The scale of the EVD epidemic in the West African countries has been unprecedented. Lack of trust in medicine has been identified as one of the major factors in the scientific literature, in media reports, and global health discourses, which accelerated the spread of EVD and posed a central challenge to the Ebola response. Our project investigated the social, medical, and historical conditions of the formation of trust in medicine in African contexts. Taking the EVD outbreak in Sierra Leone as our empirical starting point, we conducted a comprehensive case study of trust in medicine in Sierra Leone, a site of prolonged EVD epidemic and radical insecurity. This was complemented by studies in Uganda and Ghana, evaluating previous experiences of short-term EVD outbreaks (Uganda) and recent preparedness interventions in a neighboring country (Ghana). In these three country case studies we analyzed how and to what extent trust is built in health service delivery. We asked how trust relations have been shaped by the EVD outbreak, how trust was (re)built in health service delivery after the EVD epidemic, and to what extent trust formed the social basis for epidemic preparedness. Comparing individual and collective experiences of the institutionalization of care in Sierra Leone with Uganda and Ghana enabled us to produce a systematic and in-depth analysis of trust in contexts of radical insecurity and poverty. Such an analysis, grounded in the lived everyday realities in African countries, is urgently needed in order to devise culturally appropriate and locally accepted epidemic preparedness measures. To achieve these goals, we combined quantitative and qualitative research methods. Our research activities were embedded in a comprehensive framework of scientific capacity building in Africa.

Collaborating Academic Institutions and Principal Investigators:

Prof. Dr. Uli Beisel (University Bayreuth)
Dr. Sung-Joon Park (University Halle)
Dr. Sylvanus Spencer (Fourah Bay College, University of Sierra Leone)
Esther Yei Mokuwa (Njala University, Sierra Leone)
Dr. Grace Akello-Ayebare (Gulu University, Uganda)
Dr. John Kuumuori Ganle (University of Ghana)


The project was funded by the German Research Foundation, German African Collaboration in Infectiology, 2016-2019.