Public health disinformation, conflict, and disease outbreaks: a global narrative integrative review to guide new directions for health diplomacy.

The COVID-19 pandemic laid bare the unpreparedness of global and public health systems to respond to large-scale health crises, while simultaneously revealing the entangled nature of disinformation and poor global and public health outcomes. This research challenges the common treatment of public health disinformation - deliberately false information - as an emergent and technical threat, and instead situates it as a more systemic and nuanced challenge for global health governance to address. This article presents an integrative narrative literature review on the interlinkages between public health disinformation, conflict, and disease outbreaks, demonstrating mutually influencing connections between them. In doing so, the analysis raises critical questions around how reactive responses, such as doubling down on information authority, can paradoxically fuel the uptake of both disinformation especially amidst global trends towards increasing conflict and decreasing cooperation. In this evolving sociopolitical landscape for global health, the discussion explores the potential to harness health diplomacy to strengthen critical public engagement and deliberation. This reimagined approach to health diplomacy offers pathways to mitigate the harmful effects of disinformation rather than seeking to eliminate false information. This article contributes to deepening an understanding of this rapidly expanding topic for global and public health in two pathways. First, by investigating the root causes and impacts of public health disinformation that intersect with conflict. Second, by exploring how health diplomacy can foster cooperative global health governance through transparency and inclusion. This research offers a new direction to strengthen preparedness for future global and public health crises amidst disinformation.