Influencing and Advocating to Policymakers Using Scientific Evidence
On September 14, 2022, IANPHI hosted a webinar on “Influencing and Advocating to Policymakers Using Scientific Evidence” featuring leaders from member National Public Health Institutes (NPHIs): Professor Lothar Wieler (Germany), Dr. Qiulan Chen (China), and Dr. Sabin Nsanzimana (Rwanda). Moderated by IANPHI President Professor Duncan Selbie, the focus of this session was to address the challenges of NPHIs to communicate and influence policymakers and advance public health legislation. IANPHI is making available the recording and highlights of the session.
Promoting Legislation in Relation to Dog-Mediated Rabies Elimination
by Dr. Qiulan Chen, Director, Branch of Animal and Vector-Borne Diseases, Chinese Center for Disease Control and Prevention
Dr. Qiulan Chen, the director of Animal and Vector-Borne Diseases in the Divisions of Infectious Disease Control at the Chinese Center for Disease Control and Prevention, presented the work of the center to promote promotion new legislation on the elimination of dog-mediated rabies in China. Rabies is preventable but still causes a heavy burden in over 150 countries and regions, taking approximately 59,000 lives annually. About 99% of human cases in China are caused by rabid dogs, 80% are in rural areas and 40% are under the age of 15.
A global strategic plan, “Zero by 30”, aims to end human deaths from dog-mediated rabies by 2030 by focusing on the immunization of dogs. Legislation on dog management and vaccination is very important to ensure sustainable and high vaccination coverage. Due to the consistent revision of policies, since 2007, the rabies epidemic in China has been steadily declining. In 2021, there were 157 human cases nationwide, which decreased over 95% compared to 3,300 cases in 2007. However, China still faces common gaps to achieve Zero by 30, including incomplete data, infrequent data sharing between human and animal health sectors, low dog vaccination coverage, a stray dog issue, and a lack of national strategic plan towards dog-mediated rabies elimination.
The push for the new legislation needed to close these gaps started with the dissemination of the findings of the Stepwise Approach towards Rabies Elimination (SARE) assessment and their publication in a scientific journal. China CDC also relied on expert consensus, a professional committee, news agencies, publications in the specialized press targeting elected representatives, and Q&As with the media. The promotional campaign ended with China CDC’s director at the time, George F. Gao, putting forward a proposal to the Chinese People's Political Consultative Conference, whose members officially advise and make proposals on political and social issues to government bodies. As a result, China’s law on animal epidemic prevention was revised on January 22, 2021. It mandates dog owners’ responsibility against rabies and make the government accountable for the management of stray dogs and cats. Dr. Chen credited the use of a One Health, evidence-based approach and the support of experts, public figures and the media with the success of the legislation.
Science, Leadership, Community: During COVID-19 Preparedness and Response in Rwanda
by Dr. Sabin Nsanzimana, Immediate Past Director General, Rwanda Biomedical Centre
Dr. Sabin Nsanzimana, the immediate past director general of the Rwanda Biomedical Centre, shared his reflections about the past two and a half years of COVID-19 pandemic. He stressed the importance of trust as a key point of the success of Rwanda’ pandemic response. Building trust doesn’t start in the middle of a pandemic. It’s a continuous process.
The foundation of trust sits on three components: science, leadership, and community. The community must trust both the science and the leadership to mobilize effectively and take appropriate action. Without this connection between the three entities, trust cannot be built or strengthened. To begin or continue building the trust of the community, public health practitioners, institutions, and organizations must meet their community where they are. Local and government agencies must actively build trust with the populations and communities they serve. Community and population support is a critical component in supporting prevention and public health measures.
Can Scientific Evidence Speak for Itself? The Challenges of Communicating to Policymakers
by Prof. Lothar Wieler, President, Robert Koch Institute, Germany
The Robert Koch Institute (RKI) became Germany’s National Public Health Institute in 2008. RKI’s mandate includes the collection and analysis of health-related data, the planning and implementation of health measures, communication with relevant target groups on public health aspects, and basic and applied research.
RKI has identified four principles that apply when discussing scientific policy with politicians or government officials:
- Distance to ensure the independence of science from politics and prevent the mixing of interests and scientific judgement
- Plurality which requires the appropriate involvement of disciplines and advisors
- Transparency of advisory and decision-making processes to facilitate the building of trust
- Publicity to access relevant information and as a prerequisite for trust.
RKI’s preferred model to address and give policy advice was published by a German research group. This model, illustrated below, understands scientific knowledge transfer as the connection between research (R), integration (I), and utilization (U)—the RIU model. Within this RIU-model, research and science-based problem solutions are utilized within practice by political actors.
Policymakers must often consider what hangs in the balance (economy, working parents, jobs, children, collapse of healthcare, etc.) and having excellent scientific evidence can support decision making. Oftentimes, science may not be understood by policymakers and evidence must be explained and communicated clearly. Mitigating the spread of misinformation and suboptimal information is extremely important because it can influence policymakers. Suboptimal information undermines the public health response while disinformation can polarize public debate and promote hate speech, threatening human rights and social cohesion. Coherent communication is an essential public health operation; however, the lack of trust can be a barrier to that. Communicating scientific evidence can be challenging if not coherent when coming from different sources. By promoting dialogue with the society through public engagement and transparently, communicating scientific evidence clearly and coherently will increase the trust of the public.
Discussion
Following the panelists’ presentations, a participant asked how NPHIs could give advice when there is no science or evidence available.Prof. Wieler replied that in those cases, institutes may refer to historical examples on the effectiveness of the measures that are being proposed. Most importantly, the information that is being communicated must be communicated properly to ensure full understanding and awareness.
Writer: Christabelle Toso. Editor: Marie Deveaux