How to shore up trust during the "cold-period" between pandemics - closing the public trust gap in pandemic...

Public trust is crucial for effective pandemic response, influencing compliance and cooperation. Past pandemics have revealed trust gaps that have weakened response efforts. However, there is limited evidence-based guidance on how to integrate public trust into preparedness frameworks.

The objective of this study is to provide guidance on embedding public trust-building principles in pandemic preparedness frameworks and strategies.

A comparative analysis of the WHO's 'five C' framework and a public trust in health systems framework was conducted to assess the integration of trust-building principles into the WHO's framework. Each trust-building principle was classified as explicitly present, implicitly present, or absent. Absent trust principles highlight areas for strengthening public trust in pandemic preparedness. A quality checklist, adapted from research on European health data-sharing legislation, ensured systematic evaluation.

The analysis of the five C framework highlights varying integration of trust principles in pandemic preparedness. 'Community Protection' has strong trust coverage, while 'Collaborative Surveillance', 'Safe and Scalable Care', 'Access to Countermeasures', and 'Emergency Coordination' present gaps in public trust promotion, particularly in information quality, familiarity, privacy, anonymity, and time. Time is frequently absent, suggesting a need for greater emphasis.

Governments and other health policy stakeholders should prioritize incorporating familiarity, information quality, privacy, autonomy, time, and anonymity into appropriate aspects of pandemic preparedness frameworks. Incorporating these trust principles during inter-pandemic periods will assist in the promotion and strengthening of public trust in pandemic preparedness measures, ensuring effective public support and deference during a public health crisis response.