Overcoming the research to policy gap
Authors: Keith Martin, Zoë Mullan, Richard Horton
Journal: The Lancet Global Health (2019)

Although astounding improvements have been made to human wellbeing over the past 40 years—increased lifespan, reduced under-5 mortality, maternal deaths, and extreme poverty1Ortiz-Ospina E Roser M Global health.https://ourworldindata.org/health-metaDate accessed: February 11, 2019Google Scholar—daunting crises imperil our very existence. We are facing a deadly triple threat: lethal infectious diseases, non-communicable diseases, and the shredding of our planet's life support systems.2International Union for Conservation of NatureIUCN red list of ecosystems.https://iucnrle.org/Date accessed: February 11, 2019Google Scholar This, against a backdrop of a public scepticism about science, fake news, the rise of autocratic, insular regimes, and a global population that will increase by 2 billion by 2050.3UNWorld population prospects, 2017 revision.https://population.un.org/wpp/Date accessed: February 11, 2019Google Scholar The good news is that the research community has produced a stunning array of solutions to most of these challenges. Yet to be considered a success, such solutions must be translated into public policy, and the truth is that they rarely are. 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. Academics are measured by their ability to publish in peer-reviewed journals, be cited, attract grants, and teach. They are not judged by the impact their research has on people's lives, whereas elected officials are, at least in part, judged by their ability to deliver outcomes that meet their constituents' needs. There is also a communication gap. Most policymakers are not scientists and thus the language of science is not understandable to them. 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.4FHI360. Eight strategies for research to practice.https://www.fhi360.org/resource/eight-strategies-research-practiceDate accessed: February 11, 2019Google Scholar 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.5Natsios AS The nine principles of reconstruction and development.https://ssi.armywarcollege.edu/pubs/parameters/articles/05autumn/natsios.pdfDate accessed: February 11, 2019Google Scholar 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.6Woelk G Daniels K Cliff J et al.Translating research into policy: lessons learned from eclampsia treatment and malaria control in three southern African countries.Health Res Policy Syst. 2009; 7: 31Crossref PubMed Scopus (53) Google Scholar, 7INDEPTH NetworkTranslating research into policy and practice: examples from HDSS centres.http://www.indepth-network.org/pec/translating_research_into_policy_and_practice.pdfDate accessed: February 11, 2019Google Scholar Academia also needs to evolve. For research to have a greater impact, the zeal for producing research must be matched by a desire to implement that research. To facilitate this, we must change the incentives, change the criteria for tenure. Implementation, impact, public engagement, and service should all be included to evaluate a scientist's professional advancement. Governments must also do their part. To create and implement policies supported by research, a country, province, or city must have skilled human resources, funds, policies, processes, and infrastructure. The difference between a failed state and a stable one can be measured by the strength of its public institutions.7INDEPTH NetworkTranslating research into policy and practice: examples from HDSS centres.http://www.indepth-network.org/pec/translating_research_into_policy_and_practice.pdfDate accessed: February 11, 2019Google Scholar Weak public institutions and poor governance are lethal to people's wellbeing. They are a massive obstacle to the effective delivery of the public goods citizens need. They also become a haven for corrupt practices that globally result in the loss of over US$1·5 trillion per year.8International Monetary FundCorruption: costs and mitigating strategies.https://www.imf.org/en/Publications/Staff-Discussion-Notes/Issues/2016/12/31/Corruption-Costs-and-Mitigating-Strategies-43888Date accessed: February 11, 2019Google Scholar Ironically, this is the sum needed to fund the Sustainable Development Goals (SDGs).9Schmidt-Traub G Investment needs to achieve the Sustainable Development Goals: understanding the billions and trillions.http://unsdsn.org/wp-content/uploads/2015/09/151112-SDG-Financing-Needs-Summary-for-Policymakers.pdfDate accessed: February 12, 2019Google Scholar Academia can play a vital role in strengthening public service capabilities through intersectoral partnerships that provide governments with access to trainers, educational material, libraries, and research. Finally, relentless political advocacy directed towards policymakers and the public is needed to drive policy development and implementation. Academia can do this, but it needs to "up its game". 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. The Earth is our only home and it is in crisis.10Whitmee S Haines A Beyrer C et al.Safeguarding human health in the Anthropocene epoch: report of the Rockefeller Foundation–Lancet Commission on planetary health.Lancet. 2015; 386: 1973-2028Summary Full Text Full Text PDF PubMed Scopus (1125) Google Scholar, 11IPCCGlobal warming of 1·5°C.https://www.ipcc.ch/sr15/Date accessed: February 11, 2019Google Scholar We have no time to waste. We created the mess our planet is in and we are the last generation that can save it and ourselves. Carpe diem. Keith Martin is the Executive Director of the Consortium of Universities for Global Health. Zoë Mullan is Editor of The Lancet Global Health. Richard Horton is Editor of The Lancet. Causes of the knowledge gapKeith Martin and colleagues1 state that "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." 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