A new set of guidelines developed through the International Severe Acute Respiratory and emerging Infectious Consortium (ISARIC), the Pandemic Sciences Institute, and Global Outbreak and Response Network (GOARN) provides outbreak response teams with evidence-based strategies to recognise and reduce stigma. The ISARIC Anti-Stigma Guidelines are now available open access to all organisations working to improve equity and trust in global outbreak management globally.
Stigma is a recurring feature of infectious disease outbreaks. The consequences can be devastating for those affected. Stigma can also hinder outbreak control efforts While awareness of stigma’s harms has grown, outbreak responders have had limited practical guidance on how to prevent and address these issues.
To address this, 30 international experts, collaborated to produce the ISARIC Anti-Stigma Guidelines – a practical toolkit designed for use in outbreak response planning and delivery. Development of the guidelines was underpinned by a rigorous process including systematic literature review, stakeholder interviews across all World Health Organization (WHO) regions, community surveys in mpox, Ebola, and Nipah virus outbreak settings, and an expert consensus process. The guidelines feature two components:
- Guiding principles for stigma-sensitive outbreak management, with accompanying good practice indicators. These are provided as a checklist that can help organisations review their policies, communication materials, service design, and governance to ensure they do not unintentionally contribute to stigma.
- Recommended interventions to reduce outbreak-related stigma, which are expert-endorsed actions for different outbreak phases (preparedness, response, and recovery). These range from embedding stigma-aware messaging in risk communication to facilitating peer support led by people with lived experience. Each intervention includes brief implementation notes, practical examples, and a summary of the supporting evidence.
The guidelines build on earlier work by the coordinating research team, including development of the RAPID Stigma Scales. Together, these resources support both the identification of stigma and practical steps to address it.
Dr Amy Paterson, lead researcher from the PSI said, “Our hope is that these guidelines will help promote stigma-aware decision-making. The collective input of outbreak responders, stigma researchers, and people with lived experience means the guidelines reflect diverse expertise. What I take away from the guidelines is that everyone involved in outbreak response has a part to play in ensuring people affected are treated with respect and kindness, and that small, simple adjustments to the way we do things can make a meaningful difference.”
Associate Professor María Bertoglia, Centre for Research on Pandemic Resilience, Universidad Andres Bello, Chile said, "Stigma not only harms those affected but undermines public trust and the effectiveness of outbreak response. These guidelines fill a critical gap: for the first time, we have specific, evidence-based operational guidance to identify and mitigate stigma across all phases of an outbreak. As part of the contributors, I particularly value their importance for training epidemiology teams who will work in outbreak control. Understanding stigma is essential for effective risk communication, community engagement, and crucially, for proper planning and implementation of control measures.”
The ISARIC Anti-Stigma Guidelines represent a step toward building more inclusive, equitable, and effective outbreak responses. By helping responders recognise and reduce stigma, the toolkit promotes trust, participation, and better health outcomes for affected communities.
The guidelines are free to access and download, offering a concrete starting point for stigma reduction efforts.