How to assess health policy impacts of new generation trade agreements

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Koivusalo
Keyword(s):  
Public Health ◽  
Decision Making ◽  
New Technologies ◽  
Data Access ◽  
Trade Agreements ◽  
Lessons Learned ◽  
Policy Space ◽  
Case Examples ◽  
Regulation Services ◽  
New Generation

Abstract Issue Negotiation of trade agreements has become a key part of current international policy environment with the consequence of increasing concerns over impacts on public health, health protection and policy space for health. Trade agreements represent 'meta-regulation' where key impacts will be on how governments can regulate with different implications depending on existing regulatory framework within a country. Engaging with trade requires understanding how health-related arguments can be made and where they reside. Results This presentation discusses where and how public health advocates can engage with trade related decision-making on new generation trade agreements with focus on regulation, services and protection of investment and intellectual property rights. The innovative approach on policy space for health will overcome focus on existing standards and allows discussion on what exceptions and exclusions in trade agreements actually imply. Policy space allows analysis on impacts which may not relate to direct health outcomes, such as issues with privacy, health data, access to new technologies, and pricing of medicines. The presentation will use case examples from European Union trade agreements and will discuss politics of mandate negotiations as well as how diversions, rhetorical/empty claims and circular traps are used in in political decision-making and the extent to which and how these can be counteracted on key public health and health systems -related issues. Lessons learned If negotiated agreements will affect how governments can regulate in future rather than existing standards, this requires a different approach for public health researchers and advocates. The lessons learned will provide suggestions on how to approach trade policies as part of Health in All Policies and where limits and opportunities of health and sustainability impact assessments reside. Key messages New generation trade agreements impact on regulatory policy space. Assessing impacts of trade agreements need to go beyond impact assessments.

Legitimising a ‘Zombie idea’: childhood vaccines and autism

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Rizzi ◽  
K Attwell ◽  
V Casigliani ◽  
J Taylor ◽  
F Quattrone ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Media Coverage ◽  
Economic Benefits ◽  
Lessons Learned ◽  
Strategic Decision ◽  
Childhood Vaccination ◽  
Vaccine Hesitancy ◽  
Scientific Authority ◽  
Immunization Rates

Abstract Background In June 2017 the Italian government made childhood vaccination mandatory following a drop in immunization rates. In the years preceding, two court judgments affirmed a causal link between vaccines and autism. Studies have linked these decisions to internet searches about vaccine-autism, the popularity of 'no-vax' theories, and drops in immunization rates. This paper provides an in-depth case study of both decisions and their impact. Methods We use a synthetic research design reliant on: (i) a systematic collection of primary sources (publicly available and obtained via official access to information requests); (ii) interviews with key actors prominently involved in the two cases or privy to the Italian vaccine-injury compensation regime (iii) a systematic analysis of media coverage. Results Circumstantial and systemic flaws enabled these decisions. Poor trial strategies, insufficient resources and laborious communication practices between arms of government were facilitators. Lack of awareness of the social sensitivity of vaccine issues, underestimation of the phenomenon of vaccine hesitancy, and a tendency to 'think in silos' informed the lack of attention dedicated to the cases. The decisions created false expectations of economic benefits and vindication for families with autistic children, resulting in increased litigation. Systemic flaws exist in the process of appointment of expert consultants acting for the court leading to judicial reliance on false data. Conclusions Lessons learned include greater levels of attention to vaccine cases by the administration and a matured attitude of adjudicating bodies. Two issues remain: (i) the inability of government lawyers to disseminate positive results to counteract unfounded narratives; (ii) flaws in the process of appointing expert consultants advising courts, which remains focused on the fiduciary nature of the relationship, rather than scientific authority. Key messages The Milan and Rimini decisions that directly affected vaccine governance stemmed from a combination of circumstantial decision-making and systemic flaws that still lurk in public health governance. Strategic decision-making that overlooks lower levels of the adjudicative system can lead to significant public health consequences as courts of law and courts of public opinion obey different logics.

Trade, standards and politics: global pressures on front-of-pack nutrition labelling interventions

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A M Thow
Keyword(s):  
Public Health ◽  
National Policy ◽  
Policy Decision ◽  
Trade Agreements ◽  
International Standards ◽  
Policy Space ◽  
Nutrition Labelling ◽  
Health Goals ◽  
Policy Level ◽  
High Level

Abstract Although interpretive front-of-pack (FOP) nutrition labelling is rightly considered a national health policy decision, it is also influenced by global trade agreements and international standards. Over the past decade, Specific Trade Concerns have been repeatedly raised at the World Trade Organization (WTO) regarding potential impacts of FOP nutrition labelling initiatives on trade. One of the common concerns raised was regarding the consistency of the measures with international standards. The Codex Alimentarius Commission (Codex), which makes global food standards, is currently developing global guidance for FoP nutrition labelling, which will almost certainly influence national policy making. This presentation draws on qualitative policy analysis research on trade concerns and international standards work regarding FOP nutrition labelling. Two challenges are evident at the global policy level. The first is the potential for constraints on policy space for innovative FOP nutrition labelling due to binding trade agreements. The second is the potential for significant industry input into standard development at Codex, which then constitute the reference point for WTO discussions on labelling. Historically, Codex standards have focussed primarily on acute risks, for example, from foodborne disease. This shift in Codex's activities towards standards to address NCDs presents new risks for achievement of public health goals, as a result of the high level of industry involvement in this forum and thus potential commercial conflict of interest. It is imperative that public health actors engage with Codex processes to ensure policy space for national governments to implement strong and effective regulation and allow scope for innovation. At the national policy level, strategic framing of nutrition labelling policy objectives and proactive policy engagement between trade and health can also minimise trade issues.

scholarly journals Methods to support evidence-informed decision-making in the midst of COVID-19: creation and evolution of a rapid review service from the National Collaborating Centre for Methods and Tools

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah E. Neil-Sztramko ◽  
Emily Belita ◽  
Robyn L. Traynor ◽  
Emily Clark ◽  
Leah Hagerman ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Lessons Learned ◽  
Decision Makers ◽  
Rapid Review ◽  
Final Report ◽  
Health Crisis ◽  
Public Health Decision ◽  
Public Health Crisis ◽  
Health Decision

Abstract Background The COVID-19 public health crisis has produced an immense and quickly evolving body of evidence. This research speed and volume, along with variability in quality, could overwhelm public health decision-makers striving to make timely decisions based on the best available evidence. In response to this challenge, the National Collaborating Centre for Methods and Tools developed a Rapid Evidence Service, building on internationally accepted rapid review methodologies, to address priority COVID-19 public health questions. Results Each week, the Rapid Evidence Service team receives requests from public health decision-makers, prioritizes questions received, and frames the prioritized topics into searchable questions. We develop and conduct a comprehensive search strategy and critically appraise all relevant evidence using validated tools. We synthesize the findings into a final report that includes key messages, with a rating of the certainty of the evidence using GRADE, as well as an overview of evidence and remaining knowledge gaps. Rapid reviews are typically completed and disseminated within two weeks. From May 2020 to July 21, 2021, we have answered more than 31 distinct questions and completed 32 updates as new evidence emerged. Reviews receive an average of 213 downloads per week, with some reaching over 7700. To date reviews have been accessed and cited around the world, and a more fulsome evaluation of impact on decision-making is planned. Conclusions The development, evolution, and lessons learned from our process, presented here, provides a real-world example of how review-level evidence can be made available – rapidly and rigorously, and in response to decision-makers’ needs – during an unprecedented public health crisis.

scholarly journals Management of the Development and Implementation of New Generation Technologies

2020 ◽  
Vol 11 (1) ◽  
pp. 12-28 ◽  
Author(s):  
N. I. Komkov ◽  
V. V. Sutyagin
Keyword(s):  
Decision Making ◽  
Mathematical Models ◽  
New Technologies ◽  
Technology Development ◽  
Full Life Cycle ◽  
Russian Economy ◽  
Innovative Solutions ◽  
Innovative Products ◽  
New Generation ◽  
Further Development

Purpose: to justification of the need to develop new-generation domestic technologies that ensure the competitiveness and stability of the Russian economy to external challenges. Using the laws of accelerated development of various systems, objects and processes of the material world will allow us to construct a mechanism for analysis, decision-making and management of the justification, development and implementation of new generation technologies.Methods: the research method is based on the generalization of forecasting the accelerated development of various processes under the conditions of growth restrictions, methods for constructing targeted information-logic models, decision-making methods for justifying the costs of upgrading one-generation technology options and analyzing domestic and foreign technology development experience new generation.Results: within the space of creation and development of new generation technologies, in accordance with the well-known concept of the full life cycle, the process of development and implementation of new generation technologies in the form of a logistic curve has been specified. The solution to the problem of managing the creation of new generation technologies is presented as the fastest possible implementation of projects to search for innovative solutions that meet the requirements of competitiveness. Mathematical models of the formulated problem are considered. Examples of practical tasks for managing the development and development of new generation technologies are given.Conclusions and Relevance: the dynamics of development and the economic conditions for the transition to technology modernization are determined by the need for further development of new generation technologies in the interests of full use of the innovative potential of this generation. Information-logical and mathematical models have been developed for making decisions on managing the justification of the necessary resources for the implementation of projects in the full cycle during the transition from innovative solutions to new technologies and innovative products.

scholarly journals Methodological and Practical Considerations in Rapid Qualitative Research: Lessons Learned From a Team-Based Global Study During COVID-19 Pandemic

2021 ◽  
Vol 20 ◽  
pp. 160940692110403
Author(s):  
Michela Luciani ◽  
Patricia H. Strachan ◽  
Alessio Conti ◽  
Lisa Schwartz ◽  
Lydia Kapiriri ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Qualitative Research ◽  
Study Design ◽  
Lessons Learned ◽  
Detailed Account ◽  
Public Health Emergencies ◽  
Global Study ◽  
Methodological Considerations ◽  
Inform Decision Making

Rapid qualitative research (RQR) studies are increasingly employed to inform decision-making in public health emergencies. Despite this trend, there remains a lack of clarity around what these studies actually involve in terms of methodological processes and practical considerations or challenges. Our team conducted a global RQR study during the COVID-19 pandemic. In this article, we provide a detailed account of our methodological processes and decisions taken related to ethics, study design, and analysis. We describe how we navigated limitations on time and resources. We draw attention to several elements that operated as facilitators to the rapid launch and completion of this study. Rendering methodological considerations and rationales for specific RQR studies explicit and available for consideration by others can contribute to the validity of RQR, support further discussion and development of RQR methods, and make findings for particular studies more credible.

scholarly journals Lessons Learned from a DoD and Virginia Data Sharing Pilot using NSSP ESSENCE

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Erin E. Austin ◽  
Paul E. Lewis ◽  
Arden Norfleet ◽  
Jamaal Russell
Keyword(s):  
Public Health ◽  
Data Sharing ◽  
Syndromic Surveillance ◽  
Data Access ◽  
Pilot Project ◽  
Lessons Learned ◽  
Surveillance Data ◽  
Service Members ◽  
Local Health ◽  
Health Departments

ObjectiveThis panel will focus on the experiences from the Department of Defense (DoD) and Virginia Department of Health (VDH) data sharing project using the National Syndromic Surveillance Program (NSSP) ESSENCE and will discuss lessons learned, challenges, and recommendations within the following areas: 1) data sharing authority, 2) coordination and implementation of data sharing with a focus on personnel, training, and managing access and 3) communication between local, state, and federal agencies.IntroductionThe DoD and VDH both maintain local ESSENCE installations to monitor the health status of their military and civilian populations, respectively, and submit syndromic surveillance data to the NSSP ESSENCE to foster data sharing and collaborative initiatives among public health entities. Military Treatment Facilities (MTFs), housed on DoD installations, provide healthcare to all service members and their beneficiaries stationed in the area. Service members and their beneficiaries represent a substantial portion of the local community and interact with the civilian population throughout daily activities. Sharing syndromic surveillance data between DoD and public health jurisdictions can provide public health situational awareness among both civilian and military populations to support disease surveillance. DoD and VDH engaged in a pilot project to develop processes and procedures for data sharing, data access, and communication with the aim they can serve as best practices for other jurisdictions seeking to share syndromic surveillance data with DoD.DescriptionThe pilot project began in June 2018 with the Centers for Disease Control and Prevention (CDC) NSSP team providing technical support. NSSP ESSENCE users from the VDH state and local health departments across nine Virginia city/counties participated in the project. VDH shared syndromic surveillance data from 34 healthcare facilities (17 urgent cares, 3 emergency care centers, and 14 hospitals) with DoD, which shared syndromic surveillance data from 18 MTFs (16 clinics and 2 hospitals) in Virginia. To standardize the analysis of syndromic surveillance data and use of NSSP ESSENCE across project participants, myESSENCE tabs were created and shared by between VDH and DoD. The goal was to facilitate and enhance communication between local public health departments and their DoD counterparts through the sharing of syndromic surveillance data.How the Moderator Intends to Engage the Audience in Discussions on the TopicThe moderator will solicit feedback from the audience regarding their data sharing experiences with other entities or agencies, data sharing practices, and ideas for use cases when sharing syndromic surveillance data with DoD.

scholarly journals 17.B. Round table: Including public health considerations in trade and investment agreements

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Services ◽  
Trade Agreements ◽  
Access To Medicines ◽  
Policy Space ◽  
Health Services Access ◽  
The Uk ◽  
Investment Agreements ◽  
Policy Engagement ◽  
Trade And Investment

Abstract There is widespread recognition that trade and investment agreements (TIAs) can affect health services, access to medicines, NCD prevention (particularly related to tobacco, alcohol and unhealthy food) and health systems structures. In addition, these binding international economic agreements can constrain the policy space available for innovative, evidence-based health policymaking. Although TIAs can have positive outcomes for employment and economic growth, these benefits are only likely to accrue when governments are pro-active in implementing complementary policies to mitigate impacts on other sectors and to address potential inequalities arising. The aim of this panel session is to examine the ways in which TIAs can be designed to achieve economic goals while also protecting public health, and identify complementary policy measures that may be needed as well as strategies for strategic policy engagement. This panel will be hosted by the UK-PRP PETRA Network (Prevention of the noncommunicable disease using trade agreements). The UK will be negotiating a range of new TIAs over the coming years, representing a window of opportunity for strategic engagement with policymakers regarding how public health can be protected and promoted within these agreements. There is an emerging global body of evidence regarding how consideration of health can be integrated into TIAs, both textually and through strategic engagement with policymakers before and during the negotiation phase. Experience to date indicates common global challenges and opportunities for health and trade, as well as significant potential for cross country learning regarding trade and health. The panel discussion will use the UK experience as a springboard to address these global issues. The expert panel, drawn from the PETRA Network with expertise in political economy, trade law, economics and public health advocacy, will provide brief overview of the current issues in trade and health and how public health can be protected in trade agreements. The 5-minute panel presentations will briefly summarise how inclusions in TIAs can support and protect policy space for health systems and health services, access to medicines, NCD prevention, and nutrition and food systems. The session will then open for a roundtable discussion among participants regarding 1) country-specific examples and questions regarding health protections; 2) experiences related to health-trade policy engagement; 3) lessons for elevating health on the political agenda, particularly regarding trade. (Note that if there are more than 16 participants, then the workshop will split into small groups for discussion with panel/ PETRA Network resource people. The panel session and discussion will provide the basis for a planned public health-oriented briefing note by the PETRA Network on including public health considerations in trade and investment agreements. Key messages Including consideration of health in trade and investment, agreements can protect policy autonomy for public health and promote good public health outcomes; In order to promote consideration of public health in trade and investment agreements, strategic engagement with trade policymakers before and during the negotiation period is critical.

Empowering Educators to Make Data-Informed Decisions

2018 ◽  
pp. 158-183
Author(s):  
Margie L. Johnson
Keyword(s):  
Decision Making ◽  
Data Access ◽  
Lessons Learned ◽  
Informed Decision ◽  
Informed Decision Making ◽  
Informed Decisions ◽  
Accountability In Education ◽  
System Data ◽  
Teacher Data ◽  
Data Informed

With increased accountability in education, resources are being invested to ensure educators have access to a computerized data system. Data access is one component of data-informed decision making. This chapter shares one district's journey toward developing and implementing the data-informed decision-making ecosystem as a guide for empowering one school district's educators to use data, no matter the source, for making informed decisions. Not only might leaders benefit from the implementation lessons learned, but they may also benefit from the implementation tools, such as the teacher data use survey (TDUS) and the school district's innovations configurations map (IC Map) for collaborative inquiry, which supported the work.

scholarly journals Life as a knowledge broker in public health

2008 ◽  
Vol 29 (3) ◽  
pp. 79 ◽  
Author(s):  
Paula Robeson ◽  
Maureen Dobbins ◽  
Kara DeCorby
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Controlled Trial ◽  
Health Sector ◽  
Organizational Capacity ◽  
Lessons Learned ◽  
Information Professionals ◽  
Typical Day ◽  
Regional Health Authorities ◽  
The Impact

Program objective – Knowledge brokers (KBs), like clinical librarians (CLs), are information professionals involved in the promotion of evidence-informed decision-making (EIDM). As with CLs, the impact of literature-evaluating KBs on the health sector is sparse, and there is limited consensus on their role. To provide guidance to information professionals and organizations regarding the KB role, this paper describes a typical “day in the life” of a KB in delivering a program to promote EIDM among Canadian public health professionals. Setting – The KB program was implemented in a randomized controlled trial evaluating knowledge transfer and exchange strategies. Participants – Public health managers at various levels within Canadian public health units or regional health authorities. Program – The KB identified decision makers’ (DMs) evidence needs; facilitated access to and use of high-quality evidence; assisted in decision making; and facilitated EIDM skill development. Results – The KB role, activities and related tasks, lessons learned, and challenges are described. Conclusion – Central themes included the importance of relationship development, ongoing support, customized approaches, and individual and organizational capacity development. The novelty of the KB role in public health provided a unique opportunity to assess the need for and reaction to the role and its associated activities.

Applying precaution to environmental health issues at the local level: A proposed guide based on the research and experiences of Toronto Public Health

2012 ◽  
Vol 55 (01) ◽  
pp. 11-18 ◽  
Author(s):  
Loren Vanderlinden ◽  
Donald C. Cole ◽  
Monica Hau ◽  
Monica Campbell ◽  
Ronald Macfarlane ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
Environmental Health ◽  
Local Level ◽  
Health Issues ◽  
Support Tool ◽  
Case Examples ◽  
Trade Offs ◽  
Health Practitioners ◽  
Public Health Practitioners

While the Precautionary Principle (PP) is an important policy innovation relevant to public health, practitioners do not agree on how or when it should be applied. Action on environmental health issues at Toronto Public Health (TPH) has clearly been informed by the PP. We have recently developed a guide to applying precaution that can be used to assist local public health practitioners in decision making to address environmental health hazards in the community. We applied the Guide retrospectively to TPH case examples involving education, program, policy, legislative, and advocacy interventions to manage exposures to environmental hazards. This exercise served to refine the Guide and increase our understanding of how and when TPH has applied precaution in the past. Our Guide promises to be a useful decision making support tool that will help users (1) assess what degree of precaution is appropriate for a given context; (2) systematically document evidence about harms and exposures (including uncertainties) while making the assumptions about evidence more explicit and transparent; (3) highlight potential trade-offs (including consideration of both risks and benefits), explore alternatives, and assess feasibility of interventions; (4) plan adequate communication and stakeholder engagement; and (5) institute monitoring and evaluation so as to ensure interventions still meet users’ needs. We see the Guide as a tool that deepens the process of learning and enquiry on issue management in environmental health practice. We urge others to share their applications of the PP using our Guide to promote mutual learning.

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