Poor Transparency and Corruption in Disease Reporting Could Precipitate the Next Pandemic

One of the growing public health concerns this year is the Bird flu, or avian influenza A(H5N1) 2.3.4.4b clade virus, which has been circulating in the Americas since 2022. Between 2022 and 2025, 19 countries reported 4,713 animal outbreaks and 74 human infections. The virus has been mutating rapidly, and its implications are hard to predict. Surveillance to detect any potential mutations in the virus is critical, especially given its 50 percent fatality rate in human cases.  

Effective surveillance requires disease reporting. Making these data public ensures that government officials can understand the nature of the public health threat, assess the risk, gather the necessary resources, and prepare an effective plan to contain it. The global response to Covid-19 demonstrated that countries with higher prevention, detection, and response capabilities achieve lower pandemic mortality rates.

Yet, this widely acknowledged truth is rarely put into practice. One reason is the lack of transparency and corruption that have loomed over countries’ level and quality of disease reporting 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. While there is no documented case of a human-to-human transmission, there has been a human-to-cat spread, which reveals that humans can transmit the virus. Moreover, the wider transmission from birds to mammals is causing widespread exposure for humans, representing a deadly threat to humanity. The ongoing mutations have also enhanced this virus’ resistance to viral drugs. 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 in France, England, and the United States were barred from reporting on the Spanish flu, contributing to its spread. Delayed reporting from Guinea, and then Liberia and Sierra Leone, enabled the spread of Ebola across West Africa in 2014. China’s active concealment of SARS emergence in 2002-3 contributed to its expansion. Similarly, China’s initial denials of a new virus and its decision to underreport cases at the start of the Covid-19 pandemic enabled its early spread. Five years later, the WHO is still imploring China to share data on the origin of this virus. Today, we are witnessing similar trends with H5N1. There are allegations that veterinarians who first reported H5N1 cases in dairy cows at the start of the year are now being silenced, with some even losing their jobs.   

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. Despite the establishment of WHO’s International Health Regulations (IHR) in 2005—a legally binding tool that requires 196 member states to report public health events—many states have not duly complied.

The political and economic costs of outbreaks may explain this behavior. States often conceal outbreaks to avoid trade and travel restrictions, potential reputational damage regarding their ability to manage outbreaks, and public distrust in their agricultural products. In fact, countries may use vague terms to obscure the threat of an epidemic. For instance, in India, an outbreak of cholera was reported as gastroenteritis; similarly, in Thailand, an H5N1 outbreak was labeled as avian cholera. Furthermore, countries with media biased in favor of the ruling regimes are less likely to report outbreaks.  

States that actively conceal and delay disease reporting data may also silence whistleblowers through threats or intimidation, directly restricting free civic space. In the 2008 hepatitis crisis in Nevada, doctors and nurses failed to report cases due to fears of whistleblower retaliation. During the 2003 SARS outbreak, lead whistleblower Dr. Jiang was put under house arrest for his outspokenness. At the start of Covid-19, the Chinese government criminalized Dr. Li Wenliang for alerting colleagues about new upper respiratory infections. 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. Governments in Brazil, India, the Philippines, Tanzania, Zambia, and Venezuela allegedly manipulated data on Covid-19 infections and death rates. In Brazil, the Health Ministry went as far as temporarily removing Covid-19 data from its website in June 2021. 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 can be catastrophic. First, global leaders cannot effectively contain an outbreak without reliable data to identify its source and transmission patterns. Second, if an outbreak escalates into a pandemic, the resulting social, political, and economic costs far exceed the initial concerns governments may have regarding transparency at the onset. As demonstrated by Covid-19, pandemics disrupt trade, create food supply shortages, increase health care costs, strain health care systems, and result in a 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 key areas to work on:

1. Enhance whistleblowing protections for scientists and officials who report suppressed data: The most effective whistleblowing laws guarantee whistleblowers’ protection from any potential retaliation. They do so through providing protection against criminal or civil liability, reducing the burden of proof, and/or imposing remedies or interim reliefs when retaliation has occurred. Strong whistleblowing systems should also establish independent reporting channels that facilitate  disclosures. 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 from 2020 to 2023 claimed 7.1 million lives globally and exposed our weaknesses in global pandemic preparedness and response, particularly in effective disease reporting. Currently, the spread of H5N1 in the Americas, along with its various mutations, poses a significant threat to global public health once more. This time, we must commit to getting things right— beginning with addressing corruption and improving transparency in disease reporting.

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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.