epidemiologists, psychologists, digital media specialists and mathematical modelers. We set ourselves the task to investigate historic episodes of rumors and their impacts, from trying to figure out what were the early signals, what were the amplifying factors and the impacts, how did they get traction, so we could start to understand what we should be looking for, how we could help governments and immunization programs be more alert and responsive to early signals of problems. It was an early warning system.
Zapustila sem Unicef in se vrnila k raziskovanju, k uporabni znanosti, ter leta 2010 ustanovila projekt zaupanja v cepiva, na Londonski šoli za higieno in tropsko medicino. Skupaj sem pripeljala antropologe, epidemiologe, psihologe, poznavalce digitalnih medijev in strokovnjake za matematične modele. Zadali smo si nalogo, da raziščemo epizode govoric skozi zgodovino ter njihov vpliv. Iskali smo zgodnje znake, dejavnike, ki so govorice okrepili, njihov vpliv, kako so se oprijele, da bi razumeli, kaj moramo iskati, kako lahko pomagamo vladam ter programom cepljenja, da bodo bolj pozorni in odzivni na zgodnje znake težav. Šlo je za sistem zgodnjega opozarjanja.
In 2015, we developed a vaccine confidence index. It's a survey trying to investigate to what extent do people agree or disagree that vaccines are important, they're safe, they're effective -- they work -- and somehow they're compatible with my religious beliefs. We've run this with over hundreds of thousands of people around the world, trying to get our finger on the pulse of confidence and trust, but also, more importantly, looking at when that trust goes up or down, because we want to see when it starts to decline, that's the time to jump in, to get there before there's a crisis like the Nigerian one. We also set up 24-7 media and social media monitoring around the world -- multilanguage -- listening for what's going on in vaccine conversations, trying to pick up early concerns or changes in sentiment that we should be paying attention to.
Leta 2015 smo razvili indeks zaupanja v cepiva. Gre za anketo, ki ugotavlja, do kakšne mere se ljudje strinjajo ali ne s tem, da so cepiva pomembna, varna, učinkovita, da delujejo in da so v skladu z verskim prepričanjem. Vprašali smo na stotine tisoče ljudi po vsem svetu, da bi ugotovili, kakšen je pulz zaupanja, pa tudi, da bi videli, kdaj zaupanje raste ali pada, saj ko začne padati, je čas za ukrepanje, da preprečimo krizo, kakršna je bila nigerijska. Vzpostavili smo tudi stalno opazovanje medijev in družabnih medijev po svetu, v več jezikih, in poslušali razprave o cepivih, da bi odkrili zgodnje skrbi ali spremembe v odnosu do cepiv, na katere bi morali biti pozorni.
We've created an ecosystem of different types of information to try to understand: what are the public thinking and how can we engage? We look for early signals. When we find one, we have a global network of collaborators in a number of countries who have more local intelligence in that setting to try to understand -- is this signal misinformation, or is something brewing that we should know about?
Ustvarili smo ekosistem različnih vrst informacij, da bi razumeli tole: kaj meni javnost in kaj lahko storimo? Iščemo zgodnje znake. Ko kakega najdemo, naša globalna mreža sodelavcev v več državah s svojim poznavanjem lokalnih okoliščin poskuša razumeti, ali je signal dezinformacija ali se kuha nekaj, kar bi mi morali vedeti.
In London, we have a bigger picture. We watch the swarms of rumors, not just traveling locally but jumping countries. We've seen them jump from Japan over to Colombia, through Europe and around. They move. We live in a hyperconnected environment.
V Londonu gledamo širše. Opazujemo roje govoric, ki potujejo ne le lokalno, pač pa med državami. Videli smo skoke z Japonske v Kolumbijo, preko Evrope in okrog nje. Gibljejo se. Živimo v hiperpovezanem okolju.
One of the things that we found fascinating, and we've learned a lot in the last 10 years -- this is our 10th anniversary, this didn't start yesterday, this rumor problem -- and one of the things we've learned is in our global monitoring, that Europe is the most skeptical region in the world. France won the prize, actually.
Ena od stvari, ki se nam zdi fascinantna, in v desetih letih smo se ogromno naučili, letos praznujemo deseto obletnico, saj težave z govoricami niso od včeraj; ena od stvari, ki smo se jih naučili, prihaja iz globalnega opazovanja: Evropa je najbolj skeptična regija sveta. Zmaga pa Francija, pravzaprav.
(Laughter)
(smeh)
By far. And actually some of those rumors have traveled to other parts of the world. But we were trying to understand Europe. Hmm. Why Europe? I thought the US was really -- had some of the most skepticism, but boy, I was wrong.
In to z naskokom. Nekatere od teh govoric so se razpredle po svetu. A hoteli smo razumeti Evropo. Hmm. Zakaj Evropa? Mislila sem, da so ZDA zelo, da imajo največ skeptikov, ampak, opala, motila sem se.
And a political scientist, a colleague we work with, Jon Kennedy, he took our data from 28 European countries and he looked at it and correlated it with political opinion polling. And what did he find? He found that people who are most likely to vote for a populist party also were the ones most likely to strongly disagree that vaccines were important, safe or effective. What did we learn? Vaccines cannot escape the political and social turbulence that surrounds it. Scientists were unprepared for this tsunami of doubt and questions and distrust.
Eden od naših kolegov, politolog Jon Kennedy, je pogledal naše podatke o 28 evropskih državah in jih povezal s političnimi anketami. In kaj je ugotovil? Da se ljudje, ki bodo najbolj verjetno glasovali za populistično stranko, tudi najbolj verjetno močno ne strinjajo s tem, da so cepiva pomembna, varna ali učinkovita. Kaj smo spoznali? Da cepiva ne uidejo političnim in družbenim vetrovom okoli njih. Znanstveniki niso bili pripravljeni na tak tsunami dvoma, na vprašanja in nezaupanje.
What -- why are vaccines so ripe for resistance? Well, we identified a number of things, but one: they're highly mediated by government that requires, regulates and sometimes recommends vaccines -- or often recommends and sometimes requires. Big business makes vaccines, and neither institution, government or big business, are high in the trust ranks these days. And then there's scientists who discover and develop vaccines, and they're pretty elite and not accessible to the general public, at least the language they speak. Third, we're in a hyperconnected environment with social media these days, and people can share their unfettered views, concerns, anxieties and worries and find a lot of people that think the way they do, and think maybe their worries are worth paying attention to. And finally, vaccines touch every single life on the planet. What other health intervention, besides water, touches every single life? So if you're looking for something to disrupt, it's a perfect stage.
Kaj - zakaj so cepiva tako dovzetna za odpor? Več stvari je, sploh pa tale: vlade o njih veliko govorijo, saj zahtevajo, regulirajo in včasih priporočajo cepljenje, ali ga pogosto priporočajo in včasih zahtevajo. Velika podjetja cepiva proizvajajo. In nobena od teh institucij, ne vlade in ne velika podjetja, te dni niso visoko na seznamih zaupanja. Potem so tu še znanstveniki, ki odkrivajo in razvijajo cepiva, ti so dokaj elitni in nedostopni splošni javnosti, vsaj njihov jezik je nedostopen. Tretjič, z družabnimi mediji smo danes v hiperpovezanem okolju, kjer ljudje lahko neomejeno širijo mnenja, skrbi in strahove in najdejo mnogo somišljenikov ter menijo, da so njihove skrbi vredne pozornosti. In konec koncev cepiva vplivajo na vse življenje na planetu. Kateri drug zdravstveni ukrep, razen vode, vpliva na vse? Če torej hočete nekaj zmotiti, je to popolna tarča.
Perhaps that's one of the reasons that we need to pay more attention and rebuild our trust in issues. People are asking all kinds of questions. They're asking, why are vaccines -- and these are the kinds of things we're hearing in our social media -- why can't my child have a personalized vaccination schedule? What's the wisdom of so many vaccines? What about all those ingredients and preservatives? These are not crazy people, they're not uneducated; they're actually worried mothers. But some of them have come to me and said, "We feel ignored, we feel judged if we ask a question, and we even feel demonized that maybe we're part of some antivaccine group."
Morda moramo zato biti bolj pozorni in vrniti zaupanje ljudi v zadeve. Ljudje imajo vprašanja vseh vrst. Zanima jih, zakaj pri cepivih - in take stvari vidimo v družabnih medijih - zakaj njihov otrok ne more dobiti osebnega urnika cepiv. Zakaj tako veliko cepiv? Kaj pa vse sestavine in konzervansi? To niso nori ljudje, niso neizobraženi, gre za zaskrbljene matere. A nekatere pravijo: “Počutimo se ignorirane, obsojajo nas, če kaj vprašamo, celo demonizirajo nas, da smo morda del kakšne skupine, ki nasprotuje cepivom.”
So we have some listening to do. And maybe that's why last year, there was research that found that in six months in 2019, online -- this was with hundreds -- 100 million different users on social media -- although the numbers of individuals who expressed in their online groups, they were positive, as groups, the ones who were the most negative were recruiting the conversations in the middle that were undecided about whether they wanted to get vaccines. The highly negative -- what we might call the antivaccine groups -- were recruiting the undecided at a rate 500 percent faster than the provaccine groups. 500 percent faster. They were more nimble, they were responsive and they were listening.
Tako da moramo bolj poslušati. Morda zato ne čudijo rezultati lanskih raziskav: v šestih mesecih leta 2019, na spletu, med sto... sto milijoni različnih uporabnikov družabnih medijev; čeprav je bilo veliko posameznikov, ki so bili v svojih spletnih skupinah za cepljenje, so bile med skupinami najbolj negativne tiste, ki so privabljale razprave iz sredine, med neopredeljenimi za ali proti cepljenju. Te zelo negativne... lahko bi rekli skupine proti cepljenju ... so pridobivale neopredeljene ljudi, in to 500 odstotkov hitreje kot skupine v podporo cepljenju. 500 odstotkov hitreje. Bile so spretnejše, bolj odzivne, poslušale so.
Most people believe that vaccines are good and they believe in their importance. But that belief is under attack. We need to build in more opportunities for conversation. And there are ways to do it.
Večina ljudi verjame, da je cepljenje koristno in pomembno. A to prepričanje je v nevarnosti. Ponuditi moramo več priložnosti za razpravo. Obstajajo načini za to.
It's not easy for some health professionals to have conversations where their authority is questioned. It's uncomfortable. And they're just too busy to listen to all these questions. But we need to do something about that, because we're losing a lot of concerned parents that just want a conversation. We should get volunteers trained to sit in waiting rooms, to be on hotlines, to have online chat forums, to have chat boxes. In younger kids, with younger kids in school, teach them about immune systems and teach them that actually, you know that vaccine your little brother got? Well, it just inspired your natural immune system. It's a great thing and this is why. We need to build that confidence; we need to listen.
Zdravnikom je včasih težko govoriti o temah, kjer drugi dvomijo v njihovo avtoriteto. Neprijetno je. In preveč dela imajo, da bi se ukvarjali z vsemi temi vprašanji. A nekaj moramo storiti, saj izgubljamo veliko zaskrbljenih staršev, ki bi se radi samo pogovorili. Usposobljeni prostovoljci bi morali sedeti v čakalnicah, biti na telefonu, v spletnih forumih, na voljo za pogovor. Mlade v šoli učimo o imunskem sistemu in o tem, kako so cepiva, ki so jih dobili njihovi mlajši bratje, okrepila njihov naravni imunski sistem. Zato je to dobra stvar. Zgraditi moramo to zaupanje, poslušati moramo.
Despite all this questioning -- and there's a lot of it -- I hear probably more than a lot of people -- I am an optimist. And my optimism is with a younger generation. The younger generation who actually now are becoming very aware of the risks of social media, the false news, the false identities, and they're starting to embrace science. And some of them are a group of children whose mothers refused to vaccinate them.
Kljub vsem dvomom - in veliko jih je - verjetno jih poznam več kot večina - sem optimistka. In moj optimizem je pri mladih. Mladi se vse bolje zavedajo tveganj družabnih medijev, lažnih novic, lažnih identitet in se bolj obračajo k znanosti. Nekateri med njimi so otroci, ki jih matere niso hotele dati cepiti.
Last spring of 2019, 18-year-old Ethan Lindenberger went on Reddit and put out a post. "My mother doesn't believe in vaccines. She's really worried they cause autism. In fact, she strongly believes that. But I'm 18. I'm a senior in high school. I can drive a car, I can vote and I could go get my own vaccine. Can someone tell me where to get it?" That post went viral. It started to get a whole younger movement going.
Spomladi 2019 je 18-letni Ethan Lindenberger objavil tole na Redditu: "Moja mama ne verjame v cepiva. Boji se, da povzročajo avtizem. Celo močno verjame, da je to res. Star sem 18 let. Sem v zadnjem letniku srednje šole. Lahko vozim, lahko volim in lahko se grem cepit. Mi lahko kdo pove, kam naj se obrnem?" Njegova objava je obšla svet. Sprožila je pravo gibanje med mladimi.
I saw Ethan speak at a conference, the Global Vaccine Summit at the EU last fall. He spoke eloquently, and I was impressed, in front of a whole forum. He told his personal story, and then he said to the group, he said, "You know, everybody talks about misinformation, but I want to tell you about a different kind of misinformation, and that's misinformation that says that people like my mother, who is a loving mother, is a bad person because she doesn't give me vaccines. Well, I want to tell all of you that she didn't give me a vaccine, because she loves me and because she believed that that was the best thing for me. I think differently and I will never change her mind, but she's not a bad person." That was the message from a teenager. Empathy, kindness and understanding.
Ethana sem poslušala, ko je lansko jesen govoril na Globalnem vrhu cepiv v EU. Bil je prepričljiv, navdušil me je z govorom pred celotnim forumom. Povedal je svojo osebno zgodbo in potem občinstvu dejal: "Vem, vsi govorijo o dezinformacijah, jaz pa bi vam rad povedal o druge vrste dezinformacijah, tistih, zaradi katerih ljudje, kot je moja mama, ki je ljubeča mama, postane slab človek, ker me ne da cepiti. Veste, ni me dala cepiti zato, ker me ima rada, ker je verjela, da je to najbolje zame. Jaz mislim drugače in nikoli je ne bom prepričal, da nima prav, ampak ni slab človek." To je bilo sporočilo najstnika. Empatija, ljubeznivost in razumevanje.
We have an abundance of scientific information to debunk false rumors. That's not our problem. We have a relationship problem, not a misinformation problem. Misinformation is the symptom, not the cause. If people trust, they'll put up with a little risk to avert a much bigger one.
Imamo ogromno znanstvenih podatkov, da lahko ovržemo lažne govorice. Ni v tem problem. Problem je v odnosu, ne v dezinformacijah. Dezinformacije so simptom, ne vzrok. Če ljudje zaupajo, bodo sprejeli majhno tveganje, da bi se izognili veliko večjemu.
The one thing that I want and I hope for is that we as a medical and health community have the moral courage and humility to productively engage, like Ethan, with those who disagree with us. I hope so.
Želim in upam, da bomo kot zdravstvena skupnost imeli moralni pogum in skromnost, da se bomo, kot Ethan, produktivno ukvarjali s tistimi, ki se ne strinjajo z nami. Res upam.
Thank you.
Hvala.
(Applause and cheers)
(aplavz in vzkliki)