Public trust in institutions in all parts of society is critical for health emergency preparedness. Leaders in government, science, public health, the private sector, international organizations, civil society, and the media are charged with identifying potential health risks and developing measures that will minimize their impact. But often, the threats are theoretical, something that may occur in the future, and difficult for many people to grasp as they address their very real day to day needs. It is only through empathy, accurate communications, community partnership, and effective actions that leaders generate the societal investments in resources and energy required to mitigate the effects of potential health hazards. Understanding the importance of public trust in institutions is especially critical during the COVID-19 outbreak, whose containment relies on the cooperative actions of business, NGOs, governments, communities and individuals.
Despite its importance, trust has been deteriorating in recent years in many of the institutions required for effective preparedness, driven by political polarization, income inequality, marginalization of some populations, institutional incompetence, and misinformation amplified by new and readily available forms of media. Lack of confidence in institutions and organizations leads to questioning the validity and impact of predicted threats, contributing to poor preparation and adherence to recommended actions. In its most extreme form, it engenders open rebellion against authorities and even endangers the lives of responders. Mistrust impedes crisis planning and response, resulting in unnecessary loss of life and livelihoods, and lost opportunities to build resilience for the next threat.
To better understand the role of trust in health emergency preparedness and develop strategies for its enhancement, the United Nations Children’s Fund (UNICEF) and the International Federation of Red Cross and Red Crescent Societies (IFRC) convened a consultation in April 2020 with experts from a wide range of fields. Participants included experts in data, the media, public health, program implementation, human behavior, and research from the private sector, academia, and non-governmental organizations (see appendix 2 for full list). Over the course of three video sessions, participants discussed the nature of the trust gap, its causes and impacts, and strategies for improving trust in institutions and organizations tasked with helping societies prepare and respond to health emergencies. Turning to the current crisis, participants also reflected on the role of trust and mistrust in the response to COVID-19. Except where noted through specific references, this paper is based on the consultation process and author analysis.