The growth of populist politics, fuelled by what has been termed ‘fake news’, has been having a clearly negative impact on decisions affecting public health in an increasing number of countries, both in Europe and beyond. For policy makers and public affairs professionals, this represents a challenge that we must rise to in this critical period for the future of European public health policy and debate.

What do populists and ‘anti-vaxxers’ have in common?

The denial of human responsibility for climate change is one obvious example of the danger of post-truth populists; another is opposition to vaccination.

If we take a look at Europe – the region with the lowest vaccine confidence levels in the world, according to a recent report by the European Commission on the State of Vaccine Confidence in the EU – we are seeing an increasing number of examples of how vaccine scepticism is growing with the rise of populism. We see this for instance in Italy, where the issue of mandatory vaccination has been exploited (or strumentalizzata, a profoundly Italian concept) by populist parties preaching for direct democracy and parental choice. As a result, the number of measles cases in the country increased sixfold between 2016 and 2017. France, Poland and Greece have also seen significant increases, as is the case for almost the entire continent.

A recent paper published in the European Journal of Public Health has analysed data in Western European countries and concluded that there is indeed sufficient evidence of the link between the rise of political populism and vaccine hesitancy and that they are both driven by a profound popular distrust in elites and experts. The study concludes that this distrust can only truly be resolved by addressing its underlying causes: the political and economic alienation of increasingly large parts of the Western European population.

The Guardian has matched the findings of the European Commission’s vaccine confidence report with the outcome of votes in support of populist parties in 14 European countries and has identified a strong correlation between support for populist parties and vaccine scepticism, resulting in measles cases in Europe currently being at a 20-year high.

So how can public affairs professionals play a role in effectively shaping health policy in an increasingly irrational world?

Overcoming the political and economic alienation of a growing proportion of the European electorate is a necessary but daunting long-term objective. The scale of this challenge can also discourage some from believing that they can play a concrete role in effectively influencing health policy in the current environment.

I believe that, as health policy and public affairs professionals, we have the responsibility to never miss an opportunity to counter-argue irrational scepticism and anti-science narratives – or ‘bio-populism’ as The Economist calls it – with facts. While vaccination is a highly emotionally charged topic, we need to focus on relentlessly supporting fact checking and the use of evidence in every argument we make, knowing that, in the long run, this is the most effective way to inform and shift the debate.

Populist health policies are fuelled by fear. We therefore need to look at ways to reassure people by highlighting the many positive examples and success stories at national, regional and European level, rather than trying to fight fear with fear. The Economist notes the example of my own region, Emilia-Romagna – one of the most progressive and forward-looking Italian regions – as proof that there is hope in the fight against bio-populism, with Emilia-Romagna taking the lead in making vaccines compulsory for schoolchildren in 2016, paving the way for a similar law across the country and offering inspiration across borders. Further success stories will also be generated by supporting policy initiatives on vaccination at national and European level.

I also firmly believe in the power of building broad, multi-stakeholder partnerships and coalitions, speaking strongly with a united voice in support of vaccination and contributing to creating an established vaccine culture. The Commission’s report shows that confidence varies for different vaccines, highlighting the need for targeted responses to rebuild trust. Stakeholder coalitions – more likely to be perceived as unbiased if properly framed -can play an important role in raising awareness and call for vaccination policy for specific vaccine preventable diseases at national, regional or European level.

Two months ahead of the European elections

The upcoming European elections on 23-26 May 2019 will provide further scope to chart the rise of populism. There has never been a European Parliament election as decisive as this one, as the Parliament could soon be heavily influenced by self-proclaimed Eurosceptic populists who, in countries like Italy, Austria and France, continue to play the fear card and argue that there are alternative causes of disease than lack of vaccination, pointing the finger towards migrants and ‘bacterial immigration’.

With two months to go ahead of the elections, let’s remember and keep on reminding others that aEurope sceptical of any expertise, including scientific expertise, will find it harder to cope with any crisis, including a possible cross-border health crisis, as shown by the difficulty in managing the recent measles outbreaks. Should the outcome of the elections be as expected, national populist arguments will increasingly become part of the European narrative and public affairs professionals will have an even greater responsibility to intensify their efforts to influence a less liberal Europe through the rigorous application of an evidence-based discourse, underpinned by robust processes of democratic engagement such as facilitating the creation of unbiased multi-stakeholder coalitions at European level.