Patrick W. Kelley, MD, DrPHDirector, Board on African Science Academy

DevelopmentUS National Academy of Sciences

How Science Academies Provide Evidence-based Advice

A Scandal in Search of a Solution

• 265,000 mothers die due to complications of pregnancy and childbirth

• 1,243,000 babies die before they reach one month of age

• 3,157,000 children, who survived their first month of life, die before their

fifth birthday

A Scandal in Search of a Solution

Reduce the MMR by 75%

Reduce the U5MR by 67%

An Array of Solutions

Some Questions

• What is the best regimen for prevention of maternal to child transmission of HIV (PMTCT)?

• What is the most cost-effective way of preventing malaria during pregnancy?

• What immunizations should be in the routine childhood package?

• What is the best way to deliver counseling services to new parents?

Why Ask for Scientific Advice?

“The central argument of evidence-based practice is hard to refute. In essence it says that policy-makers and practitioners take it upon themselves to intervene in the lives of others, intending to do good, but sometimes doing more harm than good.

To minimize the risk of harm, it is argued that interventions should be informed by reliable research evidence, and that evidence-based or evidence-informed decision-making should always be undertaken whenever possible. Not to do so would be to act irresponsibly.”

James VolminkASSAf CouncilEvidence-based Practice – Symposium 1, 2006

(photo credit – University of Stellenbosch)

Some Sources of “Scientific” Advice to Policymakers

• The Media

Some Sources of “Scientific” Advice to Policymakers

• The Media

Some Sources of “Scientific” Advice to Policymakers

• The Media • The Internet

Some Sources of Advice to “Scientific” Policymakers

• The Media• The Internet• Personal Study• Personal Contacts

Some Sources of Advice to “Scientific” Policymakers

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists

Photo: www.cleanupwashington.org

Some Sources of Scientific Advice to Policymakers

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists• Government Scientists• Government Panels• Universities

Some Sources of “Scientific” Advice to Policymakers

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists• Government Scientists• Government Panels• Universities• Foreign Consultants

Photo: quinn-thefinanceguru.blogspot.com

Some Sources of Scientific Advice to Policymakers

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists• Government Scientists• Government Panels• Universities• Foreign Consultants • Foreign Governments

Some Sources of Scientific Advice to Policymakers

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists• Government Scientists• Government Panels• Universities• Foreign Consultants • Foreign Governments• International Bodies such as WHO

Photo: http://static.howstuffworks.com/gif/who-assembly.jpg

Many Sources of Scientific Advice to Policymakers Create a

Noisy Policy Space

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists• Government Scientists• Government Panels• Universities• Foreign Consultants • Foreign Governments• International Bodies such as WHO

Photo: www.arktimes.com/blogs/shale/2008/12

Some Sources of Scientific Advice to Policymakers

• The Media• The Internet• Personal study• Personal Contacts• Lobbyists• Government Scientists• Government Panels• Universities• Foreign Consultants • Foreign Governments• International Bodies such as WHO• National Science Academies

The Unique Role of National Science Academies In Africa

• Trusted, home grown, independent, authoritative source• Apolitical, not motivated by profit• Convening power to mobilize the best scientific minds

from across the nation and the world• Can help foster innovation through

multidisciplinary, multisectoral discourse• Can clarify emerging scientific issues• Features scientifically rigorous peer

reviewed analyses of evidence and the consensus of diverse experts

• An independent, credible “second opinion” in the face of politically charged issues

• A “Supreme Court” for science

Photo: L. Augustine

Convening (Forum or Workshop-type) Activities

• Brings together in a neutral setting representatives of academia, government, industry, and others for ongoing discussions to illuminate critical issues and potential solutions

consistent with the society’s priorities, values, and resources.

Convening (Forum or Workshop-type) Activities

• Brings together in a neutral setting representatives of academia, government, industry, and others for ongoing discussions to illuminate critical issues and potential solutions

consistent with the society’s priorities, values, and resources.

Convening (Forum or Workshop-type) Activities

• Brings together in a neutral setting representatives of academia, government, industry, and others for ongoing discussions to illuminate critical issues and potential solutions

consistent with the society’s priorities, values, and resources.

Convening (Forum or Workshop-type) Activities

• Is not intended to issue conclusions and recommendations in the name of the academy because the procedure is not necessarily independent of sponsors and government and is not necessarily

free of biases and conflicts of interest.

Consensus Activities

• Policy studies or other formal advisory activities carried out in a unique way to explore in depth an issue of importance to the country and its government. Studies offer evidence-based guidance to national decision makers concerned with science and technology.

• Is intended to issue conclusions and recommendations in the name of the academy because the procedure is

independent of sponsors and government and is managed to minimize biases and conflicts of interest.

Characteristics of the Best Scientific

Advice to Policymakers

• Authoritative• Transparent and open to public input• Objective, evidence-based, referenced• Thorough, fair, and balanced• Conveys uncertainty fairly and completely• Differentiates fact from judgment• Contextually grounded• Candid and apolitical• Independent of particular interests• Represents a multi-disciplinary consensus• Rigorous peer review

Photo: Lauren Augustine