How to create trust in science: the responsibility of academic institutions

A painful tension has arisen in modern times: as medical advances continue apace, increasing distrust permeates society. Researchers and academic institutions have an important role to play in remedying this

We are living in a paradoxical time for global health. On the one hand, we experience great developments in medical treatment and prevention strategies, such as ground-breaking treatments for formerly incurable diseases, gene therapies, and the rapid development of effective and safe vaccines. On the other hand, these success stories in medicine and global health are accompanied by a substantial loss of trust in health sciences, health systems and medical practice.

This mismatch became painfully evident during the Covid-19 pandemic. Lockdowns, mask mandates and the launch of novel mRNA vaccines saved millions of lives, yet also sparked waves of misinformation and mistrust. We had to learn that health research can no longer assume that its breakthroughs will be benevolently appraised and used by the broader public.
Reasons for this can be clearly identified

A preparedness paradox generates a bias against evidence-based preventive measures. While the negative corollaries of, say, contact restrictions are felt directly by all affected, the positive effects can only be estimated in theoretical models and, therefore, remain hypothetical.

Social media, in addition, plays a central role in driving waves of dangerously false claims, which can spread to a global audience in an instant. This inherent vulnerability in modern communication allowed certain actors to use the critical situation of the pandemic to erode global trust in science, politics and multilateral organisations.

Academic institutions bear significant responsibility for fostering trust in science-based approaches. In the past, trust in science and academic institutions was assumed, based on the concept that academic statements reflect universal laws of nature and are thus independent of cultural and political boundaries. However, medicine is not a simple enactment of natural laws. Especially in the health sector, scientific efforts must relate to questions of societal relevance, and research-based approaches must be adapted to local needs and conditions. Thus, the implementation of scientific approaches requires a constant interplay with all parts of society.

To fulfil this task, academic reward and promotion mechanisms must be coupled with sustained progress and tangible external benefits. Academic institutions must also intensify their efforts to improve global equity in health research and development.

Two maxims can guide them here: truth will generate trust, and science demands humanitarian responsibility.

Truth will generate trust

There is no absolute and final truth. Even in science and knowledge, truth must evolve through constant improvement and adjustment. The scientific community must acknowledge the ‘truth’ of this reality. The more clear academia is in addressing the fact that its statements reflect a temporary and always imperfect state of knowledge, the more trust it will generate, and the more science-based decisions will be accepted in the political and societal domain.

Science demands humanitarian responsibility

Researchers should always reflect on their responsibility to foster societal progress. The moral integrity of researchers and their academic institutions, as well as their efforts towards open and equitable approaches in science, is the basis for people’s trust in their work.
It is especially difficult to fulfil and combine these two maxims in health sciences. Cause-and-effect relations underlying health and disease are extremely complex and therefore often hinder simple answers and solutions. The lack of simple solutions, in turn, gives disruptive actors the chance to endorse misinformation, even in areas where scientific evidence is available.

To generate trust in such a complex context, academic institutions need to interact more intensively and efficiently with the public and with political decision makers. In this process, academic institutions must respect the fundamental uncertainty of scientific knowledge but make it consistently clear that all decisions and measures should be based on the best available evidence-based information. This requires coordinated action by many researchers and academic institutions and thus a previously unfamiliar form of cooperation for many in the scientific domain, given that both individual scientists and academic institutions are used to worldwide competition as the basis for their success.

One step in this direction is to generate worldwide academic networks that establish internal trust, coordinate their communications strategies and establish themselves as a point of reference in times of crisis. Accordingly, the World Health Summit emphasises the importance of intersectoral exchange based on science and objective evidence. It fosters an eye-level interaction among all stakeholders from all regions of the world to reflect the complex challenges in global health. It provides academic institutions, politics, the private sector and civil society representatives with a platform to cooperate for better global health coverage and to regain trust in health science and health actions globally.