Lancet Global Health: Overcoming the research to policy gap

7 April, 2019

Dear HIFA colleagues,

Interesting commentary in The Lancet Global Health, introducing a special issue that includes a large number of the papers presented at the 2019 Consortium of Universities for Global Health conference (see here for CUGH papers: https://www.thelancet.com/journals/langlo/issue/vol7nonull/PIIS2214-109X(19)X0004-2 )

Citation, abstract and a comment from me below.

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CITATION: Comment| volume 7, special issue, s1-s2, march 01, 2019

Keith Martin, Zoë Mullan, Richard Horton

Overcoming the research to policy gap

Open Access Published: March, 2019

DOI:https://doi.org/10.1016/S2214-109X(19)30082-8

Our central challenge is therefore not a knowledge gap but a translation deficit. Given the urgencies we face, producing research is not enough. It must be translated into public policy and scaled up.

There are many causes for this translation failure. Academics and policymakers have different incentives... The two sectors fail to engage and communicate effectively with each other. Failures also exist in planning a project that restricts the impact the research could have. These include: insufficient stakeholder involvement in the creation of a research project, investing in pilot projects that are not scalable, an absence of a plan to disseminate and advocate for the research findings to be included in public policies, and a lack of a plan to scale up evidence-based solutions. At the implementation interface, deficits exist in: having a workforce with the needed management and technical skills, knowledge of existing research, and access to funding. This is particularly true in public institutions tasked with service delivery.

So how can we overcome these challenges? At the research level, stakeholders' inputs must be included from the planning stage of a study and projects should be designed with a view towards replicating and scaling up the findings. Early plans should also be made to disseminate findings to key audiences, including the general public, and respected thought leaders could be enlisted to help promote the policies. Checklists and other job support tools could be developed that can increase the use of research findings...

Researchers must get out of their comfort zones, become politically active, and communicate in powerful ways that not only inform, but also move people emotionally. Scientists must learn to communicate for impact. This will not happen through the pages of an academic journal.

2019 marks the 10th anniversary of the Consortium of Universities for Global Health's (CUGH's) annual conference. This year's theme, “Translation and implementation for impact”, was chosen to highlight the urgent need to implement the knowledge we produce. Over 600 abstracts were selected across seven subthemes that reflect the challenges we and our planet are facing. 18 satellite sessions convened attendees to address challenges including cancer, surgery, emergency medicine, mental health, planetary health, public health, child health, gender equality, education, research, and more. A communications workshop was held by the Pulitzer Center for Crisis Reporting to strengthen attendees' communication skills.

With funding from the Bill and Melinda Gates Foundation, CUGH is developing a network of academic advisers to engage and inform US policymakers and the public about the importance of US leadership and funding for global health programmes.

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Comment (NPW): I fully agree the central challenge is a translation deficit, but it is important to recognise the key manifestation of this deficit is indeed a knowledge gap. We are talking here not about the gap of what is known to science, but the gap between what is known and the knowledge of individual policymakers, health professionals and the public. It is the second 'know' in what we have described previously on HIFA as the 'know-know-do gap'. This lack of knowledge is in turn directly related to the availability and use of healthcare information in the right language and format for the individual. As Muir Gray and Anne Brice said more than 15 years ago, 'The application of the knowledge we already possess has greater potential to improve the health of patients than any drug or technology likely to be developed in the next decade.' In hindsight, we know that the 'next decade' was much too short a timescale for comparison. The situation today in terms of 'applying the knowledge we already have' is not that much different to what it was in 2003, because we have collectively failed to make a difference. The vast majority of the tens of thousands of deaths that occur every day worldwide in 2019, just as in 2003, could have been prevented with basic life-saving interventions, most of which have been known about for many decades.

Best wishes, Neil

Let's build a future where people are no longer dying for lack of healthcare information - Join HIFA: www.hifa.org

HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - www.hifa.org ), a global community with more than 19,000 members in 177 countries, interacting on six global forums in four languages. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org