In 1996, Kano, Nigeria, a majority Muslim city, was experiencing one of the worst epidemics of meningococcal meningitis sub-Saharan Africa had ever seen.
Pharmaceutical company Pfizer decided to test its new antibiotic, trovafloxacin (Trovan), as a treatment for pediatric meningitis in Kano. 100 children in Kano were given Trovan, and 100 children were given ceftriaxone, the standard treatment for meningitis.
Eleven children died, five of those given Pfizer’s trovafloxacin and six of those given a reduce-dosed ceftriaxone, while others were left disabled. The deaths were not disclosed nor linked to Pfizer’s trials until 4 years later when a Washington Post reporter released an exposé in December, 2000.
Belinda Archibong, assistant professor of economics at Barnard College and a visiting professor at the King Center in winter quarter 2022, presented a new working paper on the long-term effects of this tragedy on vaccine hesitancy to the King Center’s Predoctoral Research Fellows in March 2022. As part of the King Center’s mission to train the next generation of leaders in global development, visitors to the King Center engage with predocs and discuss their ongoing academic research. Archibong’s research shows that the Washington Post disclosure, in 2000, that Muslim children had died during the 1996 Pfizer trials led to a sudden drop in routine childhood vaccinations (for illnesses like polio, tuberculosis, and measles) among children born to Muslim mothers. The effect was stronger for children of educated mothers and mothers residing in minority Muslim neighborhoods, who were more exposed to the news and subsequent anti-vaccine protests led by trusted religious leaders in their regions. The resulting reduction in childhood vaccinations set back polio eradication efforts globally by over a decade, incurring significant costs for local households as well. These results illustrate the potential for perceived medical malpractice to erode trust in the health care system, with real negative consequences for global public health.
This isn’t the first time Archibong’s research involved studying the consequences of meningitis epidemics. Her research with Francis Annan, assistant professor of economics and insurance at Georgia State University, showed how a 1986 meningitis epidemic in Niger dampened the educational levels of girls relative to boys. When facing increased direct and indirect costs of the epidemic that put significant stress on household incomes, families in Niger tended to prioritize investments in sons over daughters, because the perceived returns to education are greater for boys. The epidemic widened the gender gap in education and increased early marriage of girls, with parents sometimes marrying young girls off at earlier ages to receive traditional bride price payments earlier as a way to cope with the financial burden of the epidemic.
While a visiting professor at the King Center, Archibong met with colleagues across campus and made progress on research examining how citizen-led protests can lead governments to increase economic redistribution efforts, using evidence from Nigeria (her country of origin). She also completed historical work studying how prison labor can distort incentives for incarceration and have lasting negative effects on trust in legal institutions like police, using evidence from British colonial Nigeria.
“With the wealth of opportunities at the King Center,” Archibong explains, ”I’ve been able to attend seminars and continue to connect with Stanford researchers and plan for future collaborations. Research is collaborative, and never conducted in a bubble.”
“It’s been wonderful to have Belinda at the King Center,” said Faculty Director Pascaline Dupas. “Belinda brings an unmatched knowledge of historical factors that have shaped current challenges for global development in Nigeria and sub-Saharan Africa more generally.”