Understanding "Technologies of Trust" Key in Epidemic Response

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Understanding “Technologies of Trust” Key in Epidemic Response

Posted by TRRU on May 22, 2019 in News
Recent TRRU publication finds renewed relevance as Ebola outbreak in the DRC continues in a volatile context of mistrust and violence.
Recent TRRU publication finds renewed relevance as Ebola outbreak in the DRC continues in a volatile context of mistrust and violence.

This past February, TRRU researchers Molly Ryan and Dr. Janice E. Graham (@JEGAnthro) collaborated with Dr. Tamara Giles-Vernick (@GilesVernick) to share their findings in BMJ Global Health on the role of trustworthiness in epidemic response: Technologies of Trust in Epidemic Response: Openness, Reflexivity, and Accountability during the 2014-2016 Ebola outbreak in West Africa [Full-text here]. By examining how trustworthiness was earned during the 2014-16 West Africa Ebola outbreak, the authors explore how responders engaged three successful “technologies of trust”:

  1. Openness – a willingness and genuine effort to incorporate multiple perspectives
  2. Reflexivity – engaging in ongoing dialogue and being flexibly responsive to local contexts 
  3. Accountability – taking responsibility for local contexts and investing in solutions that extend beyond epidemic response 

These technologies form a “framework for genuine engagement…that embraces the principles and practices of openness, reflexivity and accountability to provide a useful tool for both understanding and improving future epidemic response.”1

Their publication finds renewed relevance as the 10th Ebola outbreak in the Democratic Republic of the Congo (DRC) proves difficult to contain. Now the second deadliest Ebola outbreak on record, with the World Health Organization (WHO) reporting 1826 cases and 1218 deaths, as of May 20, 2019.Despite DRC’s extensive previous experience with Ebola, and a comprehensive re-vamped vaccination strategy,the response remains stop-and-go due to the increasingly violent and volatile conditions in the affected provinces of North Kivu and Ituri.4-5

Central to this problem is a lack of trust. Many people in the hard-hit northeastern province of North Kivu are not seeking care because they don’t think that those responding to the disaster will help and protect them. Responders and clinics are receiving death threats, assaults and attacks, and rumours are rife. Some community members see Ebola as a government scheme to marginalize people or as a business that profits aid workers, researchers and government officials, or think that the government’s health system is unable to help.” - Nature Editorial, March 20196

TRRU hopes that their analysis can provide some useful insights moving forward, and act as a point of comparison between the technologies of trust responders are using on the ground in the DRC and those enacted in West Africa. 

For more information on the social science research currently being conducted on the DRC Ebola outbreak, turn to the efforts of Sonar-Global (@SonarGlobalEU). Coordinated by Dr. Giles-Vernick, this project aims to “build a sustainable international social sciences network to engage in the active participation of the social sciences in the prevention and response to infectious threats and Antimicrobial Resistance.” The project website includes an interactive map where readers can view summaries of ongoing Ebola social science research. 


Further reading and resources



  1. Ryan, M. J., Giles-Vernick, T., & Graham, J. E. (2019). Technologies of trust in epidemic response: openness, reflexivity and accountability during the 2014-2016 Ebola outbreak in West Africa. BMJ Global Health, 4, e001272. [Full text here]
  2. WHO. (n.d.). Ebola situation reports: Democratic Republic of the Congo. Accessed May 22, 2019: https://www.who.int/ebola/situation-reports/drc-2018/en/
  3. WHO. (2019, May 7). WHO Adapts Ebola Vaccination Strategy in the Democratic Republic of the Congo to Account for Insecurity and Community Feedback. World Health Organization. Retrieved from: https://www.who.int/news-room/detail/07-05-2019-who-adapts-ebola-vaccination-strategy-in-the-democratic-republic-of-the-congo-to-account-for-insecurity-and-community-feedback
  4. Branswell, H. (2019, May 7). ‘On a knife edge’: Ebola outbreak threatens to escalate as violence rises. STAT. Retrieved from: https://www.statnews.com/2019/05/07/ebola-outbreak-escalate-violence/
  5. Maxmen, A. (2019, May 2). ‘The world has never seen anything like this’: WHO chief on battling Ebola in a war zone. Nature. Retrieved from: https://www.nature.com/articles/d41586-019-01432-y
  6. Nature. (2019, March 22). Building trust is essential to combat the Ebola outbreak. Nature, 567, 433. doi:10.1038/d41586-019-00892-6