EFFECTIVE PUBLIC HEALTH RESPONSE BOOSTS TRUST AND STATE LEGITIMACY: evidence from the 2014 Ebola epidemic

01 Jul 2019

Reacting effectively to emergency situations can increase government’s legitimacy and trust among citizens. This is according to findings by Matthias Flückiger, Markus Ludwig and Ali Sina Önder which show that large scale, effective public health responses during epidemics can strongly affect the perception of states in a short amount of time.

The study published in the July 2019 issue of The Economic Journal, focuses on the Ebola epidemic in the West African countries of Guinea, Liberia and Sierra Leone in 2014-15 to show how exposure to the disease affects the perception of the state.

The authors found that trust in state legitimacy increased with exposure to the epidemic. People residing in high-transmission-intensity areas valued government-led eradication efforts more compared to people that lived in less affected regions. Legitimacy especially rose in regions where the majority of the population belongs to ethnicities that are politically alienated. This suggests that the ability to eradicate a highly infectious disease may have provided a relatively stronger signal of government quality in areas excluded from the political decision–making process.

The authors offer several potential explanations for these results. One is that people residing in high-transmission areas valued government-led eradication efforts more compared to people who lived in less affected regions. Another is that the epidemic required central governments to involve and coordinate with local leaders and communities in their eradication efforts, likely increasing the levels of trust and legitimacy in doing so.

They also suggest that the changes in perceptions may have a political impact. In the post-epidemic presidential elections, the share of the vote for the incumbent party disproportionately increased in regions that experienced a more intense transmission of the disease.

The authors conclude that by reacting effectively to emergencies, governments can increase legitimacy and trust among citizens in a short period of time. In the context of weak states and developing countries, this leaves an important role for international organisations. By providing technical and financial support to governments, they cannot only help eradicate diseases, but also promote state legitimacy.

Ebola and State Legitimacy by Matthias Flückiger, Markus Ludwig and Ali Sina Önder is published in the July 2019 issue of The Economic Journal

Matthias Flückiger

Lecturer in Economics | Queen’s University Belfast

Markus Ludwig

Postdoctoral Researcher | the Chair for Empirical Economic History, University of Bayreuth

Ali Sina Önder

Senior Lecturer | University of Portsmouth