Infectious disease outbreaks drive political mistrust.

The COVID-19 pandemic has renewed attention to the far-reaching social implications of emerging infectious diseases, an issue with historical parallels in the transformative effects of the Black Plague and Spanish Flu. However, the potential for epidemics to reshape political trust and fuel instability has remained underexplored. This study leverages a novel dataset on zoonotic disease outbreaks-including Ebola, Marburg, H1N1, and the Black Plague-and geolocated Afrobarometer survey data from dozens of African states to investigate whether exposure to these deadly outbreaks alters public confidence in political institutions. Estimating the average-treatment-effect-in-the-treated with coarsened exact matching, we find that individuals with an infectious disease outbreak experience significant declines in trust toward the political establishment, especially the president, parliament, and ruling party (reductions of 0.2, 0.18, and 0.22 points, respectively, on a four-point scale). These findings, consistent across various spatial and temporal windows, provide robust empirical evidence that deadly infectious disease outbreaks can exacerbate political polarization and undermine political stability. The study emphasizes the critical need for policy strategies that integrate public health preparedness with efforts to preserve and rebuild institutional trust during outbreaks.