By Mary-Ann Etiebet, M.D., President and CEO, Vital Strategies
In the past year, the world of public health has been tested at its core. We’ve seen misinformation fuel hostility toward health agencies, disinformation erode confidence in evidence, funding shortfalls paralyze life-saving services, and political divides threaten the coalitions that protect communities both within and across borders. These fractures signal the emergence of a new era – one with a profound disconnect between the public and the promise of public health. Rebuilding connections will require renewing trust in our public health systems. Without trust, we risk further deterioration of public support for the policies and practices, from routine childhood vaccinations to funding universal health coverage, that save lives.
The work of public health has always been rooted in science. Yet, our ability to act on the science depends on connection — our capacity to listen, communicate and respond in ways that resonate with peoples lived realities. Despite our best intentions, the gap between evidence and experience, data and believing, institutions and the communities they serve, keeps widening. Closing this trust deficit is not just a nice to do; it’s measurably a matter of life and death. We must figure out how to bring the public back into public health.
Creating Responsive Systems by Design
Misinformation now spreads faster than verified science, and in an era where information platform algorithms favor emotion over evidence, next generation public health systems must listen, so that they respond, not just to pathogens, but to people. In South Africa, Indonesia, China, Mexico, Brazil, India and beyond, we’re using AI-powered surveillance to detect and counter hidden threats on social media. Our monitoring system, known as CANARY, enables policymakers to respond in near real-time and devise long-term solutions. In Indonesia, they’ve extended tobacco marketing bans to social media, shielding millions of children from previously undetected harmful messages.
Public health systems must also transition from merely collecting data to cultivating dialogue, from simply counting cases to better understanding communities. To do this they will need to capture sentiment, detect misinformation, and ensure that those insights shape public engagement strategies and policy formulation.
And we know how to do this. In Brazil — a country of over 200 million people, characterized by immense regional and cultural diversity – More Data Better Health (MDBH), a 100% online, self-administered survey delivered through digital ads proves that it is possible to monitor population health rapidly, inclusively, and affordably, without sacrificing rigor or reach. By combining public health and political polling techniques, MDBH is leveraging private-sector innovation and demonstrating that citizen-generated data can be collected and analyzed rapidly enough to inform policy discussions, offering a promising model for people-centered public health monitoring.
Reimagining and Rebuilding the Connection Between Science and Society
There are already signs of renewal. To restore trust across our diverse communities, public health must double down on the following:
- Institutionalize listening. Pair traditional surveillance with social insight through new data science like artificial intelligence to detect early signals of mistrust or misinformation.
- Invest in communications expertise. Build and embed these capabilities and best practices, including from the private sector, so effective engagement becomes an enduring public good.
- Leverage trusted messengers and platforms. Pierce echo-chambers to reach people where they form opinions. Use familiar digital and community-based channels to connect information with lived realities.
Together, these approaches ensure that our work does not just generate knowledge, it makes knowledge accessible and relatable.
Reclaiming Trust
The gulf between science and society will widen if we fail to act. But if we meet this moment with humility and purpose, building systems that listen and connect as much as they measure, we can begin to repair the connective tissue between the public and public health.
At Vital Strategies, we aspire to do just that. How can we help governments build next generation foundational public health data systems that make the invisible visible and surface unmet needs? How do we make sure that every birth is counted and digitally connected to a lifetime of rights, benefits and services, so that no-one is left out by the march of technology? How can we build communication campaigns that instead of telling people what to do, reflect what matters to them?
Our solutions are as diverse as our partners’ challenges; what they share is a focus on lasting change where data-informed policies are put into practice by strong institutions in dialogue with the public, creating communities where all people can live healthier lives. When listening becomes a habit, data becomes a bridge to reclaiming trust.
Putting the public back into public health is not a slogan but a roadmap for renewal. The public is not the audience for public health; they are its center. Our collective future depends on whether we will be successful in bringing the public back into public health.