In Conflict-affected Countries, Distrust in Government Undermines COVID-19 Vaccine Rollout
By Hilde Deman, Kaila Harris and Samah Abdalrahman
As COVID-19 has ripped across the world, even the most developed nations have struggled to mount effective vaccination campaigns.
Challenges are even starker for countries amidst violent conflict. The World Bank estimates that by 2030, two-thirds of the world’s poorest will be living in settings defined by fragility, conflict, and violence, while violent conflict will drive 80% of humanitarian needs — sobering realities that complicate vaccine efforts.
At Search for Common Ground (Search), the world’s largest dedicated peacebuilding organization, we have been collecting data since the start of the pandemic in six places where we work — Kenya, Nigeria, Palestine, Tanzania, Uganda, and Yemen. We know that, when policymakers overlook conflict dynamics, large-scale health interventions can collapse, or even yield dire unintended consequences.
Our core finding across all six countries is that distrust in government authorities is undermining pandemic response efforts. As peacebuilders, we are sounding this alarm in hopes that health responders, the international community, and local actors can integrate trust-building into vaccination efforts — or else risk many more lives lost, and international funds wasted.
The Determinants of (Dis)Trust
In countries in conflict, many people have genuine reasons to distrust their government. Corruption might be a persistent challenge, or government services might be inadequate. In some cases, the government has actively persecuted certain groups — ethnic, religious, or otherwise — for decades, producing fear and resentment.
Yet this distrust of the government or public health system can persuade people not to listen to health officials and not to get the vaccine. Without trust, vaccination campaigns collapse.
Our research finds that, across many countries, trust in authorities largely depends on the same factors: access to information, governmental service provision, and the effectiveness of pandemic response and enforcement measures. As peacebuilders, we worry that vaccine rollout will fail if we neglect these factors.
Access to Information
During COVID-19, misinformation and rumors have proliferated. Our research finds that, when people distrust their government, they are less likely to trust any public health guidance, coming from the government or otherwise. People are reluctant to credit official messengers, which allows rumors to flourish.
The issue is not only whether people have accurate information but also whether they trust the information source itself. Indeed, if distrust of the government runs high, then even the most clever information campaign about vaccine efficacy will fall short.
By understanding what information sources people trust, we can increase confidence in the pandemic response in general and vaccine roll-out in particular. The best approach is often to equip trusted figures, from religious leaders to social influencers, with useful information and dissemination tools, rather than communicating through public officials with high levels of distrust.
Additionally, we may be overlooking critical information channels. In Yemen, many respondents identify Whatsapp and family and friends as their top information resources on COVID-19, while only 8 percent turn to radio. We can think creatively about how to reach these channels — for example, through communications training for religious leaders or flyers in markets.
Governmental Service Provision
Overall, only 39 percent of our survey respondents say that they are satisfied with government services for COVID-19, and widespread dissatisfaction fuels distrust.
In many cases, people perceive that the government is favoring certain groups when providing pandemic support. In Nigeria, for instance, some allege that the government is prioritizing Muslim communities, and only 26 percent of respondents trust that the government is doing its best to consider the needs of everyone equally when making decisions about COVID-19 services. In a context challenged by ethnoreligious conflict, these perceptions are incredibly worrisome.
We can address such grievances by diversifying response efforts so that trusted, non-governmental actors share in COVID-19 response. While governments may have lower levels of trust, 72 percent of respondents report that non-governmental responders have their best interest in mind. Such actors include international non-governmental organizations such as Search for Common Ground, but also health responders, community-based organizations, religious leaders, community leaders, and others.
Moreover, satisfaction levels tend to be higher for services provided by non-governmental actors. Our research shows that positive experiences with non-governmental responders tend to increase trust in the wider pandemic response, relieving tensions between citizens and the government.
Pandemic Response and Enforcement
In conflict-affected countries, public resources and the existing health system are often limited, which leads to security forces playing a central role in pandemic response and enforcement efforts.
Yet, from experience with the Ebola epidemic, we know that the presence of security personnel at health centers can cause fear, anxiety, and tension, dissuading people from getting vaccinated. And throughout COVID-19, clashes between security forces and ordinary people have led many countries to impose lockdowns.
Replacing security personnel with trusted actors at vaccine centers can not only legitimize the process but also reduce tension and violence. At a minimum, training security personnel on conflict sensitivity — such as Search for Common Ground did in Liberia, Sierra Leone, and Guinea during the Ebola outbreak — can avert violent clashes.
Looking Ahead
COVID-19 may be a health challenge, but an effective response requires mastery of not just medicine but also social dynamics. In conflict-affected countries, low trust in the government is one of the greatest threats to defeating the virus.
Across all countries, we can manage this threat by partnering with trusted figures and integrating actors outside the government in the pandemic response. However, any solution must reflect localized conflict dynamics. In some places, women trust different actors than men do; in other places, religious leaders might have trust in some areas but not others. Internally displaced people may have different perceptions of international non-governmental organizations.
As the world’s largest peacebuilding organization, we see red flags but also see clear opportunities. We cannot afford the missteps of past crises, especially the Ebola outbreak. Let’s hope that we can recognize the essential role of trust before too long, or else risk leaving behind millions of people in the global fight against COVID-19.
-
Hilde Deman leads Search for Common Ground’s global response to COVID-19.
Kaila Harris supports research, evaluation, and learning for Search for Common Ground’s global strategy and learning agenda, particularly as it relates to the intersection between conflict and COVID-19.
Samah Abdalrahman is a data analysis expert at Search for Common Ground.
