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

在世界范围内，对科学专业知识的挑战正在上升。美国和欧洲的反疫苗接种运动和麻疹疫情死灰复燃与民族主义民粹主义崛起等地震性政治变化有关。最近和目前在非洲各地爆发的埃博拉疫情同样突出了抵制流行病控制措施的政治含义：谣言和焦虑反映了对国家当局和外部干预的脆弱信任。流行病成为这些争端的战场，这些争端为重新谈判政治包容的条件创造了新的机会。因此，如何有意义地应对不同世界观的不信任和冲突，不仅是全球卫生从业者的问题，也是对当代民主国家的重大考验。如果全球“专业知识危机”揭示了更深层次的政治紧张局势，我们需要了解这在实践中是如何发挥作用的，以便解决它。我们必须关注科学专业知识的日常遭遇和挑战，因为在这些地方，信任是谈判的，政治权威是挑战的，现状的替代方案是明确的。在这个奖学金，我将开发一个新的跨学科的研究议程，探讨对科学证据的日常谈判的政治，以流行病的应对和准备领域作为案例研究。通过培训、实证研究和疫情应对部署，我将开发一个原创的分析框架来探索：1）在流行病准备和应对的生态系统中存在什么样的“证据文化”？2)这些假设和实践是如何在日常生活中实施的？3)通过这些遭遇，什么样的政治关系、身份和想象得以显现？这一研究议程直接回应了全球卫生界对创造性的跨学科方法和机会的日益增长的兴趣，以便向各种不同的声音开放流行病准备。近年来，人们越来越重视制定干预措施，这些措施可以考虑到社会、文化和政治背景以及有效干预的地方观点。这引发了富有成效的合作，但也清楚地表明，整合和翻译理解和体验世界的不同方式存在重大挑战。迫切需要找到解决方案和新的方法来实现一体化和有意义的公民参与，但这也提出了关于信任、不同形式证据的合法性和对权威的政治挑战之间关系的难题。我将进行技能发展，以支持新的跨学科视角，并在构成流行病的不同空间开展民族志研究。从全球研究和政策论坛到“实地”的互动，我将绘制出不同的行为者，观点和准备活动在国内，观察不同形式的知识和政治关系和身份之间的紧张关系和交叉点，通过在外地的遭遇出现。我将通过与坎比亚区卫生管理小组的合作，在塞拉利昂进行一项国家案例研究。然后，我将通过与Anthrologica的合作，通过疫情部署和参与干预措施的设计来测试和完善我的框架，Anthrologica是一家在疫情环境中提供社会科学研究的领先组织。在部署过程中，我将专注于为协作、社区参与和建立信任开发创新。从长远来看，我将对流行病准备和应对的政治进行比较研究，从政治上的反对与对科学干预的不信任相结合的其他背景中发展见解。

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.