In the absence of credible, strong political leadership, paranoia about disease can go viral. We've seen this happen around the world with a wide range of illnesses, from swine flu to SARS to Ebola.
And even after threats are addressed, a new form of conspiratorial thinking often emerges, this time focused not on the microbes but on the tools used to keep the germs at bay — especially vaccines.
Since 2008, the Council on Foreign Relations has been collecting data and publishing weekly updates to an interactive map of vaccine-preventable diseases, and the map is now robust, dense with six years of data. One terrible truth stands out: Misinformation and rumors from just one persuasive voice, delivered effectively, can derail entire immunization campaigns and persuade millions of parents to shun vaccinations for their children.
In 2007, Maulana Fazlullah, who currently heads the Pakistani Taliban, went on Pakistani radio and denounced vaccinations as a conspiracy of Western nations to render Muslims infertile. A few years before that, a handful of political and religious leaders in Nigeria advocated the boycotting of polio vaccinations, claiming the products were contaminated with sterilization agents, HIV or cancer. In both cases, the misinformation resonated with parents.
In Nigeria, mothers refused immunization for their babies and the number of polio cases there doubled in just a year, going from 355 in 2003 to 782 in 2004. It has taken years to recover the lost ground in West Africa, with Nigeria finally reporting only six cases this year.
In Pakistan, the so-called Radio Mullah's exhortations also found an audience, and he was given an assist in 2011 with the release of the American movie "Zero Dark Thirty," which falsely connected the CIA to an oral polio vaccination ruse that was part of an attempt to catch Osama bin Laden.
In reality, the CIA used a false hepatitis B vaccination scheme in hopes of injecting children inside the compound in which it was believed that Bin Laden was hiding, and then testing the syringes for evidence of his genes. The fake vaccine effort failed when the immunizer was denied access to the Bin Laden children. But the movie's incorrect linking of it to polio immunization heightened existing mistrust in Pakistan and provided the Taliban with "evidence" that its anti-immunization campaign had merit.
Today, vaccinators and healthcare workers providing lifesaving interventions are targeted for bombings and assassinations, and children in Pakistan are suffering. Our interactive map clearly demonstrates the correlation between an increase in Taliban propaganda and assaults on health workers and the resurgence of polio. Worse, recent outbreaks of polio and other vaccine-preventable diseases in the Middle East have been linked to Pakistani-trained combatants who have carried pathogens to Syria and Iraq, along with their anti-immunization ideology.
And anti-vaccine sentiments aren't limited to the developing world. The effects of Andrew Wakefield's now thoroughly debunked 1998 Lancet study claiming links between vaccinations and autism are still being felt in the Western world, as can be seen in our interactive map. Outbreaks of pertussis in wealthy California communities, of mumps in Ohio college towns and of measles throughout the United Kingdom demonstrate the broad impact of the anti-vaccination movement.
In light of the paranoia evoked by Ebola, political and public health leaders must appreciate that not a single voice dispensing misinformation should go unchallenged. The general public has proved its inability to weigh facts accurately and reach a rational conclusion when fear clouds its judgment. Remarkably, in the case of the purported associations between autism and vaccines, the concept has gone viral in some of America's most highly educated and wealthy communities, as has unscientific advice about delaying certain immunizations to avoid "vaccine overload."
Too many political leaders around the world have either fanned the flames of fear or have shrugged off responsibility for dispelling them, assuming that countering conspiracies and false worries is a job for doctors and public health officers.
In Islamabad, Abuja and Sacramento alike, political leaders need to confront false fears. Every baby who has died of pertussis in California, been paralyzed by polio in Pakistan or suffered from measles in the United Kingdom represents a tragedy that might have been prevented.
Laurie Garrett is senior fellow for global health at the Council on Foreign Relations and the author of "I Heard the Sirens Scream: How Americans Responded to the 9/11 and Anthrax Attacks." Maxine Builder is a research associate for global health at the Council on Foreign Relations.