Poor Transparency and corruption in Disease Reporting could Precipitate the Next Pandemic
The Bird Flu, or Avian Influenza A(H5N1), 2.3.4.4b Clade virus, has been circulating since 2022 in the Americas. Between 2022-2025, 19 countries reported 4,713 outbreaks of animal disease and 74 human infections. The virus is mutating quickly, and its consequences are difficult to predict. It is crucial to monitor the virus for any mutations, especially with its 50% fatality rate.
Effective surveillance requires disease reporting. These data are made public so that government officials may understand the nature of a public health threat and assess the risk. They can also gather resources to prepare an effective plan for containing it. The global response to Covid-19 showed that countries with better prevention, detection and response capabilities have lower pandemic mortality. The lack of transparency and corruption has impacted the quality and level of disease reporting in countries during outbreaks. The result could easily be a protracted health crisis that can transform into a pandemic.
Why is the Bird Flu outbreak concerning and why should we prioritize disease reporting?
H5N1 could be a ticking time bomb. There is no documented human-to human transmission. However, there was a human to cat spread. This shows that humans can transmit this virus. The wider spread of the virus from birds to mammals also exposes humans to a deadly strain, posing a serious threat to humanity. The virus has also become more resistant to viral drugs due to the ongoing mutations. Recently, a study documented the emergence of a H5N1 strain in poultry that is resistant to the drug oseltamivir.
When outbreaks emerge, poor disease reporting and deliberate suppression can pave the way for protracted health crises and pandemics. In 1918, newspapers from France, England, the United States, and Canada were prohibited from reporting on the Spanish Flu, which contributed to its spread. Ebola spread across West Africa, in 2014, due to delayed reporting from Guinea and then Liberia, Sierra Leone and Liberia. China’s deliberate concealment of SARS in 2002-3 also contributed to its spread. China’s initial denials and decision to underreport Covid-19 cases at the beginning of the pandemic allowed it to spread quickly. Five years after the outbreak, the WHO continues to urge China to share information on the virus’ origin. We are seeing similar trends today with H5N1. Some veterinarians have lost their jobs and others have been silenced for reporting H5N1 cases among dairy cows in the beginning of the year.
Lack of transparency and corruption in disease reporting and surveillance
From the Spanish Flu to SARS and Covid-19, lack of transparency in disease reporting has been a common denominator. Many states have not complied with the WHO’s International Health Regulations, which was established in 2005. This tool is legally binding and requires 196 member countries to report public health incidents. States hide outbreaks in order to avoid trade and tourism restrictions, reputational damage relating to their ability to control outbreaks, or public distrust of their agricultural products. Countries may use vague terminology to hide the threat of an outbreak. In India, cholera outbreaks were reported as gastroenteritis. In Thailand, H5N1 outbreaks were labeled as avian influenza. Moreover, countries where the media is biased in favor of ruling regimes will be less likely to report an outbreak.
States who actively conceal and delay disease data reporting may also silence whistleblowers by threats or intimidation. This directly restricts free civic space. Fear of whistleblower reprisals led doctors and nurses to not report cases during the 2008 hepatitis outbreak in Nevada. Dr. Jiang, the lead whistleblower during the 2003 SARS epidemic, was placed under house arrest because of his outspokenness. Dr. Li Wenliang was criminalized by the Chinese government for informing colleagues about new upper respiratory illnesses at the beginning of Covid-19. In the UK, health care professionals were threatened with disciplinary action if they spoke about their work during Covid-19.
Hand in hand with poor transparency in disease reporting are corrupt practices such as data manipulation and the wildlife farming industry’s undue influence on states’ responses and policies.
Data manipulation was a hallmark of corruption during Covid-19. Data manipulation was a hallmark of corruption during Covid-19. In Brazil, in June 2021, the Health Ministry removed Covid-19 data temporarily from its website. When the data was restored, the figures revealed that Brazil was one of the most affected countries worldwide.
Additionally, one of the most concerning forms of corruption associated with zoonotic disease outbreaks is the animal agriculture industry’s potential for undue influence and capture of state policies. A recent Harvard study indicates that the industry’s increasing political and economic significance has enabled it to lobby more effectively against regulations, and consequently, backsliding in biosecurity policies has become commonplace.
A lack of transparency and corruption in all forms significantly undermine the accuracy of disease reporting. The consequences of corruption and lack of transparency can be devastating. First, leaders around the world cannot contain an outbreak effectively without reliable data identifying its source and transmission pattern. Second, if a pandemic occurs, the social, political, economic, and other costs will far outweigh any initial concerns that governments may have had about transparency. Covid-19 shows that pandemics can disrupt trade, cause food shortages, increase healthcare costs, strain the health care system, and result in significant human toll. Third, poor disease reporting can erode public trust.
Steps to enhance transparency and accountability
Improving disease reporting requires us to consider measures to address the drivers of corruption and lack of transparency. Here are three areas where we should focus:
Enhance whistleblowing for scientists and officials reporting suppressed data
The most effective laws protect whistleblowers from any potential retaliation. These laws do this by providing protection from criminal or civil liability and/or imposing interim reliefs or remedies when retaliation occurs. In the case of outbreaks, stronger domestic legislation on whistleblower protection could empower non-state actors to report cases or outbreaks to the WHO’s IHR. In the case of outbreaks, stronger domestic legislation on whistleblower protection could empower non-state actors to report cases or outbreaks to the WHO’s IHR.
- Address the political and economic incentives behind obscurity in disease reporting: Policies to enhance transparency in disease reporting must also consider approaches to lower the economic and political costs of reporting, such as setting a financial mechanism to reimburse national and local governments for economic losses incurred during outbreaks, and not naming the outbreak after the country where it originated.
- Reduce industry influence: Measures can include creating asset and interest declaration registries for government officials to identify any potential conflicts of interest; conducting periodic wealth assessments of key staff; establishing a gift registry; and requiring asset and interest disclosure.
- The Covid-19 Pandemic between 2020 and 2023 claimed 7,1 million lives worldwide and exposed our weaknesses regarding global pandemic preparedness, response and reporting. The spread of H5N1 and its various mutations in the Americas poses a serious threat to global health. This time, we must commit to getting things right– beginning with addressing corruption and improving transparency in disease reporting.About the author
Daniela Cepeda Cuadrado
is an affiliated researcher with the Petrie-Flom Center, a senior anti-corruption adviser, and a public policy professional with extensive experience in the areas of anti-corruption, health, and sustainable development.
