Politics
Disinformation enabled Donald Trump's second term and is a crisis for democracies around the world.
Martin McKee, Professor of European Public Health1, Christina Pagel, Professor of Operations Research2, Kent Buse, co-founder31London School of Hygiene and Tropical Medicine, London, United Kingdom2University College London, United Kingdom3Global Health 50/50, Cambridge, United Kingdom United
Misinformation is the new normal, with considerable implications for society, including population health. Martin McKee and colleagues outline the challenges and propose a path forward
Donald Trump did not win the 2020 election, but claiming he did has become a prerequisite for Republicans to run for the Congressional or Senate nomination in order to win their primaries. An entire party has become a vehicle for disinformation.1 Trump did indeed win the 2024 presidential election, and the key to that victory was building on the success of that lie. If you control the information ecosystem enough, the truth no longer matters.
Another telling example: Haitian migrants in Springfield, Ohio, don't eat cats or dogs. The Vice President-elect of the United States, JD Vance, who made this claim, admitted it while justifying it. If I have to create stories so that the American media will actually pay attention to the suffering of the American people, then that's what I will do, he said.2
Disinformation in politics is nothing new. History is full of fabricated claims to promote political goals. Although threats were made against local authorities in Springfield, no lives were lost. But in other cases, they were. US President Lyndon B Johnson used a fictional attack on US ships to justify US involvement in Vietnam. British involvement in the 2003 invasion of Iraq was justified by a dubious record. BMJ readers will remember the huge amounts of misinformation (wrong or misleading content unknowingly shared) and misinformation (false content deliberately spread) during the covid-19 pandemic, some generated or amplified by politicians.3 This has reduced the vaccination rate. ,4 promoted ineffective treatments and encouraged attacks on health workers.5 In the past, factually incorrect statements could have only local consequences, but now a lie can travel around the world in seconds.6 Yet the The speed at which misinformation can spread is only part of the problem.
Modern online information is vulnerable to the human desire to seek content that provokes anger.78 Social media platforms, which benefit from increased engagement, are designed to reward such content9, and curated networks exploit this to spread misinformation.10 The 2024 US presidential campaign We have seen conspiracy theories and misinformation deliberately exploited by the Trump campaign and its supporters in a terrifyingly powerful ecosystem created by a charismatic populist and billionaires media.11
Twitter (now X) was already struggling to moderate misinformation, conspiracy theories and extremist content before Elon Musk took power in 2022. But at least in the past it tried. Among the first steps Musk took when buying the company was a drastic reduction in online moderation, accompanied by a relaxation of previous protection rules. 12131415 Combined with the sale of verification codes and the adjustment of algorithms, these actions have greatly facilitated the spread of disinformation and the far right. views.161718 It was intentional: part of the reason Musk bought Twitter was to influence social discourse.19 And he did it by using his enormous platform (203 million followers) to support Trump, broadcast misinformation about 2021 election fraud and Kamala deep fakes. Harris,2223 and amplify conspiracy theories about everything from vaccines to race replacement theory to misogyny.2425 Musk's platform is effective: his support for Trump has coincided with trending posts Republican positions were algorithmically favored over Democratic-leaning positions.26 A more mundane example: after Musk published three non-evidence-based articles on increased by 18% while the other fell by 11%.27
It's tempting to say that X is just another platform, that it couldn't happen in the UK and that it's limited to the US. But this is just wishful thinking: remember the spread of disinformation about the 2024 British riots, which was directly aided by Musk.28 The 2024 presidential election provides a powerful playbook for extremists populists around the world.
The scenario involves destabilizing the online information system to radicalize people and create distrust of public figures, scientists and mainstream media. These methods have already proven themselves. The more time people spend engaging with conspiracy theories and misinformation online, the more they seek out such content, and radicalization can occur remarkably quickly.29 The world was at the forefront of the self-radicalization of 'Elon Musk on X.30
The scenario is to place conspiracy theorists at the heart of government and dismantle the agencies that support evidence-based policymaking. Trump promised Robert F. Kennedy an important role in the administration.31 Kennedy is a well-known critic of vaccines, continuing to promote the discredited idea that they can cause autism.3233 He has been particularly critical of regarding Covid-19 vaccines and experts who promote their use, writing a book attacking Anthony Fauci.34 He has also argued that SARS-CoV-2 is ethnically targeted35 and opposes fluoridation of water. Meanwhile, the Centers for Disease Control and the Food and Drug Administration are in Kennedy's crosshairs, with Trump indicating he will give him carte blanche.36
Democracies rely on voters to make informed choices in a free and fair manner. But when a significant proportion of the population, especially younger or less educated voters, gets their information from irresponsible and unregulated social media platforms such as TikTok, Facebook or X, how free is the process and fair?
The warning signs are clear for democracies around the world. First, governments need to regulate social media companies more rigorously. Brazil's successful dispute with They directly interfere with national and international affairs. policy.
Second, public health agencies must create robust surveillance systems for infodemics, just as they have done for epidemics. They must monitor the emergence of disinformation and counter it or, ideally, anticipate and counter it (pre-layer) among vulnerable audiences (and build population resilience).39 Independent organizations that combat disinformation are already deliberately targeted (https://counterhate.com/). And we must accelerate research to inoculate people against algorithms and content that tries to radicalize them.
Finally, policymakers and the public health community must not be afraid to call out misinformation, and we must all support and applaud them in doing so. And beyond responding to false rhetoric, we must also take the lead and create compelling counter-narratives in favor of better policy that can support a kinder, more inclusive, and socially just world.
Footnotes
Competing interests: KB is a board member of the World Obesity Federation and chairs its prevention and policy committee. It receives funding from industry. MM was a member of the Lancet Commission on the first Trump administration and is a member of the current Commission on the United States, neither of which is remunerated. He is also a member of the United States National Academy of Medicine.
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