lesson #3: trust in public-health interventions is developed over time, through mutual respect
communities are “wary” of outside experts descending on them, dictating what they must do with their health and their bodies, martin says. relationships need to be developed over time, “not just during a crisis,” so people can see the consistent, everyday benefits of public-health measures. such relationships not only build trust, they also build infrastructure: supply chains, laboratories that sequence viral genomes, communications networks of doctors and nurses who share real-world experience about best practices.
all of these systems were created through community engagement, finding local partners to develop solutions that meet the needs of the population. “local communities need to be in charge of decision-making around their health,” martin says. pepfar recognized this, too, making a “strong policy switch” three years ago to take a supportive role, rather than bringing pre-made policies to people across the globe.
lesson #4: harm-reduction strategies limit infection while allowing for vital social interactions
harm reduction is a public-health approach that developed in the 1980s, when the aids epidemic first hit. since then, it’s become predominant in some public-health circles. at its core, harm reduction “abolishes the all-or-nothing approach to risk and disease,” write eric kutscher and richard greene in an
article published in jama. more colloquially, greene says it’s a way to “learn how to feel joy in a world that is not no-risk.”