Armed group responses to COVID-19 have underscored the need for long-term investment in global health campaigns
In response to the COVID-19 outbreak, armed and criminal groups around the world have sought to take advantage of the pandemic to expand their hold and swell their ranks. In April 2020, for example, Abubakar Shekau – the then factional leader of Boko Haram fighting in the North East of Nigeria – responded to the pandemic by criticizing the government's COVID-19 response and trying to attract new recruits by suggesting his followers were immune to the virus while flouting government lockdowns to promote religious worship. The response of armed and criminal groups to the pandemic, like that of Abubakar Shekau, has led to endless hand wringing about their potential impact on efforts to prevent the spread of COVID-19. But disinformation from armed and criminal groups appears to be meeting a powerful roadblock: a population that is well-versed in public health campaigns dating back to polio.
A new report out this week by the United Nations University Centre for Policy Research (UNU-CPR) suggests that at least in and around Maiduguri, North-East Nigeria, evidence from a 3,500 person survey shows that those who trusted Boko Haram's messages were almost twice as likely to believe conspiracy theories about the virus, particularly that COVID-19 was part of a foreign attack. Likewise, trusting the group's messages about COVID-19 is associated with a 10 percentage point increase in believing you are immune to the virus. The government's public health messaging campaign around COVID-19, while widely received, did not attempt to cover – or counter – such claims.
Nevertheless, what was striking from this data, especially when compared with other contexts where misinformation is rampant, is that even hearing – and believing in – Boko Haram messages did not impact their willingness to receive the COVID-19 vaccine. Why is this?
The Nigerian government's COVID-19 public health campaign and the historical investment in vaccine awareness – dating back to the WHO's polio campaign in the country – may have helped to counter Boko Haram's messaging. First, the survey found 85 per cent of respondents heard and consistently recalled messages from government or community leaders about public health and vaccination, demonstrating a high degree of message penetration and recall. Secondly, although it had been marred by its own challenges and delays, the WHO's polio vaccine campaign helped create familiarity and comfort with vaccines in Nigeria, with long-term payoffs up until today.
One reason we believe this public health investment counts is the age differential in willingness to take the vaccine. Children (12-17-years old) are six percentage points less willing than adults to take the vaccine when it becomes available in Nigeria. Having missed much of the 2000s' polio campaign, younger people may be less familiar and comfortable with vaccines than the older generations. There are potentially a number of other reasons for this discrepancy. One possible source is related to young people's reliance on peer networks and different trusted sources, which could make them or less aware of – and possibly less receptive to – today's official public health campaigns about the pandemic.
Irrespective of Boko Haram's messages, child and female respondents were more likely to believe in nefarious origins of the virus than male adult respondents, suggesting that rumor and misinformation influence subgroups differently. Female survey respondents are more likely to believe COVID-19 is an attack by foreign countries than male respondents (47 per cent compared to 30 per cent). Women in the area have access to a different social network than men and children, making them more likely to rely on peer networks for information.
These findings, though limited to this particular context, lend themselves to some overarching recommendations on global public health initiatives. Public health campaigns need to customize their messages, thoughtfully choose messengers, and ensure the right medium of delivery to account for information gaps and concerns from segments of the population. To ensure that public health efforts to combat COVID-19 are effective, more needs to be done to engage young people to promote public health responses for the availability of the vaccine. Moreover, there is a need for follow up to ensure that the reported willingness to take the vaccine detailed in this report actually translates into medical choices and there is not a drop off in vaccine follow-through. This is especially important in places like North East Nigeria where armed groups seek to take advantage of the pandemic and rumors and conspiracies related to conflict and government actions are rife, potentially eroding the investment made in public health campaigns. Going forward, the benefits of health campaigns can often be felt far after the originally prescribed mandate, and more sustained investment in these sorts of initiatives will reap long-term dividends.
Dr Siobhan O'Neil is Project Director of the Managing Exits from Armed Conflict Initiative at United Nations University Centre for Policy Research and Aliyu Zakayo is a Visiting Researcher at Harvard Kennedy School.
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