Mistrust in Medicine: The Legacy of Colonial Medical Campaigns in Central Africa (preliminary draft)*

We examine the legacy of French colonial medical campaigns for trust in modern medicine. Between 1921 and 1958, the French military organized medical campaigns focused on treating and preventing sleeping sickness. The campaigns forced individuals to participate and used medications with harsh, sometimes fatal, side effects. We digitized over thirty years of French colonial records that document the locations of campaign visits and the intensity of treatment at a granular geographic level for Cameroon and former French Equatorial Africa (present day Central African Republic, Chad, Republic of Congo, and Gabon). We use Demographic and Health Survey data to examine how exposure to the historical campaigns affects trust in medicine – measured by willingness to take a blood test for anemia or HIV. Using an instrumental variables strategy, we show a significant and positive effect of historical exposure to campaigns on refusal to consent to a blood test. We test the validity of the instrument with a falsification test comparing former French Cameroon with former British Cameroon, where there were no equivalent campaigns. Finally, we examine the importance of these historical campaigns for present day health policy. We use a difference-in-differences strategy and a universal measles campaign in Cameroon to show that those areas more exposed to the colonial medical campaigns are less likely to have their children vaccinated during the measles campaign.