“… It is hard to emphasize the role of trust in public health enough. In 2020, during the first full year of the Covid-19 pandemic, many poorer countries had better health outcomes than wealthier countries like the United States because of trust.
A key factor was not how rich a country was, but how much of a nation’s health budget went toward prevention. Countries, even very poor ones, where local populations had trusted relationships with public health outreach experts, fared better in that first lethal year than countries with no such relationships.
If, say, there’s been a person around your village for years distributing mosquito nets to prevent malaria and giving away condoms to prevent HIV, you might be more willing to heed their advice to wear a mask or hunker down to prevent Covid-19 than if that same message came from a distant health care provider.
Such long-term trust, and its broad benefits beyond HIV, has been built through programs like PEPFAR — and the doctor in South Africa told The Intercept they feared the fallout from the Trump administration’s actions. …”
