Building trust before the next crisis: lessons from the avian influenza front lines.

The United States H5N1 outbreak which began in 2022 had widespread human health, animal health, and economic impacts. This outbreak led to the death or depopulation of over 175 million domestic birds and marked the first time that a highly pathogenic avian influenza (HPAI) virus was detected in cattle. Response to this emergency required coordination among various stakeholders in public health and agriculture sectors at federal, state, and local levels. Despite national and local efforts, a lack of trust between stakeholders diminished the efficiency of the response. The National Academies of Sciences, Engineering, and Medicine hosted a webinar featuring four experts in different agriculture sectors to gain their perspectives from the field on building trust during the H5N1 response. Their discussion highlighted the importance of proactive trust-building, communication and transparency, and incentives as catalysts to building trust in advance of a public health crisis. These insights are key for improving responses to future HPAI outbreaks and other health emergencies.