There has been a sharp contrast between evidence and policies during the pandemic, but these actions will encourage evidence-informed policymaking as we move forward.
Government responses to the pandemic show a disconnect between prevailing scientific evidence and policy. Months into the pandemic, many governments continued to use the same approaches as they did at the beginning. Many did not adopt new evidence or applied lessons learned.
There has been an unequal use of evidence to inform public policies across the world. However, during COVID-19, there was more evidence to inform public policy than ever before.
Since the beginning of the outbreak of COVID-19, the scientific community has demonstrated a remarkable productive performance. In an effort to better understand the COVID-19 virus, a previously unexpected number of researchers worldwide shifted their efforts to the analysis of the new pathogen.
The genetic decoding for COVID-19 was completed quickly as well as its publication. Since then, researchers worldwide have uploaded an enormous amount of SARS-CoV-2 genome sequences online. New scientific results on COVID-19 have been published at unprecedented speed.
For example, Elsevier’s journals received 270,000 submissions between February-May 2020, a 58% surge compared to the same period in 2019. This deluge has only become larger, with 707,000 COVID-19 publications as of November 2021, tracked by the Dimensions database. And in contrast to previous practice, many newly written COVID-19 related articles are freely accessible to all, as part of the open science movement. Given this large body of research, we could imagine that health and public policies would be evidence-informed and robust.
Furthermore, researchers have enjoyed unprecedented public attention. As the pandemic affected every aspect of life, the public interest in better understanding the pandemic has been very high. While not always agreeing on every policy recommendation, the researchers had common understanding about the biology of the virus, including its dynamics.
As the pandemic progressed and new variants emerged, the knowledge of scientists evolved quickly and there was increasing consensus on how to keep the virus at bay. Research also helped understand that while COVID-19 is a threat to everyone, not everyone has the same risk of sickness or death. Age-adjusted case fatality and targeted interventions for high-risk groups should have driven different COVID-19 responses for different situations.
While research and evidence have been at the spotlight of international and national attention during the COVID-19 pandemic and decision-makers have publicly claimed to ‘follow’ the science, pandemic measures taken by governments often seemed to have been introduced too late, amounted to too little, and did not evolve.
It seems that evidence-informed policy-making is still not a concept that is well anchored in the political system of many countries. This is a pressing problem considering that the looming climate crisis requires recognition of evidence to inform policy. Misinformation, denial, and ignorance will harm next generations in particular. In order to ensure a better science to policy nexus we recommend the following actions:
First, while the pandemic has shown that in a global health crisis vast amounts of new evidence is created, the scientific evidence is accompanied by a deluge of misinformation. Policy-makers can easily be overwhelmed by the sheer amount of new information. In order to cope with such a challenging situation, multisectoral evidence advisory bodies need to be established, depending on the context, at the highest level of government, line ministries and/or at the local level.
Pandemic measures taken by governments often seemed to have been introduced too late, amounted to too little and did not evolve.
Such bodies not only have to play a role during pandemics. They should become permanent institutions that help policy-makers navigate through new evidence and inform their policy-making. To support decision-makers effectively, key stakeholders from the national ecosystem need to be linked-up and collaborate to leverage the different forms of evidence needed in decision-making (i.e., data analytics, modeling, evaluation, behavioral/ implementation research, evidence supports, technology assessment/cost-effectiveness analysis, guidelines).
Current revisions of the International Health Regulations might offer an opportunity to further promote those approaches. As also the Global Evidence Commission report says, now is the time to systematize the aspects of using evidence that are going well and address the many shortfalls, which means creating the capacities, opportunities, and motivation to use evidence to address societal challenges, and putting in place the structures and processes to sustain them.
Second, as we have witnessed over the past two years, international collaboration to jointly act against the pandemic has been lacking. Policy lessons learned in one country have often been ignored in other countries.
Furthermore, while it was clear that the most efficient response to the pandemic would be an internationally coordinated effort, almost all governments turned inwards and prioritized local solutions. To better prepare for the next pandemic, the international collaboration needs to be institutionalized.
The negotiations on a global pandemic treaty offer a unique opportunity to establish a system that actively promotes the rapid exchange of information, research, and experiences of key global and national players to avoid duplication of efforts and harmonized approaches
Such global collaboration mechanisms which act on evidence would also create global accountability that policy decisions are in the best interest of current and future populations.
Third, the pandemic has eroded trust in science among large groups of the population. The vaccine hesitancy, the missing risk stratification, and the lack of adjustment to healthy lifetstyles are a clear manifestation of the missing trust in science.
Evidence-informed policy-making can only enjoy legitimacy if citizens are convinced of the value of science. In ordinary circumstances, political decisions typically reflect many considerations, science being one of them.
In pandemic times, however, scientific evidence becomes crucial to successfully manage the public health crisis and its unintended consequences. Promoting the legitimacy of science to inform decision-making should be a policy objective during and beyond public health crises. It should reflect a broad public consensus and trust in science.
Actions need to be taken around these three issues if we want to positively impact and reduce the sharp contrast between evidence and policies that we are currently witnessing in public health.
The views expressed in this blog by Matthias Helble, Tanja Kuchenmüller are personal and do not necessarily represent the views, decisions or policies of the World Health Organization.