Crisis of Confidence: The Politics of Evidence and (Mis)Trust in Epidemic Preparedness

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Across the world challenges to of scientific expertise are on the rise. Anti-vaccination movements and resurgent measles outbreaks in the United States and Europe have been linked to seismic political changes such as the rise of nationalist populism. Recent and on-going Ebola outbreaks across Africa similarly highlight the political undertones of resistance to epidemic control measures: rumours and anxieties reflect fragile trust in national authorities and external intervention. Epidemics become battlegrounds for these disputes, and these contestations create new opportunities for renegotiating the terms of political inclusion. How to engage meaningfully with mistrust and conflicts over different ways of seeing the world, then, is not simply a question for global health practitioners: it is a major test for contemporary democracies. If a global 'crisis of expertise' reveals deeper political tensions, we need to understand how this plays out in practice in order to address it. We must pay attention to everyday encounters with and contestations of scientific expertise as sites where trust is negotiated, political authority is challenged and alternatives to the status quo are articulated. In this fellowship I will develop a new interdisciplinary research agenda that explores the politics of everyday negotiations over scientific evidence, taking the field of epidemic response and preparedness as a case study. Through training, empirical research and deployment in an outbreak response, I will develop an original analytical framework to explore: 1) What 'cultures of evidence' exist in the ecosystem of epidemic preparedness and response? 2) How are these assumptions and practices enacted in everyday encounters? 3) What political relations, identities and imaginations are made visible through these encounters?This research agenda responds directly to a growing interest in the global health community for creative, interdisciplinary approaches and opportunities for opening up epidemic preparedness to a variety of different voices. In recent years there has been increased focus on developing interventions that can account for social, cultural and political contexts and local perspectives for effective interventions. This has sparked fruitful collaborations but also made clear that there are significant challenges for integrating and translating different ways of understanding and experiencing the world. Finding solutions and novel approaches for integration and meaningful citizen engagement is urgent but also raises difficult questions about the relationship between trust, the legitimacy of different forms of evidence and political challenges to authority.To deliver a practice-oriented analytical framework, I will undertake skills development to support a novel interdisciplinary perspective and carry out ethnographic research across the different spaces that make up epidemic preparedness, from global research and policy forums to interactions in the 'field'. I will map out the different actors, perspectives and preparedness activities in-country, observe the tensions and intersections between different forms of knowledge and the political relations and identities that emerge through encounters in the field. I will have a country case study in Sierra Leone through a partnership with the Kambia District Health Management Team.I will then test and refine my framework through outbreak deployment and participation in the design of interventions through a partnership with Anthrologica, a leading organisation delivering social science research in outbreak settings. In the deployment I will focus on developing innovations for collaboration, community engagement and trust-building. In the longer term, I will develop comparative research on the politics of epidemic preparedness and response, developing insights from other contexts where political contestations have coalesced with mistrust in scientific interventions.