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A year after the start of the COVID-19 pandemic, scholars are only now discovering why some countries have done better than others in containing the virus. The main reason isn’t better medical equipment or more money. Rather, according to researchers at Columbia University, the Brenthurst Foundation, and other institutions, it is higher levels of trust within a society.

In a study that looked at 23 countries, the strength of a nation’s social compact made the most difference. “Countries with traditions of acting in concert against social problems and countries with histories of deference to public authorities fared better on compliance than countries lacking either or both,” researchers found.

A number of countries in Africa stood out, which helps explain why a continent with 17% of the world’s population has had only about 3% of the COVID-19 cases globally. The study looked at Egypt, Ethiopia, Kenya, Nigeria, and South Africa, which represent close to half of Africa’s population.

“In those societies where trust in governments is historically low, greater reliance had to be placed on bottom-up approaches led by frontline health workers to disseminate the correct information,” the study found. “Africa’s health-care systems are largely nurse-driven, an asset that made bottom-up approaches workable.”

In particular, direct communication with community health workers was set up quickly to deal with the crisis – sometimes even before the first virus cases were detected. In addition, the pandemic has now “served as a catalyst for improving both communication and trust between African citizens and their governments.”

These findings are significant in helping all countries improve on the core traits of trust between the people and their institutions: integrity, transparency, accountability, and compassion.

While levels of trust in government went up worldwide during the early months of the pandemic, the levels have fallen by an average 8% in the last six months, according to the latest Edelman Trust Barometer, which tracks trust in 28 countries. The drop in trust was very high in China (30%) and the United States (40%).

“The Covid-19 pandemic, with more than 1.9 million lives lost and joblessness equivalent to the Great Depression, has accelerated the erosion of trust around the world,” according to the Edelman survey.

In a health crisis, leaders in a society must provide straight talk with facts, act with empathy, and address people’s fears, according to Edelman. And if Africa is any model, the people who do that best are local health workers embedded in their community and who are often the neighbors of those struck during a pandemic. The traits of trust can do much of the healing work.

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