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As the world continued to reel from the COVID-19 pandemic going into 2021, the new year also brought a cautious glimmer of hope: Vaccines for the disease, more effective and developed faster than many thought possible, began to roll out. Getting the world healthy again, according to commentators, was now a problem of production and logistics.

But after working for decades with local journalists around the world covering communities facing threats like Ebola and SARS, I and my colleagues at Internews know of another, insidious challenge to ensuring public health amid a crisis: a deficit of trust.

Rethinking Social Change in the Face of Coronavirus
Rethinking Social Change in the Face of Coronavirus
    In this series, SSIR will present insight from social change leaders around the globe to help organizations face the systemic, operational, and strategic challenges related to COVID-19 that will test the limits of their capabilities.

    If people don't trust the efficacy and safety of vaccines, we may never inoculate enough of the world's population to get COVID-19 under control. Despite public health leaders pointing at the importance of such trust—the World Health Organization (WHO) in 2019 noted it as one of the top 10 global health risks—there a very few efforts focused on bolstering it.

    Any organization tasked with getting critical information to local communities—whether a government, public health nonprofit, advocacy group, or other entity taking on social issues—needs a strategy for making sure their message is received and embraced. Trust is integral to not just distributing vaccines, but fundraising, institutional reform, overcoming racial divides, and many other goals related to social change.

    Building trust won't work by relying on messages from distant figures, such as current and former national leaders around the world lining up to take vaccines on camera. Trying to clean up communication platforms—seen in Facebook's pledges to delete vaccine disinformation—may be encouraging, but is most likely a futile game of whack-a-mole.

    To build trust with communities, the experience of the journalists we at Internews work with shows us that organizations must take three actions at a deeply local level. They involve the careful selection of information partners, conversational communication techniques, and openness about data sources:

    1. Mobilize Trusted Local Messengers

    When people get good information from a trusted source, they are more likely to believe the information itself. But it's hard to claim such a respected spot in an information ecosystem overnight, and during a crisis there is little time to develop trust in new ideas or organizations.

    To solve these problems, organizations should look to leverage other groups and individuals who are already trusted. Local media, in local languages, are a good place to start. While people often say they don’t trust “the media,” you’ll find they do trust their media—the outlets that are local and known to them. Though local news outlets are struggling to survive in the United States, around 75 percent of Americans trust them, compared to just over half who trust national news. What’s more, the search for reliable pandemic information drove trust in news sources to an all-time high, according to Edelman’s Trust Barometer.

    In Zimbabwe, for example, research showed that people were more likely to follow public health guidance when they heard about it through media that they already trusted. Kubatana, a media organization that reaches audiences over WhatsApp, sent messages encouraging their followers to observe social distancing guidelines. Researchers from Harvard University found that those who received this information from Kubatana were 30 percent more likely to adhere to social distancing rules than a control group. They also scored 12 percent higher on questions about disease prevention.

    Connecting with local media also helps with dispelling local rumors that can start on digital platforms like Facebook in one of the more than 7,00 languages spoken around the world. It's not enough to rely on policing by the company and other popular online destinations. Sure, Facebook may remove pages peddling disinformation about vaccines when they attract large English-speaking audiences, but this work is a drop in the bucket. The company has around 15,000 content moderators to catch every rumor posted by the site’s 1.49 billion daily active users coming from every corner of the globe. The company's software isn't a solution, either—it can track just 40 languages.

    India is a good microcosm of the challenge. The country leads the world in Facebook users and is among the world’s deadliest places for COVID-19. Its people speak more than 22 official languages and thousands of local languages and dialects. How can Facebook or any company keep up with disinformation potentially delivered so many different ways?

    With the help of local journalists or other trusted information messengers, health providers and humanitarian actors can also set up a rumor-tracking service to keep tabs on information spread by word-of-mouth or social media. In the Philippines, for example, a bi-weekly newsletter keeps tabs on conversations about COVID-19 in four different languages and quantifies how widely they have been shared on social media and elsewhere. It helps clarify whether a rumor is worth responding to, and, if action is taken, which platform and language to use.

    2. Create Conversations

    National public health campaigns are important, but data points from distant and impersonal sources do little to generate trust. Gatherings of small groups of local communities and outside experts—virtually or in person—are a better way to distribute high-quality information. Even in distanced or virtual interactions, people trust those who speak directly with them.

    In Central Africa, for instance, a daily radio program focused on Ebola was backed up by more than 150 roundtable discussions in one hard-hit center of the Democratic Republic of the Congo. The small group dialogues provided opportunities to discuss the latest health-related news, making the educational programming more effective. Surveys found nearly 70 percent of respondents had heard of the program, and of those, more than 90 percent said the programming caused them to change their behavior to more effectively fight the spread of disease.

    3. Embrace Transparency

    Research shows that open access to data and independent review inspire more trust in health-related information. Nearly 60 percent of Americans say they trust scientific research findings more if the researchers make their data publicly available.

    And yet we see concerted efforts to keep data hidden at a time when public trust couldn’t be more important. Florida officials made headlines around the world for firing and then prosecuting a data scientist who created the state’s COVID-19 data portal and refused to take down or manipulate the information it presented. Governments around the world continue to remove or obscure data from public scrutiny.

    But others are taking important steps. For well-documented reasons, such as the legacy of the Tuskegee Study, Black Americans have lower levels of trust in the health system. With the disproportionate impact of COVID-19 on Black and Latinx communities, projects like the COVID Racial Data Tracker are shining a light on the proven inequities behind the disease, and most US states now release at least some COVID data disaggregated by race

    Accessing and working with data to effectively communicate with the public requires some training, but the effort is worth it. In Pakistan, reporters used data to get officials to act on road safety, a largely unacknowledged public health threat that was killing thousands of people per year. Our organization and many other journalism-focused groups—the Knight Science Journalism Program at MIT, Public Media Alliance, and J Lab—offer courses on analyzing and presenting data.

    A Way Forward

    The amount of disinformation and fear around COVID-19 vaccines has only begun to swell. Without community-by-community attention to people's concerns about the vaccine—particularly in countries where there is significant suspicion of the national government—we will likely fail to contain the disease.

    Like solutions to many social issues, responding to the pandemic will require action from a diverse array of individuals in communities around the world, and getting everyone on board requires trust between information providers and recipients. Building that trust relies on far more than widescale public health campaigns from distant entities or the endorsements of celebrities. It requires deeply listening to local rumors and concerns, taking them seriously, and responding.

    Local journalists can be a great ally in the fight—they already claim a position of trust in communities, they embrace communication techniques that emphasize listening and transparency, and they are increasingly skilled at data analysis and presentation. Their help may make the difference in addressing concerns about the vaccine at a deeply local level and building pathways for trust. Doing this difficult and important work must happen sooner rather than later. Not only will it aid in beating back COVID-19, but it will also lay a stronger foundation for tackling inevitable future crises.

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    Read more stories by Jeanne Bourgault.