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The creation of effective vaccines has offered a lifeline in one of the worst pandemics in world history. But targeted use of technology to support vaccination and combat the spread of false information will prove crucial to putting it more squarely in the rearview mirror.

To drive that point home, Hans Kluge, Europe region director of the WHO, visited the conference of the Health Information Management Systems Society (HIMSS) in Las Vegas on Tuesday to discuss the pressing need for global strategies to fight misinformation and leverage AI to identify — and swiftly assist — communities with low vaccination rates.

“Too many policy decisions are still being made based on assumptions and perceptions,” said Kluge, who established a WHO unit focused on behavioral and cultural insights to understand the drivers of vaccine hesitancy and develop programs to counteract it. “Increased digital literacy, and trustworthy information sources, save lives. This is so important.”

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In a wide-ranging conversation with STAT, Kluge spoke about the need for a more coordinated technology strategy, noting that modern communication platforms — and especially social media — have extended the reach of conspiracy theories that are skewing public health policy, prolonging the pandemic, and causing more deaths.

But he also emphasized that technology can be a tremendous asset, even an antidote, in fighting a virus whose roots are as social and political as they are cellular. This interview has been lightly edited for length and clarity.

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What are the pillars of a global technology strategy to fight Covid-19?

There is a lot of polarization in our society. We see this globally, in the U.S. and Europe, and there’s a lot of vaccine hesitancy. So first things first, it’s very important that we use digital technologies to check who is vaccinated, who is not, and who got only a first dose. Because the Delta variant, for example, is breaking through the first dose. Second, we need an electronic Covid certificate.

Digital technologies can help us to standardize norms and requirements of such a certificate. This is really very important to know if people are vaccinated but also to measure the coverage and effectiveness of the vaccines.

What needs to be done to combat misinformation and hold its spreaders accountable?

We need to work with governments and legal authorities to develop a framework for how to address this. The context we face globally is a lot of distrust in public authorities [and] public governance, and almost infinite information sources. This changes the whole way of communicating with people. What can we do? Work much more with communities, whether it is religious communities, youth communities, media communities, and identify champions. People are anxious, so we can’t point the finger and blame them.

What role do you see artificial intelligence playing in supporting a more effective public health response?

We have to harness the power of digital health and artificial intelligence. First of all, we need to be a better listener. And second, we need to anticipate better the concerns of the people. I would like to give the example WHO has been taking forward. It’s called EARS (Early AI-supported Response with Social listening tool).

It’s a tool that is mining public blogs, news articles, and online forums. As of now, we are doing this around 41 different narratives, in 20 countries and four languages to listen to what’s out there and to anticipate misinformation spread [and its effects]. My experience is that once people get emotional, evidence doesn’t help anymore. So we have to be a step ahead. Only the power of artificial intelligence can help us in that regard.

How do you balance individual rights and privacy against those very important public health efforts?  

It depends a lot on the governance in your country. It’s one of the main things I’m going to discuss with Dr. [Anthony] Fauci. Imagine that there are still 440,000 people who think it’s a hoax, for example. We need to address this respecting freedom of speech, including on social media. So we have to be not defensive, but do some of the things I mentioned to counteract and anticipate.

At what point in the public health response do policies need to become more aggressive, to potentially require vaccination in order to access public spaces and other freedoms?

What I have in mind is mandatory vaccination. In more and more countries, it is mandatory for the health workers to be vaccinated, but again that step was taken as a last resort in order to protect public health. I mean, we have a tool now which is preventing not necessarily infections, but at least in the majority of the cases severe disease and deaths. Vaccines save lives. And we are never going to get out of the pandemic if we have unvaccinated health workers.

So maybe we will have to think more about doing this — not through a top down approach, but a dialogue. In Europe, we have President Macron in France, who made a public speech on television to make the vaccine mandatory [to gain access to entertainment venues]. At the same time, we have [Chancellor] Merkel in Germany saying it’s not mandatory. There is no straightforward answer here. We have to work with people and have empathy.

What are some of the more effective uses of technology and public policy to encourage vaccination?

In Denmark, where the regional office of the WHO in Europe is based, the people have a lot of trust in the government and there is no dissatisfaction with the Covid pass. If you want go to a discotheque, to a restaurant or to a cinema, you show your digital certificate. There is no mandatory vaccination. If you don’t want to be vaccinated in Denmark, no one will force you. But if you want to go back to social life, you have to show a Covid negative test within the last three days or proof that you have recovered from a Covid-19 infection within the last six months. People understand that this is the price to pay for freedom and they are very happy and appreciative of the government. The economy is blossoming.

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