How Investigative Journalists Can Fight Back Against Health Misinformation

Imagine that just four industries were responsible for one-third of global deaths every year, but that this went underreported in the news.

This isn’t fiction, but our reality, argued Will Fitzgibbon, at a panel on investigative health reporting at the 2024 International Journalism Festival in Perugia, Italy. Fitzgibbon is a senior reporter and global partnership coordinator for The Examination, a new investigative health journalism outlet based in the US.

Fitzgibbon kicked off his panel segment with the “depressing statistic” that “one in three of you in this room will be killed by one out of four kinds of corporations, or corporate activities: tobacco, alcohol, processed foods, and the fossil fuel industry.” Yet, these corporate actors are also “vastly under-covered in the journalistic landscape,” he argued — partly because of a lack of newsroom expertise for investigating health and scientific evidence.

The panel, titled Mis- and Disinformation about Health is Killing Us. What Should Journalists Be Doing about It? was moderated by Pulitzer Center senior editor Susan Ferriss and explored how certain industries are exploiting a vacuum of trusted health information to misinform and disinform the public about their products and policies. Along with Fitzgibbon, Chrissie Giles, deputy editor of the London-based Bureau of Investigative Journalism (TBIJ), and Mia Malan, founder and editor-in-chief of the South Africa-based Bhekisisa Centre for Health Journalism, discussed their experiences working on impactful investigations and shared advice for journalists who want to cover health issues but don’t know where to start.

Price Gouging of Oxygen

Chrissie Giles, of UK-based independent newsroom TBIJ, explained that their work is “impact-centered… We want to tell stories that have the potential to change the world for the better.”

Giles said they look at global health stories in two ways:

1. What is stopping people from getting the stuff that helps them to be healthy?
   Things like vaccinations, education, abortion, medicine, etc.
2. What is exposing people to stuff that harms them?
   Tobacco, processed food, bad drugs, bad policy, etc.

When choosing between equally compelling pitches, they favor stories that can change problematic systems. As an example Giles referred to their early COVID-19 investigation, which probed unethical practices in Africa’s oxygen supply and how prices multinational gas supply companies charged for oxygen cylinders contributed to oxygen created shortages.

“So we went out and we got in touch with different clinics and hospitals in different countries. We found that the pricing was totally different in different clinics and hospitals, even in the same country,” she explained.

They found that a hospital could pay as much as four times more for the same amount of oxygen as another hospital in the same country. They also found that gas suppliers on occasion limited supplies to hospitals and tried to limit competition. Giles noted that once they reported on parts of Africa, they heard about cases in other countries, such as Mexico, where “companies were sending letters to hospitals that had built their own oxygen plants, saying, ‘That’s bad oxygen, that will kill people…’  Which was not true,” said Giles.

By publishing oxygen cylinder prices, Giles said TBIJ put the information directly into people’s hands so that the hospitals could ask what was happening and finally get a fair price, and help save many people’s lives, she explained.

“The biggest thing for us was that our reporting brought the two big multinational gas companies to the table to talk to charities, doctors, NGOs, and governments. They’ve never done that before,” she said. “And this sounds like a big boast, and I guess it kind of is, because if we hadn’t done that more people would have died,” she said.

Giles and her team at TBIJ believe journalism should go beyond revealing information — it should make new information available to anyone who can use it to change the world for the better. “If you’re finding something out and not putting it in the hands of policymakers, patient groups, officials, or MPs, then why are you doing it?” she said.

London-based Bureau of Investigative Journalism exposed how different countries were being charged varying rates for bottled oxygen during the height of the COVID-19 pandemic. Image: Screenshot, Bureau of Investigative Journalism

The #Anti-Diet: Eat All the Sugar You Want

“In the past decade, investigative journalism has undergone a complete revolution,” said Will Fitzgibbon of The Examination. As a former ICIJ senior editor who worked on the Panama Papers, FinCEN Files, and Pandora Papers, he’s seen reporters worldwide — from Washington, DC to Burkina Faso — become specialists in identifying financial crime.

“I wonder if the next revolution in investigative reporting… the steps that need to be taken are to train a new generation of journalists in treating health investigations and corporate drivers of what makes us sick and what kills us,” he said, in the same way journalists treat financial crime and are able to spot “dodgy contracts” or money laundering.

One of the most important ways to do that is to educate journalists to critically assess scientific health studies, he explained. For instance, instead of writing an article based on “scientific papers” that claim vaping is 95% safer than smoking, to immediately question who funded the study and look into connections between the authors and certain companies and lobby groups.

He mentioned one of The Examination’s latest collaborative investigations, with The Washington Post — into how food companies sponsor dietitians on social media to promote “anti-diet” messages. The anti-diet movement, originally aimed at combating weight stigma and unhealthy obsession with staying thin, is now being exploited by global food marketers, the investigation found.

“Companies that make ice cream and sugary cereals love that [movement] and promote this message,” Fitzgibbon said. The investigation examined more than 6,000 social media posts by 68 registered dietitians with at least 10,000 followers and found that about 40% of them — with a combined reach of over nine million followers — repeatedly used anti-diet language while promoting products from food, drink, and supplement companies, and often did not declare their sponsors.

The reporters found that a major US-based processed-food corporation leads a “multi-pronged campaign” using anti-diet research to fight “food shaming.” They tour the country, sponsor dietitians and influencers to promote their cereals online with hashtags like #DerailTheShame, and lobby against adding health information to food labels.

@no.food.rules The healthiest= what you find most satisfying. #nofoodrules #intuitiveeating #foodfreedom #nondiet #antidietculture #antidiet ♬ Monkeys Spinning Monkeys – Kevin MacLeod & Kevin The Monkey

The reporters also found that over the past three years, the number of academic studies that mention “anti-diet” has tripled.

After publication, the investigation sparked significant interest from consumers but also from regulators trying to crack down on social media influencers who don’t disclose who’s paying them.

A joint investigation between The Examination and The Washington Post looked into how major food corporations were pushing “anti-diet” messaging across various social media platforms and in academic studies. Image: The Examination

Reporting and Activism: Crossing a Line?

Mia Malan, of South Africa-based Bhekisisa, has reported on health issues across the globe for decades and has received more than 30 awards for her reporting. She observed that of the perennial problems of investigating pharmaceutical companies is that companies are secretive about the development costs of their drugs — and the price at which they sell them to governments.

Malan explained that tuberculosis — not HIV — is the disease that kills the most people in South Africa. “It’s a completely curable disease… but there are quite serious implications as to who gets to live and who gets to die.”

Drugs available for patients who suffer from multiple drug-resistant tuberculosis are limited. Except for one drug — produced by a major multinational pharmaceutical — most treatments available involve 18 to 24 months of painful injections, and “one of their most common side effects is that it makes you go deaf, so you have to choose whether you are cured from TB or whether you can hear,” said Malan.

She and her team found that the company making the drug sold it at double the price to the South African government compared to other African governments, who obtained it through a mechanism South Africa can’t access.

“If we pay double the price, our government can only help half the people that it is supposed to be able to help… So we did something we normally wouldn’t do,” she explained. They decided to work directly with an activist group that had already been fighting for fair drug prices: Doctors Without Borders.

Following their initial reporting, they decided to host an event with the NGO. Two weeks later, the company announced that they were cutting the price of the drug by half. “It would never have happened if the reporting and the activism didn’t come together… I don’t have a clear answer: Was that the right thing to do? If we didn’t, we would never have seen this outcome, but it might be crossing a line a journalism organization shouldn’t always cross,” Malan said.

Sharing the Burden 

Malan also mentioned the legal and financial difficulties they face when they cover big corporations. “The cost of doing these stories, especially legal costs, sometimes inhibits us, because we deal with multinationals that have large legal teams. We, with our one lawyer, we need to pay for many hours,” she said. When they exposed how tobacco companies in South Africa’s Limpopo province exploited poor Black farmers, “we could only cover it to a certain level because the legal implications of taking it further were just unaffordable to us,” said Malan.

Panelists agreed that these kinds of financial limitations are a reality many journalists face, and urged everyone to do more cross-border collaborations to tackle this issue. “International media partners can take on some of the burden of the frightening parts of a story,” said the Pulitzer Center’s Susan Ferriss.

Despite legal threats and corporate pressure, investigative journalists around the world persist, turning complex data into accessible truths. Their message is clear: whether it’s Big Tobacco or Big Pharma, we must question, investigate, and report — because the stories we tell today can save millions tomorrow.

Watch the full IJF panel on YouTube below. 

Serdar Vardar is an investigative journalist with a political science degree from the University of Buenos Aires. After living more than a decade in South America he moved to Germany to cover Turkey and global environmental stories for Deutsche Welle. Vardar was part of ICIJ’s global Pandora Papers and Shadow Diplomats investigations.