Global health research and evidence-based intervention
Every single day, we have conversations, interact with our friends, classmates, and professors. In addition, we read the news, scroll through our Facebook feeds, watch Sports Center. Each of these situations is undoubtedly filled with claims of all sorts: claims about roommates, about a particular concept you are learning about in class, claims about things going on around the world, claims about a sports team or an athlete. How often do we question these claims? How often do we scrutinize them? And how often are these claims based on hard, real evidence? As Julia Bunting suggests in this article, it seems to be less and less.
Let me offer my thoughts on why that might be so. By nature, we are emotional beings. Things that make us angry, sad, happy, or often something more complex are the things we tend to focus our attention to and that we often use to build ideologies and even intuitions. For example, the other day, I was watching the Celtics-Warriors game, and during the halftime show, one of the sports analysts, Charles Barkley, posited that the Celtics, despite having won 13 straight games, were worse than last year’s team and that they were not even top 3 in the Eastern Conference. Naturally, this irked me. A huge Celtics fan, my immediate response was anger. And I could have easily gone on to curse at Charles Barkley, call him delusional, and form the ideology that Chuck is a fool. But I knew from watching him for years and years that he knows basketball; his predictions, as incendiary as they may be, are often correct. So I kept an open mind to what he said and considered rationally, “Are the Celtics really as good as their record suggests?”.
That might not be the best example to illustrate the decreasing respect for evidence-based scrutiny and claims, but it does highlight our emotional tendencies. On a much more serious level, when it comes to global health issues, the stakes are much higher. The intuitions or ideologies we may have about something, or more specifically, that policymakers or investors have about something, are what lead to certain programs being instituted or policies being enacted. But how are these intuitions and ideologies formed? Do they arise from research studies, from solid, tangible evidence? Unfortunately, these days it seems it is not so. It seems they are formed from the information overload, from the claims overload that we are subject to in our conversations, in our news feeds, which, often sensationalist in nature, target or at least elicit emotional responses. As Julia notes, this is because it is difficult to focus on dull or “quaint” things like evidence or research studies. It is a huge problem, then, if the actions that policy makers and investors take are derived from these intuitions or ideologies.
Let me offer another example. Julia notes, “On a fundamental level, evidence identifies needs, providing us a roadmap to invest in what works, determine what is scalable, and assess what makes financial sense”. This statement resonates very strongly with PGHT’s mission. I wasn’t part of PGHT during its initial stages, but I know that when the group first went to Zanzibar, they realized very quickly that what they thought were the most important problems were not what the locals found to be the most important; rather, it was other things that demanded more attention. Crucially, this revelation came from actually going to Zanzibar, from interacting with the people there, from gaining direct evidence on what they saw as the biggest problems. When we develop our intuitions or ideologies, we don’t often dig deep into the subject matters and interact with them and look at the objective evidence. But crucially, that is what researchers do. They spend their lives trying to uncover truths about what really is the problem, what really can be done about it.
It is up to policy makers and governments and investors, then, to heed what the researchers have to say, as what they have to say is based on solid, tangible, real evidence. It is the researchers who do what everybody else does not have the time or commitment to do. Having this trust is of paramount importance, and without it, there will be no advance in global health. As Julia summarizes beautifully, “Evidence gives us the tools we need to be proactive, rather than day-to-day reactive… For those of us who care about truth, now is the time to stand up and fight for it”.