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Commentary

Mehrnaz Kheirandish,¹ Tanja Kuchenmuller,² Ludovic Reveiz,³ Marge Reinap,⁴ Joseph Okeibunor,⁵ John Reeder ⁶ and Arash Rashidian ¹

¹Department of Science, Information and Dissemination, World Health Organization Regional Office for the Eastern Mediterranean, Cairo, Egypt. ²Department of Research for Health, World Health Organization, Geneve, Switzerland. ³Department of Evidence and Intelligence for Action in Health and Incident Management System for COVID-19, WHO Regional Office for the Americas/Pan American Health Organization, Washington, District of Columbia, USA. ⁴Division of Country Health Policies and Systems, World Health Organization Regional Office for Europe, Copenhagen, Denmark. ⁵Emergency Preparedness and Response Programme, World Health Organization Regional Office for Africa, Brazzaville, Congo. ⁶Department of Research for Health, World Health Organization, Geneva, Switzerland. (Correspondence to Arash Rashidian: This e-mail address is being protected from spambots. You need JavaScript enabled to view it ).

Keywords: evidence, policy-making, health systems, research, data, EVIPNet

Citation: Kheirandish M, Kuchenmuller T, Reveiz L, Reinap M, Okeibunor J, Reeder J, Rashidian A. Institutionalizing evidence-informed policy-making in the post-pandemic era. East Mediterr Health J. 2023;29(7):498–499. https://doi.org/10.26719/emhj.23.101

Copyright: © Authors; Licensee: World Health Organization. EMHJ is an open access journal. All papers published in EMHJ are available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

¹ Evidence-informed Policy Network (EVIPNet) that includes the regional networks of: EVIPNet Africa (WHO African Region), EVIPNet Americas (WHO American Region), EVIPNet Europe (WHO European Region) and the Regional Network of Institutions for Evidence and Data to Policy (NEDtP) in the WHO Eastern Mediterranean Region.

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The COVID-19 pandemic caused unprecedented misery and death across the globe (1), highlighting the importance of reliable health information systems and local research data and evidence to guide policies (2-4). Currently, most countries are harnessing public trust for the rebuilding, and sometimes rethinking, of the health systems (5). One remains optimistic that in all these efforts the key lessons from the pandemic will not be forgotten and investing in data systems and processes for evidence-informed policy-making will be prioritized. Such hopes are not always realized after crises, and in this commentary, we highlight a few key actions that require careful attention to catalyze change.

At the end of 2021, in the midst of the COVID-19 emergency, a Call for Action (6) was developed by EVIPNet  and its partners to chart the way forward for evidence-informed decision-making, for future health emergencies and for more routine societal and environmental challenges, in view of building a more resilient, equitable and sustainable world. This call for action was based on taking stock of lessons learnt during the COVID-19 pandemic, as well as from regional and global WHO resolutions and action plans in support of evidence-informed policies for health (7-9).

Three key aspects differentiate the call for action and more recent WHO initiatives from previous efforts. First, there was a clear and increasing emphasis on institutionalizing evidence-informed policy-making at country level, complemented by the need to move away from project- or issue-focused approaches and toward programmatic, integrated and system-focused approaches. From the WHO point of view, institutionalization of evidence-informed policy-making is defined as “process and outcome of (re-)creating, maintaining and reinforcing norms, regulations, and standard practices that, based on collective meaning and values, actions, as well as endowment of resources, allow evidence to become – over time – a legitimate and taken-for-granted part of policy-making” (10,11). Policymakers should ensure the use of research and data evidence as an integral part of decision-making processes.

Second, there is a growing recognition of the importance of the broader evidence system and its diverse actors in shaping decision-making at country level. Efforts should focus on collaborative, synergistic and integrative approaches to resource use, avoiding duplication of efforts and reducing potential confusion arising from conflicting decisions in policy and health system (11,12).

Third, enhancing the use of data and research evidence in health policies requires addressing the rapid growth of misinformation (the infodemic), and eliminating poor practices in research, which together have contributed to the erosion of trust in health systems and in governments in general (13). Although WHO has developed frameworks that can help countries in addressing infodemics (14), building trust and confidence in science requires improved research governance at all levels, including reinforcing good principles and standards that strengthen the transparency, accountability and societal value of the routine use of evidence in policy.

Initiatives such as EVIPNet are actively committed to creating conditions that increase and improve the engagement of citizens in decision-making. This is achieved through bottom-up approaches such as levering real-life experience and building a shared understanding of evidence-informed policy-making processes. On the other hand, the urgent need for evidence, highlighted during the pandemic, in some instances resulted in overlooking basic principles of good research practice. Academic institutions and academic journals should take more responsibility in this regard, so that the race for evidence to answer questions in emergency situations will be better prioritized and governed to avoid waste of resources.

To build on the current momentum and accelerate global action, WHO is convening a virtual global evidence-to-policy summit with the theme “Evidence as a catalyst for policy and societal change: building trust and bridging the gap” in August 2023. The key objective of this event is to bring together researchers and policymakers from WHO, international institutions, Member States, universities, research institutes, and other partners, to take stock of the progress on implementing the Call for Action, identify common challenges, share innovations and lessons learned, and provide recommendations for the next steps.

We call for the enhancement of interagency collaborative initiatives on evidence-informed policy-making. The United Nations, as well as the multilateral, regional and national partners should work together to streamline and strengthen their support to countries in this regard. There is also a need to increase the number of academic institutions working more closely with WHO (e.g. as collaborating centers) in support of evidence-informed policy-making. WHO is keen to enhance and expand existing capacity and partnerships for research evidence in healthcare (15).

References

1. World Health Organization. 14.9 million excess deaths associated with the COVID-19 pandemic in 2020 and 2021. Geneva: World Health Organization. https://www.who.int/news/item/05-05-2022-14.9-million-excess-deaths-were-associated-with-the-covid-19-pandemic-in-2020-and-2021.
2. Schmidt AE, Abboud LA, Bogaert P. Making the case for strong health information systems during a pandemic and beyond. Arch Public Health 2021;79(13). https://doi.org/10.1186/s13690-021-00531-5.
3. World Health Organization. Evidence, policy, impact. WHO guide for evidence-informed decision-making. Geneva: World Health Organization, 2021. https://www.who.int/publications-detail-redirect/9789240039872.
4. Kuchenmüller T, Reeder JC, Reveiz L, Tomson G, El-Jardali F, Lavis JN, et al. COVID-19: investing in country capacity to bridge science, policy and action. BMJ Global Health 2021;6(2):e005012. http://dx.doi.org/10.1136/bmjgh-2021-005012.
5. Sagan A, Thomas S, McKee M, Karanikolos M, Azzopardi-Muscat N, de la Mata I, et al. COVID-19 and health systems resilience: lessons going forwards. Eurohealth 2020;26(2):20-4. https://apps.who.int/iris/handle/10665/336290.
6. World Health Organization. Together on the road to evidence-informed decision-making for health in the post-pandemic era: a call for action. Geneva: World Health Organization, 2021. https://www.who.int/publications/i/item/WHO-SCI-RFH-2021.08.
7. World Health Organization. Action plan to strengthen the use of evidence, information and research for policy-making in the WHO European Region. Copenhagen: World Health Organization Regional Office for Europe, 2016. https://apps.who.int/iris/handle/10665/338122
8. World Health Organization. Developing national institutional capacity for evidence-informed policy-making for health. East Mediterr Health J. 2021;27(3):314–315. https://doi.org/10.26719/2021.27.3.314.
9. World Health Organization. Framework for strengthening the use of evidence, information and research for policy-making in the African Region. Brazzaville: WHO Regional Office for Africa, July 2021. https://apps.who.int/iris/handle/10665/345395.
10. World Health Organization. Supporting the routine use of evidence during the policy-making process: a WHO Checklist. Geneva: World Health Organization, 2023. https://www.who.int/publications/i/item/9789240056145.
11. World Health Organization. Evidence, policy, impact. WHO guide for evidence-informed decision-making. Geneva: World Health Organization, 2021. https://www.who.int/publications/i/item/9789240039872.
12. World Health Organization. A guide for evidence-informed decision-making, including in health emergencies. Washington DC: World Health Organization Pan American Health Organization, 2022. https://iris.paho.org/bitstream/handle/10665.2/55828/PAHOEIHKTCOVID1921038_eng.pdf
13. Van Noorden R. How many clinical trials can’t be trusted? Nature 2023;619: 455-458. https://www.nature.com/articles/d41586-023-02299-w.pdf.
14. World Health Organization. WHO competency framework: building a response workforce to manage infodemics. Geneva: World Health Organization, 2021. https://www.who.int/publications/i/item/9789240035287.
15. World Health Organization. Together on the road to evidence-informed decision-making for health in the post-pandemic era: a call for action. Geneva: World Health Organization, 2022. https://www.who.int/news/item/30-12-2021-together-on-the-road-to-evidence-informed-decision-making-for-health-in-the-post-pandemic-era-new-evipnet-call-for-action.